November 2025 digest

In atopic dermatitis (AD)—a condition already saturated with poor quality studies on anxiety, depression, and socioeconomic burden—sexual health rarely appears on the radar of clinicians, researchers, or guideline developers.

Sexual health has long been the silent casualty of chronic skin diseases. In atopic dermatitis (AD)—a condition already saturated with poor quality studies on anxiety, depression, and socioeconomic burden—sexual health rarely appears on the radar of clinicians, researchers, or guideline developers.

The new study by Sánchez et al. from Colombia breaks this silence, reminding us of an overlooked but profoundly human dimension of AD: its impact on intimacy, desire, and sexual wellbeing.
The findings are striking in their simplicity and their implications. Sexual health disorders (SHD) were identified in 85% of adults with AD, including over half of those with mild disease. The assumption—that only severe, visibly debilitating eczema disrupts sexual function—is challenged head-on. In fact, SHD correlated not only with global AD severity but also with the location of lesions, notably the face, hands, and genital areas. Disease chronicity, too, exerted a cumulative toll.

What makes this study very relevant for ISAD is its exploration of treatment impact—a glaring omission in much of the literature on AD burden, which often catalogs associations with psychological comorbidities without examining change over time. Here, improved skin control through standard pharmacotherapy—not biologics, not JAK inhibitors, but basic treatments constrained by local healthcare regulations—resulted in meaningful reductions in SHD across all severity strata. The relative reduction ranged from −60% in mild AD to −28% in severe AD, demonstrating that even modest, accessible therapeutic progress can restore elements of intimacy and quality of life.

This is a powerful message for global dermatology. In many parts of the world, advanced systemic therapies remain rare or inaccessible. The Colombian cohort reflects this reality: only 0.9% were on dupilumab at baseline, and systemic immunomodulators were seldom used. Yet improvement was still possible. For the majority of the world’s patients with AD, this is an encouraging and actionable finding.
The study also highlights structural and cultural barriers. Men and older patients were more likely to avoid completing the sexual health questionnaire, suggesting that stigma and discomfort persist even in anonymous research settings. Clinicians, too, often shy away from initiating conversations about sexual health, constrained by time, training, or uneasiness. This avoidance leaves patients unsupported in an area fundamental to personal wellbeing.
In our increasing advocacy for comprehensive AD care, this study urges us to broaden our lens. If we claim to treat the whole patient, we must integrate questions about sexual health into routine practice—not as an afterthought but as a legitimate marker of disease burden and treatment success. The data clearly show that SHD is not an ancillary issue but a core element of lived disease experience, one that responds to treatment and meaningfully influences quality of life.

As ISAD prepares for upcoming global initiatives in capacity building, essential medicines access, and multidisciplinary approaches to AD, this study offers timely guidance. It reminds us that even in resource-limited settings, attentive clinical care—guided by simple, effective tools and a willingness to address intimate concerns—can restore parts of life that patients may have quietly abandoned.

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