Psychosomatic skin problems (Part 1): How mental health affects skin health

The relationship between mental health and skin health is complex and, in some cases, psychosomatic in nature (connecting both mind and body).

Dr Sue Peacock is a renowned consultant health psychologist based in Bedford and Milton Keynes who specialises in the management of long-term health conditions. In the first of a two-part series of articles on psychosomatic skin problems, Dr Peacock provides an expert insight into how mental health affects skin health, and vice versa.

How is the health of our skin related to our mental health?

The health of our skin can be interconnected with our mental health in several ways.

A few examples include:

• Stress and skin conditions: Psychological stress can impact the health of our skin. Stress triggers the release of certain hormones, such as cortisol, which can lead to inflammation in the body. This inflammation can exacerbate existing skin conditions like acne, eczema, psoriasis, and rosacea. Additionally, stress may cause behaviours like scratching or picking at the skin, leading to further skin damage.
• Body image and self-esteem: Skin conditions can have a significant impact on body image and self-esteem. Skin issues like acne, scarring, vitiligo, or visible skin conditions can affect confidence, social interactions, and overall psychological wellbeing. Negative feelings about one’s appearance can lead to stress, anxiety, or depression, further affecting mental health.
• Social and emotional impact: Skin conditions can impact social life and relationships. People who have visible skin conditions may experience stigma, embarrassment, or discrimination, which can negatively affect their mental health. Feelings of self-consciousness, shame, or isolation can arise, contributing to anxiety, depression, or social anxiety.
• Itch/scratch cycles: Itchiness is a common symptom of various skin conditions. Persistent itching can be distressing, and can disrupt sleep, concentration and daily activities. The continuous urge to scratch can worsen skin conditions and trigger a cycle where the skin becomes damaged, leading to more itching and further psychological distress.

It’s important to know that the relationship between mental health and skin health is complex, and not all skin conditions are solely caused by psychological factors. It’s a combination of genetic, environmental, and psychological factors that can influence both our skin and mental wellbeing. Seeking support from healthcare professionals, such as dermatologists and mental health experts, can be beneficial in managing these interconnections and promoting overall wellbeing.

What types of skin conditions can be linked to mental health?

Some examples of skin conditions that can be associated with mental health include:

• Acne: Acne is a very common skin condition that can affect people of all ages. It’s often linked to psychological distress, including anxiety, depression, and low self-esteem. The visible nature of acne lesions can lead to self-consciousness, social withdrawal, and negative body image.
• Eczema: Eczema is a chronic inflammatory skin condition characterised by itchy, red, and dry patches on the skin. The intense itching and discomfort can significantly impact quality of life and lead to feelings of frustration, irritability, and disturbed sleep. The chronic nature of eczema can contribute to stress and psychological distress.
• Psoriasis: Psoriasis is an autoimmune skin condition that causes the rapid buildup of skin cells, resulting in thick, red, and scaly patches. It’s associated with a higher risk of depression, anxiety, and impaired quality of life. The visibility of psoriasis lesions, the chronicity of the condition, and the potential for pain and discomfort can all contribute to the psychological impact.
• Rosacea: Rosacea is a chronic skin condition characterised by redness, flushing, and sometimes pimples or visible blood vessels on the face. The persistent facial redness and potential changes in appearance can lead to self-consciousness, embarrassment, and negative self-image. These factors can contribute to anxiety, depression, and decreased quality of life.
• Vitiligo: Vitiligo is a condition in which patches of the skin lose their pigment, resulting in white or depigmented areas. The visible nature of vitiligo can lead to emotional distress, self-consciousness, and reduced self-esteem. Anxiety, depression, and social isolation are common psychological experiences associated with vitiligo.
• Hidradenitis suppurativa (HS): HS is a chronic skin condition characterised by painful recurrent abscesses and nodules in areas with sweat glands, such as the armpits and groin. The chronic pain, discomfort, and the impact on daily activities can lead to depression, anxiety, and reduced quality of life.

It’s important to remember that the relationship between skin conditions and mental health is complex, and that the psychological impact can vary from person to person. Seeking support from healthcare professionals, such as dermatologists and mental health experts, can be helpful in managing both the psychological and the physical symptoms of these conditions.

Head on over to the second part of this series on psychosomatic skin problems to find out how psychological techniques and approaches can help manage psychosomatic symptoms.

If you're living with psychosomatic skin problems, don’t hesitate to reach out to Dr Sue Peacock via her Top Doctors profile today to receive expert advice and treatment.