• itch and its associated sleep loss (which can also cause considerable family disturbance)
• social stigmatisation from other children and parents
• the need for special clothing and bedding
• avoidance of activities such as swimming
• the need for frequent applications of topical treatments and visits to healthcare professionals.
In financial terms, the cost of atopic eczema is potentially very large. One study of an entire community in Scotland in 1995 estimated that the annual personal costs to patients with atopic eczema was £297 million if extrapolated to the entire UK.13 The cost to the UK NHS was £125 million and the annual cost to society through lost working days was £43 million, making the total expenditure on atopic eczema £465 million per year. This figure is likely to be an underestimate since the prevalence of atopic eczema is lower in Scotland compared with the rest of the UK. Another study from Australia found that the annual personal financial cost of managing mild, moderate and severe eczema was Aus$330, Aus$818 and Aus$1255 respectively, which was greater than the costs associated with asthma in that study.14
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