MORE THAN SKIN DEEP
What do your skin and mental health have in common? More than you think. Here, we take a closer look and talk to the experts.
Treating skin conditions and mental health together
Living with a skin condition such as eczema, rosacea, psoriasis or acne can be difficult enough, but in recent years, studies have shown that people who have one of these skin disorders are also, in severe cases, more likely to suffer from, or are at a higher risk for developing, psychological issues. Understanding the connection between your skin and mental health is the first step toward relief, and luckily, there’s a field of medicine that bridges the gap between psychology and dermatology. Psycho dermatology provides folks with solutions for their skin conditions while helping them through their own emotional stressors. Read on to learn about the practice and hear from the experts about what you can do to treat your skin and your mood.
the BRAIN-SKIN AXIS
We’ve all been there: breaking out during our periods or when we’re super stressed out. But for anyone who has ever had a chronic skin condition— acne, rosacea, eczema, dermatitis or vitiligo, for example—finding a treatment can be mentally and emotionally draining. A 2018 study in the British Journal of Dermatology shows that people with acne are more likely to develop depression, and a 2014 survey by the Illinois-based National Rosacea Society of 1,675 patients with rosacea (which causes facial redness and related symptoms) demonstrated that 90 percent of the respondents reported lowered self-esteem and self-confidence.
While most skin conditions aren’t contagious or life-threatening, many are visible—on the face, the chest or the arms, for instance—and socially stigmatizing. Dr. Julie Powell, pediatriciandermatologist at Centre hospitalier universitaire Sainte-justine in Montreal and past-president of the Canadian Dermatology Association, notes that there are many aspects to skin conditions, including the impact of the disease itself on the psychology of the person and how the skin condition can or will interfere with the person’s relationships, selfesteem, socialization or, in severe cases, attempts to find work. “All too often, skin diseases are perceived to be more benign because they’re not necessarily life-threatening,” says Dr. Powell, explaining that people may ignore taking care of them because they think the conditions are solely a cosmetic concern and don’t consider the mental and emotional impacts. With more and more individuals coming forward with their stories, Dr. Powell hopes that people will get to know their choices, noting, “We now have many good treatment options for a lot of skin disorders.” There are also rare instances when the skin disease is a result of an underlying psychological disorder or worsened by stress or trauma. In these situations, there’s usually a clear association between the stress and the exacerbation of the disease. In cases of psoriasis, for example, patients often report feeling stress before the initial flare-up, then disturbances of body image attributed to the flare-up itself. It’s a vicious cycle of stress causing a flare-up, which leads to stress and poor self-esteem, then more flare-ups.
a FRESH APPROACH to TREATMENT
Psycho dermatology explores the relationship between our skin and our mood. Dr. Benjamin Barankin, medical director and founder of the Toronto Dermatology Centre, notes that the field has been around for more than 25 years, although there are currently just five psycho dermatologists found in the U.S. and none in Canada. (The practice
is well established in Europe.) “Dermatologists want to treat people’s skin issues seriously, promptly and with the right care because we know that not only can we improve their skin condition but we can also make them feel better,” says Dr. Barankin. The aim of psychodermatology is not to substitute psychotherapy for medicine but, rather, to recognize that emotional issues may also be involved, especially when a condition resists conventional treatment. While it’s important to evaluate and treat a skin problem medically before looking into its psychological aspects, sometimes a drug or other medical approach that doesn’t work on its own becomes more effective when combined with psychological strategies.
Psychodermatology practitioners treat skin the way a psychotherapist treats behaviour—by learning how it responds to emotional and environmental stressors and helping moderate those responses. Some treatment plans can include medication, therapy and/or stress-reduction techniques. Patients may also be introduced to cognitive behavioural therapy, meditation and hypnosis to help reduce stress and, in turn, improve their skin conditions. Each person’s treatment plan is subjective based on his or her condition and the recommendations of the person’s medical team. So although you may feel trapped by your skin disease, take a deep breath and know that there are solutions to manage the breakout and improve your mood, too.
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