The euphoria courses through my body as the blood drips down my legs. Each deep scratch tears into my skin, bringing with it a temporary relief from the relentless, mind-bending itch. Somewhere deep in my mind, the guilt starts to build as I know this will only make things infinitely worse in the long run. However, at this moment I can’t stop. I’ve held out for as long as I could and now I need to satisfy that incessant screaming in my mind to scratch—if even for a few minutes.

The next day, I wake up and feel a sense of shame as I look down to the bedsheets covered in blood. My skin feels like it’s on fire. I glance in the mirror and feel a lump in my throat. I know I will spend my day in pain, embarrassed in my appearance and doing everything I can to ignore the ceaseless itch.

I have too many examples of outright feelings of humiliation after stepping into the world when I really didn’t want to. The cruel comments and stares have left permanent emotional scars that have led to deep battles with mental health and feelings of low self-worth.

To a small degree, people without atopic dermatitis (AD) can empathize with many of its symptoms. Everyone knows the discomfort of an itch and the satisfaction of a scratch. However, this can sometimes be a hindrance for people with AD as people without the condition dismiss our experience since they think they understand what it feels like. I can assure you, they absolutely don’t. 

I’ve had periods of time when my skin has been clear and have experienced a “normal itch.” Turn up that itch and satisfaction from scratching by 100 and have zero relief for days, weeks, or months on end. Then you’re getting close to knowing what it’s like to have AD.

Well-intentioned caregivers can have a catchphrase of “stop scratching.” My message to them: Scratching is a symptom of atopic dermatitis, not a cause. 

Yes, scratching certainly worsens symptoms by damaging the skin, and some efforts should be made to limit this. But there is the risk of straying into victim-blaming for making someone—especially a child—feel as if it’s their fault their skin is painful since they “chose” to scratch. This couldn’t be further from the truth. The vast majority of energy should be put into relieving the itch rather than stopping the scratch. 

Strategies such as wet wraps, cotton gloves, short fingernails, and a balanced diet can help. However, no matter how comprehensive these strategies are, they will often fail if the root issue of the itch persists. 

I remember numerous times of waking up without my gloves on and blood under my fingernails with no recollection of taking off the gloves during the night. Don’t compound your child’s guilt and discomfort by berating them for their scratching. 

If I were to cover you in itching powder, there becomes a point where it is no longer a choice to scratch. We can all sit on our hands and hold out for hours or days, but eventually we would all break, and we cannot be blamed for doing so. However, often people with AD do feel blamed, as if our condition is entirely self-inflicted. 

I fully understand the awful and frustrating situation caregivers are in. They know that a particularly heavy scratching session can result in damage—more pain and discomfort at the least and serious wounds and infection at the worst. But instead of chastisement, caregivers should get their child to stop scratching with gentle encouragement, kindness, and empathy.

The psychological effects of AD can be particularly catastrophic. There is bullying and isolation that others can inflict upon you. But there’s also internal factors at play that negatively affect your mental health.

When the entire surface area of your body feels damaged, broken, and unhealthy, you start to feel broken, damaged, and unhealthy. This is incredibly challenging to live with mentally. Frankly, there are enough psychological effects of the condition itself to have to also deal with being blamed for your symptom of itching.

The mental toll of AD and its itchiness is especially important for teachers to fully understand; children must be given the kindness and compassion they deserve. That child has to sit in a classroom and attempt to focus while feeling as if their whole body is covered in ants. It’s something which dominates your cognition, which has followed me into adulthood and continues to impact my productivity and focus no matter how hard I try to ignore it. 

My symptoms often present as redness. I remember in one class, a teacher was trying and failing to find the culprit of some bad behavior. He then decided, “It was the student who had gone the most red.” Please don’t be this teacher.

I’ve found that not even in the healthcare field is everyone empathetic toward skin conditions and their symptoms. I have, at times, noticed a cavalier and dismissive attitude toward skin conditions, and it’s been concerning. 

People with AD likely know to moisturize, avoid allergens, and wash bedsheets and clothes regularly. If I could offer one piece of advice outside these standard management tips, it would be to wear sports compression sleeves. They have helped me immensely on my arms and legs when the itch has felt unbearable, letting me get sleep.

Currently, there is no cure for AD. Thankfully, promising medications are coming through—some of which target the itch specifically. There is plenty of hope on the horizon. 

For those of us who are yet to receive the physical relief we so desperately need, emotionally we rely on our support network. It is important to have a circle of people we can go to for help when we’re struggling—without the risk of being blamed for our condition. 

If you are someone who loves a person with AD, please support us by showing kindness and empathy. And reserve any judgement when our itch becomes too unbearable and forces us to inflict self-harm through scratching.