Self-guided online treatment can help with atopic eczema

A new study from Karolinska Institutet shows that self-guided cognitive behavioral therapy (CBT) online is as effective as psychologist-led internet-based CBT in reducing the symptoms of atopic eczema. The results, which are published in JAMA Dermatology, can lead to improved access to treatment for patients and reduce the burden on health care.

Self-guided internet CBT is a new digital treatment option aimed at people with atopic eczema, a chronic skin disease that often causes both physical and mental problems. The study, which included 168 adult participants, shows that the treatment’s effectiveness in reducing itching, improving sleep and increasing quality of life is comparable to traditional treatment where a psychologist provides support.

The study was a randomized, non-inferiority study conducted between November 2022 and December 2023. The participants were randomly divided into two groups: one that received access to a self-guided online treatment and one that received traditional internet CBT with regular contact with a psychologist.

The treatments lasted for 12 weeks, and the participants were followed up using standardized measuring instruments, such as the Patient-Oriented Eczema Measure (POEM), to assess changes in the severity of symptoms.

The self-guided treatment consisted of a digital program with brief texts, exercises and tools. The focus was on techniques such as mindfulness and exposure and response prevention, which aim to break negative patterns of behavior, such as scratching, and thus reduce the severity of eczema.

The group that received psychological support worked with more extensive material and received help to adapt the exercises to their individual needs.

“Self-guided internet CBT proved to be an effective option for reducing symptoms and improving quality of life, while requiring fewer health care resources, 16 minutes per patient on average versus 50 minutes for the supported group,” says Dorian Kern, researcher at the Department of Clinical Neuroscience, Karolinska Institutet.

The results are particularly significant because access to psychological treatment for atopic eczema is often limited.

Treatment can become more accessible

This form of self-guided treatment can be a step towards making evidence-based psychological interventions more accessible to patients suffering from this chronic skin disease. In addition, for people who prefer to work independently with their problems, the method can offer increased flexibility and autonomy.

“This is an important development, not only for patients with atopic eczema, but also for other areas of dermatology and chronic diseases,” adds Kern.

The researchers are now planning to evaluate how self-guided internet CBT can be integrated into regular care, for example at health centers and dermatology clinics. They also want to investigate whether similar interventions can be used for other skin diseases such as psoriasis.