Health is a reflection of our mind, body and spirit. The mental, physical and spiritual systems are interconnected, meaning, the health of one relies on the other. If one area is imbalanced, we may eventually see imbalance in another.
The health of the skin is one great example of the complex interconnectedness of the human system. The skin is considered to be part of the physical body and is impacted by what we put on and in the body. But more recently, science is beginning to understand what eastern and alternative forms of medicine have known for millennia — the skin’s health is also a reflection of one’s emotional and spiritual state.
Psychodermatology is a relatively new branch of medicine that addresses the connection between the mind and skin. While psychology addresses non-visible, internal concerns of the neurological system, dermatology is focused on external skin imbalances. What we are learning through research is that when we are seeing co-existing skin and mental health concerns, or when one issue follows the other, it is pertinent to treat both together to see a fuller resolution of symptoms, and to support an individual’s overall health.
Depending on the dermatological concern in question, it has been established that certain psychological concerns directly precede or can possibly cause skin issues in some individuals. The opposite is also true, in some mental health diseases, certain skin concerns may follow in certain individuals. In some cases, there are even what we call psychophysiological disorders, where symptoms of the skin and neurological system arise together.
Time and time again in my practice, I see the connection between physical or emotional stress and skin disorders. Psychological stress in particular can compromise the epidermis (the outer layer of the skin) through the NICS system. The NICS, or neuro-immuno-cutaneous system, connects the brain, immune system and the skin. When one is affected, the others are too. In other words, the immune system and skin barrier can be compromised by stress. Stress may make the skin more vulnerable to inflammation from the immune system, potentially causing irritation and other skin symptoms to arise.
There are numerous examples of this. Stress can precipitate conditions like atopic dermatitis (also known as eczema) and psoriasis. Emotional triggers have also been noted in dermatological conditions like acne, rosacea, alopecia aerate, and hyperhidrosis (increased sweating). Stress management techniques, relaxation, certain medications and natural remedies used to treat psychological conditions have been shown to be helpful in these conditions.
In the case of psoriasis, the literature suggests that the condition may be preceded or exacerbated by stressors. 44% of patients surveyed in the studies reviewed reported that stress preceded the initial flare of disease, and 80% of patients said that disease flares followed a period of stress. Furthermore, once the psoriasis presents, the skin’s appearance causes psychological distress. Sleep may also be affected because of the itching that results from the psoriatic plaques, and lack of sleep also impacts mental health.
Research shows that atopic dermatitis (eczema) also has a clear connection with mental-emotional health. In more than 70% of individuals with eczema, a stressful event preceded the onset of the disease. Many patients also report that the severity of symptoms match with the severity of stressors. Stressors are often interpersonal in nature. Interestingly, one study demonstrated that 45% of children with eczema whose mothers received counselling were clear of lesions, while only 10% of the control group whose mothers did not receive counselling improved, possibly suggesting that when a mother’s stress is reduced, so is her child’s — leading to a decrease in skin symptoms.
Rosacea, hives and itching, certain types of acne, and dermatitis can also fall within this category of dermatological illnesses that may be preceded by psychological distress. Unfortunately, these skin illnesses can also cause emotional distress because of their appearance…and so goes the cycle.
One resource suggests that up to one third of dermatology patients will need to address psychological factors to achieve resolution of skin issues. In my naturopathic practice, in order to manage any skin condition completely and to the best of my ability, I ensure the mental-emotional state of the patient is well taken care of. Caring for the skin through skincare, facial treatments, gut health, and regulating the immune system is only one part of the puzzle. I often also recommend relaxation and meditation techniques, regular exercise and therapy, acupuncture, and often herbs or supplements to address the mental-emotional state, allowing the nervous system to calm and the NICS begin to heal. Cosmetic acupuncture is one of my favourite modalities to use because it simultaneously treats the skin externally, while relaxing the nervous system and regulating the immune system within. In some cases, it is pertinent to engage an MD to advise around the use of medications both for the skin and for nervous system in order to a patient to achieve best results.
Psychodermatology: A Guide to Understanding Common Psychocutaneous Disorders, Mohammad Jafferany MD.