A global pandemic, ongoing lockdown and introduction of a vaccination program can create feelings of stress and uncertainty. For people with skin conditions, this situation can become even more difficult when the effects are seen ON their skin as well as IN their mind.
What does research reveal about the link between our skin and our mental health?
There is good evidence demonstrating that people with skin conditions are at increased risk of having poor mental health and that skin conditions carry a significant mental health burden. My patients tell me often that their skin is impacting the way they feel and vice versa. I know that my patients are at higher risk of feeling embarrassed, low, anxious, have body image issues or feel socially isolated. These feelings can then impact their skin and it can turn into a vicious cycle.
Rates of depression, anxiety, and suicidal ideation are higher in people with skin conditions than those without. It is worrying that people with a skin condition are engaging in suicidal behaviours, rather than being able to live with their diagnosis.
How can lockdown impact our skin and our mental health?
- Being in lockdown will increase feelings of stress for some people. People with skin conditions are already in a vulnerable group and the added impact of lockdown could further impact their emotional wellbeing. We know from research that stress can directly impact the skin to cause or drive skin conditions
- Conditions commonly impacted by stress are eczema, psoriasis, acne, alopecia and urticaria. I have had to increase the potency of treatment for some patients during this time to control their skin condition.
- On the other hand, there are people with chronic skin conditions that feel better as they have more time for looking after their skin, they can manage their environment better, they may even be less stressed, and they are seeing improvements!
- People with obsessive compulsive disease and repetitive hand washing are finding they are developing severe hand eczema as their anxiety about hand washing increases in response to the threat of COVID19. They may also have an extreme response to the threat of the virus as they have a fear of germs.
- There are specific new onset conditions during COVID19 that I am seeing that could be a result of hygiene practices (e.g. mask-wearing, handwashing, wearing PPE). Conditions on the rise are: allergic contact dermatitis, irritant hand eczema and facial rashes.
How can people prevent a downturn in their skin conditions during long periods of isolation?
Be vigilant. Be aware of your skin and what it is telling you. If you have a skin condition and it is getting worse or flaring, think about stepping up your treatment or discussing it with a healthcare professional. Take pictures to monitor any changes. If you have a new skin problem think about whether the lockdown environment or any new stress or skin practices may have triggered it and seek help.
As we have talked about mental health it is important to maintain your emotional wellbeing, set aside regular time in your day, 10mins or so, this can even be in bed, practise some breathing exercises or muscle relaxation, try mindfulness – anything that can be used to manage stress, for some people this can be your daily exercise, or simply listening to your favourite music. Another important practice is to engage in self dialogue – tell yourself that this time will pass, that you are unique, your skin is telling your story and you are not ashamed. I can go on; the point is that these practices enhance your mood and make you more able to cope with negativity.
If you have a skin condition that is not improving or stopping you from doing the things you want to then please consider discussing this with your GP or dermatologist.
What exactly is psychodermatology? Where can listeners go for more information?
Psychodermatology is the part of dermatology that considers both the mind and the skin together when seeing a person with a skin problem.
A large proportion of the patients I see include those with chronic skin disease (e.g. acne, rosacea, vitiligo) that has a psychological impact (e.g. low self-esteem/body confidence, social anxiety and depression), and those conditions that are impacted by stress (e.g. eczema, psoriasis, urticaria). In addition, I see patients whose skin problems are rooted in psychiatric or psychological distress (e.g. chronic itch, hair pulling, skin picking, nail biting and body dysmorphia, which is a preoccupation with perceived skin flaws).
An example of a patient that I would see is someone with acne that so upset by it they have stopped socialising with their friends, spend hours in front of the mirror examining their skin, feel low and depressed about the way they look, in extreme cases leading to suicidal thoughts. My job in this scenario is to treat the acne appropriately but also explore the psychological impact and advise on how to manage that at the same time.
Psychodermatology empowers patients to recognise and manage psychosocial factors at the same time as treating their skin condition.
For more information you can go to the skin support website by the BAD. WWW.SKINSUPPORT.ORG.UK
Or read my blog to learn more about psychodermatology.
If you are suffering from persistent negative thoughts, or feel like you need to talk to someone straight away about the way that you are feeling, then you might like to get in contact with Mind, Samaritans or Changing Faces, who may be able to help.
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