Atopic Dermatitis and Bullying Among US Adolescents

Adolescents who have atopic dermatitis (AD) have previously been shown to experience discrimination, to have fewer friendships, and participate less in extracurricular activities. This study aimed to determine whether these adolescents are at an elevated risk of experiencing bullying, including cyberbullying, and if so, whether the frequency of bullying is higher compared with adolescents without AD.The study included 3207 adolescents aged 12 to17 for whom data was collected from the 2021 National Health Interview Survey. A randomly chosen adolescent in each household was included in this cross-sectional study. Of the adolescents, 11.9% had AD.Survey responses were collected. A diagnosis of AD was determined based on the question: “Does [name] get an itchy rash due to eczema or atopic dermatitis?”. The prevalence and frequency of bullying were assessed with the question: “How often was [name] bullied, picked on, or excluded by other children?”. The prevalence of bullying was analyzed between adolescents with and without AD using logistic regression, and the frequency of bullying events was compared using ordinal logistic regression.Adolescents with AD were more likely to have another atopic condition, such as asthma (21.1% versus 7.0%) and respiratory allergies (58.6% versus 36.3%), compared with those who did not. They were also more likely to be bullied (33.2% versus 19.0%, P < .01), as well as more likely to be cyberbullied (9.1% versus 5.8%, P = .04). When adjusted for demographics and other atopic conditions, adolescents with AD had an increased odds ratio of being bullied (adjusted odds ratio 1.99) and had an increased frequency of being bullied (adjusted odds ratio 1.97).In adolescents, AD is associated with a higher prevalence and frequency of bullying in the United States. There is also an increased prevalence of cyberbullying in this population.This study highlights important adverse effects on social well-being for youth who have AD. The study does have some limitations, including the lack of resources to explore how the severity of AD ties with bullying or whether these adolescents had received treatment of their AD. It also does not imply that AD leads to bullying, only that there is an association. It is nonetheless important for pediatricians to be aware of the potential for bullying in adolescents with AD, a common physical condition that can be linked with harmful social and mental consequences in this impressionable age group. It would be interesting to study whether appropriately treated AD can modify the risk for bullying.