Friday Feature – Eczema Q&A with Dr. B

Q&A with Dr Christopher Bridgett

MarcieMom (@MarcieMom) met Dr Christopher Bridgett (@ckbridgett) through Twitter – and learnt that he had a special interest of using behavioural interventions to help people with atopic eczema. DrB trained in medicine at Corpus Christi College, Oxford and St Bartholomew’s Hospital, London, then as a psychiatrist in Oxford. He now works in private practice in London. He has co-authored several publications on The Combined Approach, that proposes using habit reversal to stop habitual scratching in atopic eczema. To find out more about behavioural dermatology, click to read DrB’s interview with Peter Norén MD, the Swedish dermatologist who created The Combined Approach.

Marcie Mom: A week has flown & it’s Friday, with Dr B. Today, we have a tricky question for you. Eczema children have to keep their nails short and smooth but some children, like mine, keep biting their nails. What can parent do to keep the children from biting nails?!

Dr B: OK! Yes, keeping the nails nice is a good plan, though it doesn’t stop scratching! That is where habit reversal comes in. And biting one’s nails is a well-known common habit too, and habit reversal works for it too. There is a lot on the net about the usefulness of habit reversal – for both skin scratching and picking, and nail biting.

The way it is used in young children with atopic eczema is described in Chapter 5 of the book “Atopic Skin Disease” – now available to consult at! The technique can easily be adapted to focus on nail biting. Enlisting the help of a child psychologist interested in behaviour modification might be necessary. I hope that helps. DrB

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