Anyone who has ever experienced an embarrassed flush, a case of goosebumps brought on by fear, or hives spurred by nerves knows that the mind and the body are, without a doubt, linked. Experts at the American Psychological Association have spoken extensively about how mental health affects our skin. The more we learn about the link between skin issues and declines in mental health, the better medical providers and skincare experts alike can work to help those who suffer from both.
It's a well-known fact that poor mental health can have a negative effect on one's skin. Anxiety and depression can lead to inflammation, and poor hygiene associated with mental health issues can lead to acne or other skin disorders. When one is not in a proper mental state to care for their bodies, all systems can start to break down, including the skin.
Although popular in Europe for many years, the concept of psychodermatology has taken some time to catch on in the United States. The field, primarily comprised of dermatologists and psychiatrists, suffers from a lack of funding and attention from the medical community. However, the more information comes from the Association for Psychoneurocutaneous Medicine of North America (APMNA), the more people begin to understand the links between poor mental health and skin — and how that link is being addressed.
Psychodermatology dates back to as early as 1925 in the United States when Dr. Joseph Klauder documented the psychosomatic connection between skin issues and psychiatric disorders. This link was bandied about among scientists and medical experts throughout the 20th century, and while some emphatically believed that there was no link, many others took the exact opposite position. Little headway was made until 1991 when a psychodermatology textbook made its way into medical school lecture halls. APMNA was formed that same year, but participation in the field of psychodermatology has remained stagnant since the early 1990s, with little advancement being made.
Due in part to the lack of attention the specialty receives by the medical community, there are still very few clinicians in the United States specializing in the practice. Psychodermatology specialists work to devise appropriate responses to skin issues prompted by mental health issues. A variety of cognitive therapies and counseling approaches have been applied by specialists seeking to address this niche concern.
It's the hope that, through advocacy and marketing, APMNA can match the efforts of psychodermatological groups in Europe and lead to a broader practice in the United States.
Distressing Skin Issues
Skin issues can be distressing even for those who do not suffer from mental health concerns. They are typically noticeable to the naked eye, and many struggle to cover them or find products to stop inflammation, redness, itching, or scarring. Having others see one's skin issues can send people into a vicious cycle connected to poor mental health, causing feelings of embarrassment and shame to accompany untreated or persistent skin issues often. Unlike other bodily responses to mental health issues — such as hypertension or headaches — acne, scarring, and redness are symptoms of a deeper problem that we wear on the outside. In essence, skin issues born from conditions related to mental health can exacerbate the mental health problems they are initially derived from.
In a survey conducted with people who suffer from rosacea — which causes extreme redness in the face — 90 percent of respondents reported lowered self-esteem and self-confidence, 54 percent reported anxiety and helplessness, and 43 percent reported depression. These responses can be of more concern for those who have poor mental health, to begin with. It can also kick off the vicious cycle of anxiety and depression, making one’s rosacea symptoms even more troublesome. Similarly, people with acne are three times as likely to suffer from depression.
Skin issues can even be directly connected to specific mental health conditions. Dermatillomania, or compulsive skin picking, is linked to Obsessive Compulsive Disorder (OCD). Long-term dermatillomania can cause deep scarring, redness, and the spread of acne. This condition can be hard to treat because doctors must first address their patients’ OCD causing the picking before they can address the results of the picking. Additionally, dermatillomania can evolve into a form of addiction that can be incredibly hard to break. And while many people with affliction pick to relieve their anxiety in the first place, anxiety and stress can make dermatillomania worse.
Tackling the Mental Health Issues
Taking on the skin issues derived from mental health problems can be challenging, which is another reason why an increase in psychodermatologists could be advantageous. The cycle of one problem exacerbating the other, and vice versa, can make finding an all-in-one solution even more difficult. As a result, practitioners often combine psychological approaches with traditional skincare remedies in hopes of killing two birds with one stone.
Many psychologists and psychiatrists believe that hypnosis can be helpful in various applications, especially when trying to quell the stress and anxiety a patient may experience due to skin issues. For example, having a patient focus on what a life with clear skin looks like, or focusing on hydration or less inflammation, can lessen their overall anxiety.
There are support groups for nearly every concern, including skin issues. Resources such as the American Skin Association can point one toward a group that could work well for their needs. Specialists can help one decide if a support group could be helpful.
Cognitive Behavioral Therapy
Therapy can help people identify the source of their depression, anxiety, or stress and assist them in working through the results, including those related to skin conditions. When people are allowed an opportunity to explore why they feel the way they do, it can start to alleviate their stress, anxiety, or depression. As the patient works through their issues, the adverse effects on the skin will eventually begin to reverse. Psychologists and psychiatrists aware of the connection between the body and the mind are best suited to tackle the skin issues that present themselves as passengers to mental health issues.
Tackling the Skin Issues
Once one's mental health has been adequately and appropriately addressed, it is time to manage their skin issues. Although many skin care products are available on the market, many skin problems can be notoriously difficult to resolve. Identifying the right products for one's particular situation can be challenging.
One school of thought follows that an ounce of prevention could be worth a pound of cure. Encouraging mental health patients to approach their self-esteem and anxiety with self-care could not only help the overall appearance of their skin but work to elevate their mental health, as well. This approach could involve encouraging patients to develop a daily and nightly skincare routine, assisting them in selecting products that work for their particular affliction, or helping them develop healthy skin habits.
Seeking out skincare providers and companies that take a more therapeutic approach to their products could also prove helpful. It can be challenging to land on a suitable skincare regime, especially if one has skin problems. Not all skincare companies are the same, and those with stubborn skin issues, such as cystic acne, may succeed more with a medical-grade or prescription skincare product.
A Question of Self-Esteem
In a recent study by InStyle, 76% of women said that they felt good about themselves if they felt that their skin looked good. Indeed, how we look on the outside can affect how we feel emotionally and mentally, and this self-awareness is connected to the apparent link between skin health and mental health.
Our skin is typically one of the first things people notice when meeting someone. Whether we want to admit it or not, outward appearances can play a crucial role regarding first impressions and how we present ourselves to the world. If we feel like our skin is not up to par, it can devastate our overall mental health.
Even those who do not suffer from adverse mental health conditions can learn how specific skin issues might manifest from time to time. However, catastrophization and panic can go hand-in-hand with many mental health issues, so even the most minor skin issues can quickly feel more severe.
Some schools of thought believe that a set skincare routine can help people be happier. The ritualistic aspects can have a calming effect and improve the look of one's skin long-term, as well. Having a set skincare routine can also stabilize someone when their mental health issues peak.
People with poor mental health are more apt to experience skin issues, and those with untreated skin issues are more apt to experience poor mental health. Currently, dermatologists and psychologists predominantly work separately to help patients whose problems are commingled. By putting more effort into increasing the availability of psychodermatologists, the vicious cycle of skin issues derived from poor mental health can be disrupted.