Psychosocial Burdens of Atopic Dermatitis, with Mona Shahriari, MD

During a new interview conducted at the 2025 Revolutionizing Atopic Dermatitis (RAD) Conference in Nashville, Mona Shahriari, MD, FAAD, spoke with HCPLive about the biggest takeaways from her conference session titled ‘The Psychosocial Burden of [Atopic Dermatitis]’.

Shahriari is known both for her work as associate clinical professor of dermatology at Yale University School of Medicine and as host of HCPLive podcast The Medical Sisterhood. During her RAD 2025 interview, she was asked about why she pursued the topic of atopic dermatitis’s psychosocial burdens.

“I think a lot of times as clinicians, when we're seeing patients with atopic dermatitis, we focus on objective scores like EASI or IGA,” Shahriari said. “But the reality is the skin doesn't always tell us the whole story, and there is that burden of disease beyond what we can see that we need to keep in mind in each and every patient encounter.I've had so many patients where sleep, itch, quality of life have been impacted by their disease, but many of the treatments they're on are just doing one thing: treating that one dimension of skin clearance.”

Shahriari noted that she hoped by targeting this exact conversation in her session, the talk could bring the subject to the forefront and remind clinicians to focus on patients’ experiences first and foremost.

“We discussed itch, which is by far the most significant burden that atopics struggle with,” Shahriari explained. “A lot of times itch, in and of itself, can have so many different impacts on a patient. But one thing that we really emphasized was that even patients with mild atopic dermatitis, clinically, can actually have a moderate to severe impact on their itch. There have been studies that have been done that show people with completely clear skin may still have a burden of the itch. Oftentimes, those individuals, from a patient perspective, rate their disease as being severe, whereas their healthcare provider actually rates their disease as being less severe.”

Shahriari highlighted the disconnect between what a physician may perceive and what a patient experiences.

“We also talked about sleep disturbance, because besides the fact that itch can impact sleep independently, I consider it to be a symptom of atopic dermatitis,” Shahriari said. “And not only do I ask about how their sleep is impacted by the disease, when I start a patient on therapy, I actually monitor how their sleep is going. That can speak volumes as to how well their disease is controlled. We talked about the mental health burden [as well], because that's one of those things where I don't think, as dermatologists, we always want to go there. It's a topic that is a little uncomfortable for us, but we made the uncomfortable comfortable today by bringing it to the forefront.”

Shahriari even touched upon suicidal ideation, which she notes some patients with atopic dermatitis can struggle with.

“It independently impacts a lot of our patients,” she explained. “And as clinicians, we need to prioritize not managing the skin solely, but also managing the mental health burden of the disease. I have a couple of psychologists as well as psychiatrists in my community that I partner with to make sure that dimension of the disease is also covered. We went through the obvious financial burden of the condition as well, because sometimes you lose sight of that, but that's an obvious pain point that, for some of our patients, can lead to them being unable to comply with therapy or even start on therapy.”

For any additional information on this topic, view Shahriari’s full interview segment posted above.

The quotes contained in this summary were edited for the purposes of clarity.