In this episode of Topical Conversations, dermatologists Nicholas Brownstone, MD, and Alexandra K. Golant, MD, address the critical yet often overlooked issue of touch starvation, particularly affecting patients with inflammatory skin conditions. This discussion highlights how touch starvation impacts patients' overall quality of life and offers practical advice for clinicians on how to address this issue. 

Understanding touch starvation 

Touch starvation, in the context of dermatology, is a multifaceted issue with significant implications for patients with inflammatory skin diseases. From a clinical perspective, touch starvation can manifest as patients feeling isolated and less engaged with their health care providers. This reduced interaction may hinder providers from fully assessing the severity of the disease and its impact on the patient’s quality of life. Consequently, patients may suffer silently, experiencing challenges that health care providers may not fully appreciate. 

Another dimension of touch starvation involves the social and emotional isolation that often accompanies inflammatory skin conditions. This isolation can lead to various negative outcomes, such as mental health issues, social anxiety, and withdrawal from daily activities. Addressing these concerns is crucial for improving the overall well-being of patients and ensuring that clinicians are more attuned to the broader impacts of these conditions. 

Impact of touch starvation on quality of life 

Touch starvation significantly affects the quality of life for patients with conditions like psoriasis and atopic dermatitis. Patients may experience a substantial burden, which is often underreported. If clinicians do not actively inquire about quality of life, they may miss crucial insights into how the disease affects the patient's mental health, self-esteem, and interpersonal relationships. 

Many patients are not proactive in discussing their emotional distress or the extent to which their condition impacts their lives. Therefore, it is essential for health care providers to proactively assess quality of life to better understand the severity of the disease and adjust treatment plans accordingly. Inadequate recognition of touch starvation can lead to undertreatment, leaving patients with a diminished quality of life. 

Identifying touch starvation in patients 

To effectively identify touch starvation and its impact on patients, clinicians can adopt several strategies: 

1. Frequent follow-ups: It is important to schedule more frequent visits for patients who appear to be struggling or whose condition may be worsening. Shorter follow-ups can help ensure that providers stay updated on the patient’s condition and make timely adjustments to treatment. 
2. Intentional dialogue: During clinic visits, take the time to engage in meaningful conversations about the patient’s quality of life. Ask specific questions about how their disease affects their daily activities, sleep, and overall well-being. Open-ended questions, such as “What activities are you unable to do because of your condition?” can provide valuable insights. 
3. Holistic care: Regular follow-ups are crucial for identifying mental health strain or comorbidities that may not be immediately apparent. A comprehensive approach to patient care can reveal underlying issues that need to be addressed alongside the primary skin condition. 

Supporting patients with low self-esteem and poor body image 

For patients experiencing low self-esteem or poor body image due to their disease, several strategies can help: 

1. Access to advanced therapies: The advent of new treatments has provided hope for many patients. Informing patients about advanced therapeutics can offer them a sense of optimism and encourage them to engage more actively in their treatment plan. 
2. Support groups: Connecting patients with support groups, either through national organizations like the National Psoriasis Foundation or the National Eczema Association or through local and online communities, can provide valuable social support. These groups offer a space for patients to share experiences and find encouragement from others facing similar challenges. 
3. Interdisciplinary team: Leveraging an interdisciplinary approach, including mental health professionals and primary care providers, can address the holistic needs of patients. This team-based care model ensures that patients receive comprehensive support, addressing both their physical and emotional health. 

Touch starvation is a significant issue for patients with inflammatory skin diseases, impacting their quality of life and overall well-being. By understanding and addressing this issue, clinicians can improve patient care and outcomes. Regular follow-ups, intentional dialogue, and access to advanced treatments and support resources are essential for effectively managing touch starvation and enhancing the quality of life for these patients. For more resources, the National Psoriasis Foundation and the National Eczema Association offer valuable support and information for both patients and providers.