Psychodermatology: Skincare's Hidden Nemesis

The key to less flare-ups may lie in how well you  nurture your mental health.


 It’s no secret that life can feel like a literal dumpster fire (#2020). Maybe you’re trying to keep up with your job & perform well during a global pandemic, or maybe you’re struggling to find a balance and some stability in an uncertain, often scary time.

Whatever the case may be for you, life comes at you fast, and the added weight of it all can be pretty rough. 

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Of course, when angry skin moods appear, you visit your dermatologist - duh. This is, clearly, the obvious (and correct) first step in improving your skin health. 

Sometimes, though, even the best and brightest treatments don’t help the situation, and after awhile you may begin to question things: What else can I really do? I’ve done everything my dermatologist recommended, and still no improvement - WHAT GIVES?

Instead of playing the self-blame game, ask yourself this: do your symptoms get worse during emotionally taxing events? Is your doctor unsure why your symptoms are more stubborn and severe than expected? Are you experiencing relief from symptoms for a brief period, only to have them return a short while later?

If you answered yes to one or more of these prompts, heads up: you may be missing an important step in your treatment, and it all starts in your mind.

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Psychodermatology examines the relationship between your mind and skin, and addresses the contributing factors that a trip to the dermatologist wouldn’t be able to tell you. Here’s what you need to know. 

How does psychodermatology impact your skin? 

Psychodermatology is more than occasionally feeling stressed. Many people who experience stubborn recurring flare-ups despite undergoing heavy dermatological treatment have also experienced trauma at some point in their life.

30 to 40 percent of people with severe acne or skin conditions have also experienced psychological problems that are exacerbating their symptoms (1). 

Even with stats like that, dermatologists aren’t formally trained to diagnose emotional distress in patients, so they typically won't identify a person’s mental state as it pertains to their skin health (although many dermatologists in recent years have caught on to the importance of psychodermatology, many still don’t feel comfortable or informed enough to put the practice into place).

This could mean endless trips to the dermatologist, when really you should be booking a trip to your psychologist. 

Even the best medications and treatments simply can’t address the underlying psychological turmoil that's potentially impacting your skin health.

Take this scenario for example: if you grew up with a strict, demanding, or domineering parent, as an adult who deals with eczema, you may experience sudden flare-ups whenever you're dealing with aggressive people or high-pressure situations.

Why is that? Well, scientists are still figuring that part out - we already know that cortisol, a chemical within the body that floods your system whenever you’re experiencing stress, leads to inflammation and, ultimately, angry skin moods and flare-ups. 

The longer you're under stress, the more cortisol is pumped through your system, which leads to the tell-tale “white flag” symptoms like exhaustion, anxiety and depression, all caused by a constant disruption within your nervous system. (2)

Think of it as a never-ending pinball game, and you’re the flipper: always having to bat away the pinball - a.k.a. external stress triggers - with little to no break in between. F*cking EXHAUSTING, amiright?   

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People who experience stress-induced flare-ups can also end up even more stressed as a result and experience poor self image, shame, and low self-esteem due to their skin's appearance.

Of course, the severity of which one will experience such self-loathing varies from person to person, and is dependent on a variety of factors: personality, environment, your family and friend dynamics/support level, and a number of other outside influences can make or break a person’s ability to respond well to these events.

Having trouble managing your thoughts? Seeing a decline in your happiness? Just not feeling like yourself these days? It's time to talk, Mavens. 

Remember: knowing when to seek additional psychological care will help not just your skin, but your general wellbeing and quality of life.  

Signs you may need therapeutic intervention 

There are several categories that psychodermatologic disorders fall into, but we’ll cover the most common ones here: 

Psychophysiologic disorders are categorized as such because they are typically exacerbated by emotional stress, but stress is not the root cause. Stress is a major trigger, and is often why even the top dermatological treatments are ineffective.

The conditions most effected by this are psoriasis, atopic dermatitis, rosacea, acne, seborrheic dermatitis, hyperhidrosis and hives. The “itch scratch cycle”, which refers to a psychological response to stress that causes extensive itching, burning or irritation, further exacerbates these conditions. 

Dermatological disorders with psychiatric symptoms aren’t necessarily triggered by stress, but the development of the condition can create stress for the person trying to manage it. 

Dealing with a skin condition can make you more susceptible to developing emotional distress, and can leave people feeling ashamed or embarrassed about their physical appearance, causing them to withdraw from even their closest confidants.

With these disorders, psychological impact is sometimes more prevalent than the actual, physical symptoms (4) . This includes vitiligo and alopecia areata, to name a few. 

Psychiatric disorders, although less common, shouldn’t be dismissed. These are the more severe, dangerous side effects of deep emotional turmoil.

A psychiatric disorder refers to a condition in which the person is actually the one causing damage to the skin, and not external factors (although the person is usually triggered by emotional distress): obsessive compulsive disorder, trichotillomania (pulling out your own hair), and parasitosis (the feeling of "bugs" under your skin) are common conditions found in this category. 

If someone you know is showing signs of these conditions, seek professional help right away.* Most people with a psychiatric disorder don’t realize they are the ones actually causing the skin reaction, which can be dangerous if left untreated.

*check out mentalhealth.gov to learn more about finding help during a mental health crisis❤️

Prioritize your mental health 

It goes without saying, but always bears repeating: seeking therapy DOES NOT mean you’re unstable.

Forget the stigma - if you’re ashamed, embarrassed or scared to seek treatment, know that you are NEVER alone and it’s completely normal to struggle with trauma... especially when everyday feels like the world is being tossed into a blender. 

When your skin and overall health is on the line, seeking help through psychodermatology (as well as a dermatologist) could finally mean an improved complexion.

At the very least, a therapist can help provide you with the tools you need to better deal with all of the tough days, skin moods and stubborn conditions life throws your way. It may even help your medication and treatment work better, all by eliminating that unnecessary stress on your shoulders. 

Look, we’re not saying it’ll solve all of your problems - but psychodermatology may just be that missing piece that’s keeping you from achieving your best self, both inside and out. 

Written by Adrianne Neal 


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  1. https://practicaldermatology.com/articles/2015-may/psychodermatology-a-review
  2. https://www.dermatologytimes.com/view/psychodermatology-where-skin-and-mind-meet
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911167/
  4. https://www.psychiatrictimes.com/view/psychodermatology-when-mind-and-skin-interact

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