So­ci­ety’s un­re­al­is­tic beauty ideals can make feel­ing free in our own skin seem like an in­sur­mount­able chal­lenge. But the key to that free­dom lies just be­low the sur­face—we need only have the courage to take it.

Marie Claire (Malaysia) - - News - By Clara Siew

Is your beauty stash tak­ing over your liv­ing space? If you're col­lec­tion is caus­ing more anx­i­ety than joy, it's time to take a step back and re­assess what it re­ally means to you.

What is it like to feel trapped in your own skin? Feel­ings of iso­la­tion, help­less­ness, de­pres­sion, frus­tra­tion, low self-worth, and some­times even sui­ci­dal thoughts, are com­monly re­ported by in­di­vid­u­als suf­fer­ing from chronic skin con­di­tions like cys­tic acne, eczema, alope­cia, se­b­or­rheic der­mati­tis, rosacea, adult acne and pso­ri­a­sis. Ac­cord­ing to Har­vard Med­i­cal School clin­i­cal psy­chol­o­gist Dr. Bart Gross­bart, our body im­age con­sti­tutes about one quar­ter to one third of our self-es­teem, and self-es­teem has a mon­u­men­tal in­flu­ence on our over­all psy­cho­log­i­cal health. So it makes sense that deal­ing with a skin dis­or­der would take a hit on one’s self-es­teem and psy­cho­log­i­cal well­be­ing.

There are in­di­vid­u­als who end up putting their life on hold un­til their skin gets bet­ter. And if things don’t seem to im­prove, it only re­in­forces their feel­ings of low self­worth. Skin con­di­tions af­fect peo­ple from all walks of life, and can cause them to iso­late them­selves both phys­i­cally and emo­tion­ally. Mak­ing mat­ters worse are fam­ily, friends or strangers who high­light their in­se­cu­ri­ties by mak­ing

ig­no­rant or cruel re­marks about their ap­pear­ance. “They (the pa­tients) of­ten cre­ate in­tense feel­ings of shame and guilt that slowly di­min­ish self-es­teem, build­ing a neg­a­tive emo­tional snow­ball that grad­u­ally grows un­til it lim­its their lives,” in­ferred Cal­i­for­ni­abased clin­i­cal psy­chother­a­pist, Matt Traube. There is a wide va­ri­ety of skin ail­ments such as eczema, rosacea and acne that man­i­fest them­selves dif­fer­ently on the out­side, but the emo­tional im­pact and in­ter­nal an­guish are very sim­i­lar.


The “snow­ball” thought process of­ten in­volves in­di­vid­u­als look­ing at them­selves and feel­ing bad about how they look, that there’s some­thing wrong with them, that they’re unlov­able, and they may bat­tle with hope­less­ness of ever hav­ing good skin and re­sent­ment to­wards oth­ers with seem­ingly flaw­less com­plex­ions. Such in­ter­nal tur­moil and self-loathing cre­ates a great deal of stress, which ag­gra­vates ex­ist­ing skin con­di­tions and trig­gers flare-ups, which in turn, in­duces more stress. Thus, a vi­cious cy­cle is formed. A con­trib­u­tor on acne.org who suf­fered from cys­tic acne shared that she couldn’t even go any­where with­out hat­ing her­self and her face, and feel­ing in­fe­rior to those around her. Many replied that they felt the same way and some even went out of their way to avoid mir­rors, brightly-lit rooms, so­cial sit­u­a­tions and hav­ing their pic­tures taken be­cause they hated the way their skin looked.

Acne alone is one of the most com­mon skin con­cerns, and is frus­trat­ing to deal with at any age. How­ever, Traube noted that adults who deal with acne re­port feel­ing less se­cure about their so­cial lives, re­la­tion­ships and ca­reers. In a world where looks mat­ter and peo­ple with beau­ti­ful skin are placed on a pedestal, these adults feel com­pelled to base cru­cial life de­ci­sions on how they feel about their acne. The con­di­tion of their skin in the morn­ing would dic­tate the out­come of their en­tire day. The acne acts as a so­cial bar­rier that ends up dom­i­nat­ing al­most ev­ery as­pect of their lives. Even­tu­ally, the is­sue be­comes more than an un­der­ly­ing skin con­di­tion—it be­comes a deepseated (and to­tally un­true) be­lief

Body im­age con­sti­tutes about one quar­ter to one third of our self-es­teem, and self­es­teem has a mon­u­men­tal in­flu­ence on our over­all psy­cho­log­i­cal health.

