Addressing Pediatric Patients' and Caregivers' Fears in Dermatology, With Lisa Swanson, MD

In the second segment of the latest episode of The Medical Sisterhood, host Mona Shahriari, MD and pediatric dermatologist Lisa Swanson, MD continued their discussion on the emotional realities of pediatric dermatology, focusing on the burden chronic skin disease places not only on patients but also on parents and caregivers.

The conversation began with Shahriari reflecting on the importance of counseling families following diagnoses such as vitiligo. She described a memorable encounter with the mother of a child diagnosed with a small patch of vitiligo, recalling the parent’s immediate fear and emotional reaction despite the limited extent of disease. Shahriari emphasized that much of dermatologic care involves reassuring families that skin disease is not their fault and helping them navigate fears surrounding a child’s future and self-confidence.

Swanson expanded on the psychological burden associated with pediatric inflammatory skin disease, particularly atopic dermatitis. She referenced research showing elevated anxiety and depression levels among parents of children with atopic dermatitis, noting that in some cases parental emotional distress may even exceed that experienced by adult patients with the condition themselves. Swanson also mentioned hearing discussions suggesting that atopic dermatitis may contribute to strain within marriages and family dynamics, particularly due to chronic sleep disruption and differing opinions regarding treatment decisions.

The pair discussed how lack of sleep, stress, and long-term caregiving responsibilities can intensify emotional exhaustion among parents. Swanson noted that pediatric dermatologists frequently find themselves serving as mediators between caregivers who may disagree about treatment approaches or disease severity.

Later in the segment, Shahriari shifted the discussion toward the emotional expectations often placed on women physicians. She noted that behaviors frequently accepted in male physicians, such as directness or emotional detachment, are often interpreted differently when displayed by women clinicians, who may instead be labeled as cold or difficult.

Swanson acknowledged struggling with those expectations throughout her career, particularly while balancing advocacy, leadership, and compassion in pediatric dermatology. She explained that women physicians are often expected to remain endlessly empathetic while simultaneously maintaining clinical authority and professionalism.

The discussion concluded with both physicians reflecting on the importance of boundaries in medicine. While empathy remains central to patient care, Shahriari and Swanson emphasized that constantly absorbing the emotional burdens of others can lead to exhaustion if physicians fail to prioritize their own well-being alongside that of their patients.

Editor’s note: This segment was summarized with the help of AI tools.

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