Women’s Health Needs in Psoriasis and Atopic Dermatitis

For women living with chronic inflammatory skin diseases such as plaque psoriasis and atopic dermatitis (AD), disease burden can extend well beyond visible skin manifestations. Pain, pruritus, sleep disruption, mental health challenges, reproductive concerns, and hormonal changes throughout different life stages can all contribute to the patient experience.^1,8

Research has also identified differences in the ways women experience the psychosocial burden of these diseases. Women with psoriasis and AD may report greater effects on mental health and quality of life, including depression, fatigue, loneliness, stress, and stigma. However, questions remain about how sex, hormones, reproductive considerations, and different stages of life interact with chronic inflammatory skin disease over time.^5,7,8

Dermatology Times spoke with Doral Fredericks, PharmD, MBA, global vice president of medical affairs and outcomes research at Organon, about these unmet needs and how clinicians can better integrate mental health, reproductive health, and individualized support into dermatologic care.

Dermatology Times:

What differences in women’s experiences are supported by research, and where are the biggest evidence gaps?

Fredericks:

The physical burden of plaque psoriasis and atopic dermatitis [eczema] can be especially complex for women. In addition to symptoms such as pain, persistent itch, visible lesions, and disrupted sleep, women may experience changes in disease onset, severity, and flare patterns as hormones fluctuate across menstruation, pregnancy, postpartum, and menopause.

And it can take an emotional toll, too. Women with these conditions report a disproportionately greater mental health and quality-of-life impact than men, including higher rates of depression, fatigue, loneliness, stress, and stigma.

What remains missing is research that looks at the whole picture, how sex, hormones, reproductive considerations, and life stages interact with these conditions over time. This research can help us better understand the necessary care for women that is individualized to their evolving physical and emotional needs.

Dermatology Times:

How can clinicians identify and address depression, stress, and stigma during routine visits?

Fredericks:

Clinicians can start by making emotional well-being a routine part of the visit rather than waiting for a patient to raise it. A few direct, empathetic questions about mood, anxiety, stress, stigma, relationships, and daily functioning can uncover concerns that skin-focused assessments may miss.

We know that many patients with atopic dermatitis and plaque psoriasis have impacted sleep due to itching and other symptoms, making this an important question to ask. Acknowledging that these effects are clinically meaningful and connecting patients with appropriate referrals and support, when appropriate, can help break the cycle in which stress and untreated conditions reinforce one another.

Collaborating holistically with the patient’s extended specialty care team, such as endocrinologists or gynecologists, and especially if a patient sees a psychologist or psychiatrist, holds tremendous value in understanding the full picture of a patient’s experience and ultimately providing the best care plan possible.

Dermatology Times:

How should providers approach concerns about family planning and passing a condition on to a child?

Fredericks:

Providers should invite this conversation early and approach it with empathy, clear information, and shared decision-making. A quarter of women with psoriasis have reported delaying motherhood because of concerns about passing the condition to a child, while some women with eczema may underuse treatment during pregnancy out of fear of harm to the child.

We know that inheritance of any condition is determined by many factors, so clinicians should provide counsel as well as offer space for patients to talk about their concerns about family planning, proactively discuss available treatment options, and ensure they are providing the latest available information. This will ensure women can make an informed decision about their health while accounting for any family planning considerations.

Dermatology Times:

What practical steps can improve coordination between dermatology, mental health, and reproductive care?

Fredericks:

By taking the lead on addressing emotional well-being as part of dermatologic care, clinicians open doors for honest conversations and ultimately better care. Acknowledging the psychosocial aspects of chronic skin conditions offers an opportunity for the patient to feel comfortable enough to honestly share their experiences and then share any worries or symptoms they may be experiencing.

Clinicians can then document any patterns between disease onset, flares, and the patient’s mental health symptoms and establish clear referral pathways. Research demonstrates multidisciplinary care that combines dermatologic treatment and mental health interventions can reduce inflammation, lower stress biomarkers, and improve patient outcomes.

Shared decision-making and anticipatory guidance, especially before pregnancy and during postpartum or menopausal transitions, can reduce fragmented care and help the patient’s care team address physical symptoms, emotional burden, and reproductive considerations together.

Dermatology Times:

What barriers to treatment access particularly affect women, and what could help address them?

Fredericks:

Women can experience a long and fragmented path to effective diagnosis and care, from self-treatment and primary care visits to specialist referrals, often compounded by delays in diagnosis, treatment, and support.

Stigma, unmet mental health needs, and treatment considerations that change across pregnancy, postpartum, and menopause can create additional barriers. Addressing these requires broader access to appropriate treatment options, stronger patient education, timely referrals, and care that reflects each woman’s life stage and individual needs.

At Organon, we bring our longstanding focus on women’s health to dermatology because we recognize that skin health and women’s health can be interconnected. We are committed to equipping health care professionals with both trusted and innovative treatment options and resources to support individualized care through our dermatology portfolio of 11 medicines, which are available in more than 70 markets.

Organon also works closely with advocacy organizations, including the National Eczema Association, National Psoriasis Foundation, and Women’s Dermatologic Society, to help expand education, resources, and support for patients and health care providers.

References

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