Is Your Child's Atopic Dermatitis Causing ADHD-Like Symptoms?

If your child has been struggling to sit still or focus in class, you may not think to blame atopic dermatitis. Rather, you might be wondering whether they have attention deficit hyperactivity disorder (ADHD).

“Itchy kids are wiggly kids,” says Teresa S. Wright, MD, division chief of pediatric dermatology at Le Bonheur Children’s Hospital and a professor of pediatric dermatology at the University of Tennessee Health Science Center in Memphis. “Sometimes they are just so itchy that they can’t sit still, and this can be mistaken for hyperactivity.”

Just because a child with atopic dermatitis acts hyper or distracted doesn’t mean they have ADHD, though, and there are ways to tell.

The intense itching and other skin symptoms that come with atopic dermatitis can cause kids to stay up all night scratching, interfering with their ability to get a good night’s sleep.

During the day, this can manifest as hyperactivity, rather than sleepiness, interfering with their ability to concentrate or sit still for long periods.

The itchy, flaky skin that comes with atopic dermatitis can also interfere with a child’s ability to focus during the day. They may be distracted by the intense discomfort and feel compelled to scratch their eczema patches.

“It’s important to distinguish between ADHD and behaviors that resemble ADHD,” says Dr. Levine. “Eczema cannot ‘cause’ ADHD. However, children with moderate-to-severe eczema often experience intense itching, especially at night, which can significantly disrupt their sleep. Poor sleep affects attention, concentration, emotional regulation, and impulse control during the day.”

Plus, their focus on eczema symptoms can take their attention away from school and other tasks. “When a child is constantly thinking about how uncomfortable their skin feels or trying to resist the urge to scratch, it’s much harder to pay attention in school, complete homework, or stay engaged in activities,” says Levine.

Atopic dermatitis can also take a mental or emotional toll on kids, with skin symptoms and a lack of sleep causing distress, depression, or anxiety.

“Children with visible eczema may feel embarrassed or self-conscious, worry about being teased, or become frustrated by frequent flares and the daily treatment routine,” says Levine. Those mental health issues can further affect their concentration.

So how do you know whether your child has just eczema or both eczema and ADHD? Experts say tracking symptoms and other aspects of your child’s behavior can be a good start.

“The first step is to look at the bigger picture,” says Levine. “If a child’s difficulty concentrating seems to worsen during eczema flares or after nights of poor sleep from itching, the skin disease may be playing a significant role. Parents can be helpful detectives by tracking eczema symptoms, sleep quality, and behavioral changes to see if there’s a pattern.”

Try talking to your child’s teachers and observing how your child acts during an eczema flare-up, as opposed to when the condition is under control.

It can also be useful to have your child screened by a doctor or therapist for ADHD to determine whether they’re showing other signs of the condition.

“Sometimes kids are misdiagnosed as having ADHD when they just have eczema,” says Dr. Wright.

The first step is making sure the eczema is under control.

“I would recommend getting the eczema under good control to see if the behavioral issues improve first,” says Wright. “Adequate control of eczema involves a good daily skin-care regimen and use of topical and systemic anti-inflammatory medications, as indicated.”

Also, make sure your child is practicing good sleep hygiene (with a relaxing bedtime routine, a consistent sleep schedule, and a calming sleep environment) and getting enough solid z’s overnight.

“When you combine chronic sleep deprivation with the stress of living with a persistent, uncomfortable skin condition, it’s not surprising that some children may exhibit symptoms that look very similar to ADHD,” says Levine. “Persistent itching is incredibly distracting.”

Even if your child is also diagnosed with ADHD, you can treat and manage that, too, with behavioral therapy, accommodations at school, and, in some cases, ADHD medication.