“Eczema is like a rollercoaster; it’s characterized by flares and remissions and flares and remissions — and the cruelest thing is that it’s unpredictable and the flares come at the absolute worst time,” said Dr. Maxwell Sauder, a dermatologist at the Toronto Dermatology Centre, in a session supported by Galderma during Benefits Canada’s 2026 Chronic Disease at Work conference.
Dr. Sauder focuses on medical dermatology with a special interest in inflammatory skin diseases that are pruritic — meaning extremely itchy. Atopic dermatitis — the most common form of eczema — is known as the itch that rashes, he said, noting it’s a chronic disease that’s variable in the ways it presents.
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Around 20 per cent of children and 3.5 per cent of adults in Canada experience atopic dermatitis with most cases mild to moderate, he said, adding 20 per cent of cases are severe, requiring life-changing systematic treatment.
Chronic itch is the most burdensome symptom of atopic dermatitis, said Dr. Sauder, which leads to decreased sleep resulting in workplace presenteeism and absenteeism.
In a chronically sleep deprived state, mental-health issues arise, he said, noting people with eczema are twice as likely to be at risk for depression and anxiety and three-times more likely to be at risk of suicidal ideation.
In addition, Dr. Sauder explained people with eczema are twice as likely to have absenteeism, which equates to 10-19 hours per week of lost productivity and they’re also more likely to be on short- or long-term disability.
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“The goal of treatment — whether topical or systemic — is to decrease the severity of flares and increase the period of remission because it’s a chronic disease.”
He also depicted a rarer, more debilitating condition — prurigo nodularis — characterized by symmetrically distributed, firm nodular lesions with itch lasting more than six weeks. More than half of individuals with prurigo nodularis are on antidepressants, he added, and they have a worse quality of life compared to a lot of other medical conditions due to a lack of treatment options.
A new medication has been approved for both atopic dermatitis and prurigo nodularis — a biologic injection every four to eight weeks depending on indication — that can help those whose condition isn’t adequately addressed by topical prescriptions, noted Dr. Sauder.
Some best practices he suggested for employers are: providing comprehensive drug benefits coverage; reducing barriers to accessing advanced therapies; offering flexibility during symptom flares; creating a skin-friendly workplace through minimizing triggers such as extreme temperatures, irritants, harsh cleansers and fragrances; and encouraging access to supportive care by promoting coverage for employee assistance programs and mental-health support.
Read more coverage of the 2026 Chronic Disease at Work conference.