Did you know that there’s a chance your skin problems can be affected by your mental health? Jeet Dalvi & Pearl Mathias tell you what you need to know about psychodermatology
Many of us are still sceptical about the connection between our minds and our bodies. However, think about how quickly your cheeks redden into a blush when you’re embarrassed, or how you can break out into acne when you’re stressed. Your body can react to your psychological state in a number of ways, and dermatologists are beginning to get on board with the idea of the relation to skin issues as well.
A form of treatment that could help, called psychodermatology, has recently come into focus. Its aim is to tackle skin disorders with psychological and psychiatric techniques instead of using medication only. While nothing has been confirmed yet and we can’t be sure of how effective this would be, research is being conducted to examine the role that stress, depression and psychological distresses play when it comes to skin problems. We’ve been programmed to rush to a dermatologist for quick medical aid for any skin issue, so we don’t realise the other dominant factors that may be causing them. Here’s what you should know while the research to determine the link between them continues.
Dr. Shefali Batra, a psychiatrist, cognitive therapist and the co-founder of InnerHour, shares a few myths and facts about psychodermatology with us. “It’s difficult for people to digest the fact that mental conditions could be the cause of skin issues. Psychodermatology is simply a way to understand the complex issue of the mental state and how your body reacts to it. In some cases, an undiagnosed mental disorder manifests in a coetaneous disorder (when a medical condition affects the skin, hair, nails and related muscles). In some cases, a particular skin condition is aggravated because of another skin condition that damages your self-esteem and confidence in a way that it causes you to feel depressed solely because of the condition,” she says.
Categorizing mind-skin connections
Psychodermatologic disorders can be classified into three broad categories: psychophysiological disorders, primary psychiatric disorders and secondary psychiatric disorders. Take a look at what they are and then read our box below to see what skin conditions are associated with each of them.
- Psychophysiological disorders are skin disorders that are made worse by emotional stress.
- Primary psychiatric disorders are skin disorders where the primary problem is psychological, and the skin manifestations are self-induced.
- Secondary psychiatric disorders are seen in people who have disfiguring skin disorders — disfigurement results in psychological problems. So, in a way, this is the opposite of the conditions we mentioned above. Here, skin conditions could lead to psychological problems, not the other way around.
TREAT IT WELL
Now that you know there is a connection between your mind and body, you will begin to realise that several skin disorders reveal a clear link with your state of mind. For example, stress and sleep deprivation can directly damage skin barrier function. The following techniques have shown positive results and appear to be safe. They also help to minimise your exposure to treatment that involves more drastic side effects. According to the National Eczema Association of the USA, skin diseases can be treated with psychological techniques such as:
“Since most of these dermatological conditions arise due to mental issues, it is important to first understand and then accept that a proper diagnosis is essential for treatment. These are typical cases where psychological intervention is needed. Along with required medical dosage, it is observed that these people are victims of acute stress and anxiety, which is a result of low self-esteem that can result from a variety of reasons. For those with trichotillomania, Habit Reversal Therapy along with Cognitive Behaviour Therapy (CBT) is usually very effective. If BDD (body dysmorphic disorder) — a mental disorder in which you can’t stop thinking about one or more perceived defects or flaws in your appearance, which in reality are minor or not observable — has affected self-esteem, CBT along with REBT (Rational Emotive Behaviour Therapy) really helps,” says Kinjal Pandya, a counselling psychologist.
Skin conditions related to psychological issues
If you suffer from severe skin issues that arise seemingly without any cause, it is a good idea to talk to a counsellor and then follow up with your dermatologist. According to the UK medical publication Psychiatric Times, these are the most commonly associated disorders. We also tell you about the related skin conditions.
- Psychophysiological disorders Skin conditions are often triggered by psychological stress. People who suffer from this experience a clear association between stress and the aggravation of the condition. Examples in this category include atopic dermatitis, psoriasis and acne.
- Primary psychiatric disorders These are disorders with dermatological symptoms. There isn’t an actual skin condition and everything seen on the skin is self-inflicted. These are associated with underlying psychopathology and are stereotypical of psychodermatological diseases. Examples include dermatitis artefacta, trichotillomania and body dysmorphic disorder.
- Secondary psychiatric disorders These are dermatological disorders associated with psychiatric symptoms. Emotional problems are more prominent as a result of skin conditions, and the psychological consequences are more severe than the physical symptoms. Examples include vitiligo and alopecia areata.
MYTHS THAT CAN PREVENT YOUR SKIN FROM GETTING BETTER
Medical problems need medical solutions.
Those with medical conditions may seek medical treatment, but this only works for some people. For example, warts are caused by viruses, but according to a few studies, when medication didn’t work for some people, psychological treatments proved successful.
If a skin symptom is not caused by psychological factors, then psychological treatment will not help.
Psychological therapies won’t be able to cure the underlying cause of your skin symptoms, but they can offer substantial relief. In the case of burn patients, hypnosis coupled with medication helps them to heal faster and they are less likely to develop infections when compared with those who are only administered medication.
Sensitive skin is always a disadvantage.
People with sensitive skin are more at risk because of emotional and environmental exposure. But, psychodermatology works here because their skin may react harshly or unpredictably with medication. Physical or emotional trauma tends to bring the mind and the body closer in these cases.