Adjustments we see, and the ones we may miss
With thanks to our member, Paul Cullen, for this blog. Recently, I broke two bones in my hand. It was a silly mistake, followed by a painful drive to the hospital, several hours in the emergency room...
With thanks to our member, Madeleine Ayling PNCPS(Accred) (https://blackcatcounselling.co.uk/), for this blog.
Did you know that there are links between ADHD, autism and eczema?
I am a late-diagnosed autistic counsellor with ADHD and I have had eczema since I was a baby. Many of my clients are autistic and/or have ADHD, and I have heard so many similarities to my own story from those clients who have also had eczema. Eczema is so common but is rarely spoken about in the counselling world, and it is important that clients’ experiences of living with eczema while being autistic and having ADHD are understood.
According to the National Eczema Society, eczema affects 1 in 5 children and 1 in 10 adults. It is a dry, itchy skin condition that can affect people of all ages, on many different parts of the body. The skin can become red and inflamed, can crack and bleed and is prone to infections. Some people have small patches of eczema limited to one part of the body, for others it may be widespread, and this can change over their lifetime. The severity of eczema can change rapidly, getting worse during flares often with unpredictable triggers.
The link between childhood eczema and ADHD has been studied for over 30 years, with the risk of developing ADHD symptoms doubling for children with eczema (Loo et al., 2022). There is also a link between eczema and autism - children with atopic conditions show more severe autism symptoms, and this increases for those with eczema compared to those with asthma and hayfever (Jameson et al., 2022).
Autistic people often also have ADHD and vice versa - studies show 22-83% of autistic children also have ADHD, and 30-65% of children with ADHD are also autistic (Ronald et al., 2008; Sokolova et al., 2017). Adults with eczema have a high chance of also living with anxiety and depression, are almost 50% more likely to have OCD, and those with mild and moderate eczema have a higher risk of suicide (Wan et al., 2024). This means that clients with ADHD, autism and eczema may also be struggling with a long list of mental health problems.
Eczema often has a significant effect on a client’s life, and for autistic people and those with ADHD, this can be especially complex. For autistic people, the sensory impact of having to apply creams and lotions can be overwhelming, and the itchiness of the eczema can lead to feeling overstimulated. Clothing that was previously “safe” can become unwearable if it aggravates or sticks to patches of eczema, and soothing items such as weighted blankets can be too hot - a potential trigger for eczema flares. Scratching and skin picking can become self-stimulating repetitive behaviours (“stims”) and can also be linked to body focussed repetitive behaviours such as dermatillomania which can develop with eczema.
The impulsivity often related to ADHD can make it much harder for eczema sufferers to stop scratching, resulting in increased skin damage. The itchiness affects focus, which may lead to problems at school or work. Eczema can also be extremely challenging when combined with executive functioning difficulties - treatment often relies on consistency such as keeping to a schedule of how many times a week to apply ointment. For severe eczema, there can be a significant amount of medical admin such as chasing GP appointments, attending hospital several times a week for phototherapy, keeping track of blood tests. Medication for ADHD can help some and hinder others - it can help with self-care routines and lowering the urge to scratch, but can also lead to dehydration which can trigger eczema flares.
Sleep is often a problem for people with eczema due to the itchiness, and lack of sleep can trigger a flare-up. Unfortunately sleep problems are also common for autistic people and those with ADHD, which means finding suitable strategies can be more complex than for neurotypical people.
Emotional dysregulation is often a feature of autism and ADHD. Intense emotional experiences can lead to picking and scratching as soothing mechanisms which damage the skin, causing pain and distress despite temporary relief. Anxiety and stress often increase the severity of eczema, and eczema in itself often causes stress, due to the pain, itching and all-too-frequent childhood bullying and social isolation, compounding that already often experienced by neurodivergent people.
References
Jameson, C., Boulton, K. A., Silove, N., and Guastella, A. J. (2022). ‘Eczema and related atopic diseases are associated with increased symptom severity in children with autism spectrum disorder.’, Translational psychiatry, 12(1).
Loo, E. X. L., Ooi, D. S. Q., Ong, M., Ta, L. D. H., Lau, H. X., Tay, M. J. Y., Yap, Q. V., Chan, Y. H., Tham, E. H., Goh, A. E. N., Van Bever, H., Teoh, O. H., Eriksson, J. G., Chong, Y. S., Gluckman, P., Yap, F. K. P., Karnani, N., Xu, J., Tan, K. M. L., Tan, K. H., Lee, B. W., Kramer, M., Shek, L., Meaney, M. J. and Broekman, B. F. P. (2022). ‘Associations Between Eczema and Attention Deficit Hyperactivity Disorder Symptoms in Children.’, Frontiers in pediatrics, 10:837741.
National Eczema Society (no date) Who we are. Available at: https://eczema.org/what-we-do/who-we-are/ (Accessed: 20 August 2025).
Ronald, A., Simonoff, E., Kuntsi, J., Asherson, P. and Plomin, R. (2008). ‘Evidence for overlapping genetic influences on autistic and ADHD behaviours in a community twin sample.’, Journal of Child Psychology and Psychiatry and Allied Disciplines, 49, pp.535-542.
Sokolova, E., Sluiter-Oerlemans, A., Rommelse, N. N., Groot, P., Hartman, C., Glennon, J., Claassen, T., Heskes, T. and Buitelaar, J. (2017). ‘A Causal and Mediation Analysis of the Comorbidity Between Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD)’, Journal of Autism and Developmental Disorders, 47(6), pp.1595–1604.
Wan, J., Wang, S., Shin, D. B., Syed, M.N., Abuabara, K., Lemeshow, A. R. and Gelfand, J. M. (2024). ‘Neuropsychiatric disorders in adults with atopic dermatitis: A population-based cohort study’, J Eur Acad Dermatol Venereol, 38, pp.543–548.
Updated September 2025
