Wearable technology offers new hope for atopic dermatitis patients struggling with itching

A recent study published in JAMA Dermatology has shown that an artificial intelligence (AI)-enabled wearable sensor can significantly reduce nocturnal scratching in patients with atopic dermatitis (AD).

By integrating haptic feedback technology, the device alerts users when they begin scratching, helping them break the itch-scratch cycle that exacerbates the condition. With AD affecting millions of people and causing significant discomfort and sleep disturbances, this innovation provides a promising nonpharmacologic approach to symptom management.

The itch-scratch cycle in atopic dermatitis

Atopic dermatitis is the most prevalent form of eczema, affecting approximately 16.5 million adults in the U.S., with 40% experiencing moderate-to-severe symptoms. The chronic skin condition leads to dry, inflamed, and itchy skin, significantly impacting the quality of life of those affected. Itching, or pruritus, is the hallmark symptom, often leading to excessive scratching that worsens inflammation, damages the skin barrier, and increases the risk of infection.

Many AD patients struggle with sleep disturbances due to nocturnal scratching, which contributes to increased stress and reduced overall well-being. While a variety of treatments exist—including topical steroids, oral medications, and biologic injections like dupilumab—these interventions may not be suitable for all patients.

Some individuals prefer to avoid systemic therapies due to side effects, while others have only mild skin involvement but experience severe itching. This highlights the need for nonpharmacologic interventions that can help mitigate scratching behavior without the use of medication.

Existing challenges in measuring scratching

One of the main difficulties in treating AD-related itching is the lack of objective methods to measure scratching behaviors. While video recording can provide direct observation, it is impractical in real-world settings. Wrist-mounted actigraphy devices, commonly used for sleep studies, lack sensitivity in detecting finger-dominant scratching, limiting their usefulness. Researchers have sought to address these challenges by developing a wearable AI-enabled sensor capable of accurately tracking and responding to scratching behaviors.

AI-powered wearable sensor for AD

The AI-powered wearable sensor, developed by Sibel Health, is mounted on the dorsal hand and incorporates a validated AI-driven scratch detection algorithm. It continuously monitors hand movements, distinguishing between scratching and non-scratching actions with high accuracy. The device’s closed-loop system includes a haptic motor that provides real-time feedback to the wearer, gently vibrating when it detects scratching to prompt the user to stop.

Study findings on nocturnal scratching reduction

In a study involving ten adult participants (six women and four men) with mild AD and moderate-to-severe scratching behaviors, researchers evaluated the effectiveness of the wearable sensor over two weeks. Participants wore the device while sleeping, allowing it to detect and intervene in nocturnal scratching episodes.

The study demonstrated promising results in detecting and reducing scratching events in patients with atopic dermatitis. The AI-powered wearable sensor achieved 99% accuracy, 95% sensitivity, and 99% specificity in identifying scratching behavior. Participants experienced a 40% reduction in total scratch duration per night, decreasing from 96.5 seconds to 58.1 seconds.

Additionally, total scratch events per night dropped by 28%, from 45.6 to 32.8 events. When adjusted for sleep opportunity hours, researchers observed a 50% decrease in scratch duration per hour and a 39% reduction in scratch events per hour, highlighting the device’s effectiveness in minimizing nighttime scratching.

All participants reported that the haptic feedback successfully alerted them to scratching episodes, helping them reduce unconscious nighttime scratching. Most participants also found the device comfortable and easy to use, with eight out of ten expressing a preference for nonpharmacologic interventions to manage their condition.

Behavioral and psychological factors in scratching

The success of the AI-enabled sensor highlights the role of behavioral interventions in managing AD. Many patients scratch unconsciously, particularly during sleep, making it difficult to break the cycle without external intervention. The wearable sensor provides real-time alerts, reinforcing awareness and promoting behavioral changes that can lead to long-term improvements in scratching habits.

Future implications and areas for improvement

While the study demonstrated promising results, its small sample size limits the generalizability of findings. Future research should involve larger and more diverse patient populations, including children, who are particularly prone to scratching-related skin damage. Additionally, the current study focused solely on nocturnal scratching, leaving daytime scratching unexamined. Investigating the effectiveness of the device in managing scratching throughout the day could further establish its role in AD treatment.

Beyond AD, the AI-powered wearable sensor could be useful for other dermatological conditions involving pruritus, such as psoriasis, chronic urticaria, and neuropathic itch. Patients with anxiety-related skin picking or compulsive scratching disorders might also benefit from this technology.

Integration with other AD treatment approaches

While the wearable sensor offers a promising nonpharmacologic solution, it is unlikely to replace existing treatments. Instead, it can serve as a complementary tool alongside traditional therapies, helping patients reduce scratching behavior while continuing to use medications as needed. Future studies should explore its long-term effects on skin health, inflammation levels, and overall disease management.

The AI-enabled wearable sensor represents a significant advancement in the management of atopic dermatitis, offering a noninvasive method to reduce nocturnal scratching. By leveraging real-time haptic feedback, the device helps break the itch-scratch cycle, improving sleep quality and potentially enhancing overall skin health.

Although further research is needed to validate its effectiveness in larger and more diverse populations, this technology provides hope for AD patients seeking alternatives to pharmacologic treatments. As AI-driven health solutions continue to evolve, wearable sensors like this could play a vital role in personalized, nonpharmacologic disease management strategies.