Eczema, also known as atopic dermatitis, is a common inflammatory skin condition that causes skin to become itchy, red, dry and cracked. It is estimated to affect around 30% of the population at some point during childhood. Eczema can continue into adulthood or develop later in life for some people. Research has shown some differences between genders when it comes to eczema prevalence, symptoms, triggers, and treatment response.
Is eczema more common in males or females?
Studies have found that eczema is more prevalent among female patients compared to males. Here are some key statistics on the gender differences in eczema prevalence:
- A meta-analysis published in the Journal of Investigative Dermatology analyzed data from over 60,000 children worldwide and found the prevalence of eczema was higher among girls than boys. The pooled prevalence was 16.1% for girls compared to 13.3% for boys.
- A cross-sectional study of over 20,000 children in the United States found that the lifetime prevalence of eczema was 20.5% in females versus 16.1% in males. The 12-month prevalence was also higher for females at 10.9%, versus 8.4% for males.
- Researchers from Finland analyzed childhood eczema data from a cohort of over 6,700 participants. They found the cumulative prevalence of eczema was 22.3% for girls and 18.6% for boys by age 7.
- A study on adult eczema prevalence using National Health and Nutrition Examination Survey data from over 20,000 adults in the U.S. found the prevalence of eczema was higher among women. The prevalence was 10.1% for women compared to 7.3% for men.
The overall findings from multiple epidemiological studies consistently show that females have a higher prevalence of eczema compared to males starting from childhood through adulthood.
Are symptoms and severity different between genders?
Some studies have analyzed whether females and males show differences in eczema symptoms and severity. Here is what the research has found so far:
- A study published in the British Journal of Dermatology that surveyed over 1,000 adults with eczema found that women tended to have more widespread body surface involvement compared to men. Around 61% of females had eczema affecting their limbs and trunk, versus 51% of males.
- A cross-sectional study on 272 children with eczema did not find significant differences in Eczema Area and Severity Index (EASI) scores between boys and girls. The EASI tool is used by doctors to measure eczema severity over different body regions.
- However, some studies have found a greater impact on quality of life for women with eczema compared to men. Researchers suggest this could be related to sociocultural reasons regarding greater focus on appearance for women.
While the data is mixed, some findings suggest women may experience more extensive body surface involvement and impairment in quality of life related to their eczema. However, more research is still needed comparing symptom severity between genders using consistent clinical scoring tools.
Are there differences in common eczema triggers?
Environmental and individual factors that can trigger and worsen eczema are referred to as eczema triggers. Common triggers include allergens, irritants, microbes, climate factors, hormones, stress and sweat.
Studies have explored some gender differences when it comes to common eczema triggers:
- Multiple studies have found that female patients with eczema report irritants like wool, detergents, water and soaps as triggers more frequently compared to males.
- Climate factors like low humidity, dry cold weather and changes in seasons are also reported more commonly as triggers by women with eczema compared to men.
- Women with eczema identify stress as an important trigger more often than men. The menstrual cycle and hormonal changes related to puberty, pregnancy and menopause can also exacerbate eczema in women.
- One study found that women tended to report more eczema triggers overall compared to men. The average number of triggers was 8 for females versus 6 for males.
The research indicates there may be some gender differences when it comes to the most bothersome environmental and individual eczema triggers. Identifying and managing triggers is an important part of eczema treatment and control. More studies are needed to confirm if tailoring trigger avoidance advice based on gender could improve patient outcomes.
Do males and females respond differently to eczema treatments?
Eczema is typically treated with prescription topical corticosteroids and other topical agents like calcineurin inhibitors. Other medications like phototherapy or systemic immunomodulators may be needed for severe cases. While guidelines do not differ based on gender, some studies have explored whether certain treatments work better for males or females.
- A study published in the Journal of Dermatological Treatment evaluated methotrexate treatment for severe eczema in adults. It found that males had a significantly better treatment response compared to females. After 6 months, 82% of males had excellent symptom improvement versus only 42% of females.
- Researchers from Iran published a study in 2018 looking at cyclosporine effectiveness for severe eczema. They found no statistically significant differences in treatment response between males and females.
- A study from Japan evaluated sex differences in response to dupilumab, a biologic medication for moderate-to-severe eczema. It found that dupilumab was highly effective in both male and female patients. There were no observed differences in treatment efficacy between sexes.
More high-quality research is required to determine if there are true differences in treatment responses between genders. Personalized medicine and factoring gender may help optimize eczema therapy in the future. Currently, treatment decisions are guided by disease severity rather than demographical factors.
Conclusion
In summary, research to date shows some notable gender differences when it comes to eczema:
- Eczema appears to be more prevalent among females compared to males in childhood through adulthood.
- Some studies suggest women may experience more extensive body surface involvement and impairment in quality of life.
- Females often report irritants, climate factors and stress as frequent triggers more than males.
- Data on whether treatment responses differ between genders is still limited and mixed.
However, there are also many similarities between genders when it comes to eczema. Diagnosis, assessment tools and treatment guidelines do not differ based on sex. All patients with eczema go through cycles of flares and remission. More research is still required to understand the interplay between biological, environmental and sociocultural factors that influence gender differences in eczema. Identifying differences could potentially help personalize management and improve outcomes for both male and female patients in the future.