that they them­selves are not good enough, and that as long as they have acne, they wouldn’t be able to suc­ceed in life. “Clients of­ten tell me that ev­ery­thing in their lives would be fine if their acne was gone,” said Traube. These feel­ings of vul­ner­a­bil­ity and in­ad­e­quacy trig­ger a neg­a­tive in­ner di­a­logue that be­comes their way of life. An in­di­vid­ual with rel­a­tively milder symp­toms may suf­fer worse psy­cho­log­i­cally than oth­ers with more se­vere con­di­tions. “It all de­pends on an in­di­vid­ual’s per­cep­tion,” Dr. Gross­bart ex­plained. “I see pa­tients who suf­fer from a kind of skin post-trau­matic stress dis­or­der – their skin looks bet­ter but they don’t feel bet­ter. The der­ma­to­log­i­cal scars are gone, but the psy­cho­log­i­cal ones re­main.” If left unchecked, feel­ings of not be­ing good enough be­come rou­tine think­ing pat­terns, and will even­tu­ally take an im­mense toll on their self-es­teem.


In all her years of treat­ing hun­dreds of pa­tients with skin con­di­tions like eczema, acne and pso­ri­a­sis, Dr. Flor A May­oral from the Amer­i­can Academy of Der­ma­tol­ogy has seen first­hand how stress can ex­ac­er­bate un­der­ly­ing con­di­tions and trig­ger un­ex­pected flare-ups. Stud­ies have shown that the ac­ti­va­tion of our sym­pa­thetic ner­vous sys­tem brought about by in­tense emo­tions (like stress, anger and fear) can trig­ger in­flam­ma­tory path­ways in the skin. “Learn­ing how to man­age the ef­fects of stress on your skin can help al­le­vi­ate some of the anx­i­ety and symp­toms”, she said. That’s where psy­cho­der­ma­tol­ogy comes into play. It in­cor­po­rates both clin­i­cal and psy­cho­log­i­cal as­pects into an in­di­vid­ual’s over­all skin treat­ment plan, by learn­ing how skin re­sponds to in­ter­nal and ex­ter­nal stres­sors and mod­er­at­ing these re­sponses. To­gether with med­i­cal treat­ment, ther­apy can help us un­der­stand and de­vise bet­ter emo­tional cop­ing mech­a­nisms to help man­ag­ing skin con­di­tions a less stress­ful en­deav­our.


Cruel and in­val­i­dat­ing com­ments from fam­ily mem­bers, friends and strangers can hurt an al­ready dam­aged sense of self-worth. But no one can make you feel in­fe­rior with­out your con­sent – not even your­self. Fo­cus in­stead on turn­ing your val­i­da­tion in­wards and by prac­tis­ing self-care. Never doubt the va­lid­ity of your own emo­tions – what you ex­pe­ri­ence and feel is very real and unique to you. Set aside time just for your­self, in­dulge in a lit­tle pam­per­ing skin­care rit­ual, read up on your skin con­di­tion and de­ter­mine in­gre­di­ents to avoid, or share your sto­ries with peo­ple who have had sim­i­lar skin ex­pe­ri­ences. Any step taken to­wards tak­ing care of your­self and strength­en­ing your self­es­teem is an act of love and kind­ness to your­self.


The anx­i­ety and frus­tra­tion of hav­ing to deal with tem­per­a­men­tal skin is­sues that are dif­fi­cult to man­age, let alone un­der­stand, can of­ten cause in­di­vid­u­als to with­draw into them­selves. The cy­cle of low self-worth and shame can be bro­ken by chang­ing dis­torted think­ing pat­terns that per­pet­u­ated the cy­cle in the first place. Deep-seated feel­ings of shame and self-loathing can dis­tort the way we per­ceive our­selves, and in turn, the way we think the world per­ceives us. Dis­torted think­ing trig­gers in­tense emo­tional chaos, and when we be­lieve these false thoughts of be­ing ugly and un­wor­thy to be true, they even­tu­ally be­come our re­al­ity. By be­ing self-aware and mind­ful of the way we speak to our­selves, we are tak­ing re­spon­si­bil­ity for our own thoughts. It’s eas­ier said than done, but although skin con­di­tions are be­yond our con­trol at times, know­ing that we are in con­trol of how we view and speak to our­selves will give us power over our own self-es­teem. It in­volves un­learn­ing a lot of old cog­ni­tive pro­cesses and re­plac­ing them with new and self­as­sur­ing ones. By con­stantly check­ing in with your­self daily and ap­ply­ing pos­i­tive daily af­fir­ma­tions, a health­ier self-im­age will be­gin to sur­face.

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