Haptic wearable may dial down nocturnal scratching in mild eczema

A hand-mounted wearable sensor that delivers closed-loop haptic feedback has the potential helps reduce nocturnal scratching in patients with mild atopic dermatitis (AD), as shown in a small study.

“[This] sensor leverages advancements in soft electronics, artificial intelligence, and edge computing to accurately quantify scratch and sleep metrics validated in both paediatric and adult patients with AD,” according to authors.

It interferes with scratching behaviour by providing an immediate vibration as soon as the patient starts to scratch during sleep, they explained.

When tested in 10 adults (mean age 36 years, 60 percent female) with mild AD who reported a moderate-to-severe degree of scratching, the use of the device led to a 28-percent reduction in mean scratch events nightly, from 45.6 at baseline to 32.8 after a 2-week intervention (p=0.03). The mean scratch duration per hour of sleep opportunity decreased by 50 percent, from 15.8 to 7.9 s (p=0.01). [JAMA Dermatol 2025;161:406-410]

Most participants found the device easy to wear and use and believed that most people would learn to use it very quickly. Regarding clinical need for such a device, all patients reported a desire to reduce scratching activity, with eight of them expressing keenness for a nonpharmacologic method.

These findings demonstrate the applicability of a wearable sensor with the ability to notify users of scratching behaviour via biofeedback, according to the authors.

“This technology may serve as a standalone or, more likely, a supportive therapeutic device for decreasing scratching behaviour in patients with mild AD who may not meet the criteria for systemic therapy or prefer to not use topical corticosteroids yet still report a high degree of scratching,” they said.

The study was conducted at the Northwestern University Department of Dermatology in Chicago, Illinois, US, and carried out in an at-home environment. The participants were instructed to wear the sensor on their dorsal dominant hand using medical-grade adhesive and secured with a nonadhesive fabric, if needed, for 2 weeks.

During the first week of use, haptic feedback was disabled to collect baseline nocturnal scratching data through the scratch detection algorithm. During the second week of use, haptic feedback was activated and the same data were measured. The participants contributed a total of 114 nights and 791 monitoring hours of data.

Scratch detection algorithm

The scratch detection algorithm was previously developed and validated in a controlled environment in 10 healthy volunteers. These volunteers were instructed to scratch at five common AD locations (dorsal hand, cheek, neck, inner elbow, and posterior knee) for 5 s, repeated 10 times with a 5-s interval, while wearing the device. Subsequently, the volunteers performed five types of nonscratching activities, including waving, tapping, texting, typing, and writing.

Overall, the device had a mean accuracy of 99 percent for detecting scratching behaviour. The sensitivity was 95 percent, and the specificity was 99 percent. All volunteers reported being alerted to scratching events by the haptic motor.

“Currently, there are limited objective methods of quantifying itch. The criterion-standard method of direct visualization of scratching by video recording is impractical in real-world settings,” the authors noted. “By leveraging acoustic and motion signals, the [haptic wearable] is able to classify scratching only when the hand directly impacts the skin.”

Need for further trials

Despite the promising results, the authors acknowledged that the findings are preliminary and need to be validated in randomized clinical trials.

“A potential confounder is that the sole presence of the device on the dorsal hand via sustained pressure may have contributed to reducing scratching behaviour with or without haptic feedback in this study,” they continued. “Additionally, this study only [evaluated the] device worn on the dominant hand. Thus, scratching with the nondominant hand was not captured.”

The authors recommended that future trials include a device sham arm, longer intervention periods, and more sustained follow-up assessments of both clinical benefit and scratching metric changes. Research also needs to include paediatric patients, evaluate potential benefits of the device to daytime scratching behaviours, and assess its impact on skin improvement, they added.