Mind Skin Connection in a Nutshell
Have you ever wondered if the acne you cannot get rid of is not just a result of raging hormones? Or the dry and itchy skin you get occasionally is not only because of your soap? Or the rash that keeps re-appearing every now and then is not because of an allergy?
Well, if you did, you are on the right track. While there could be a thousand reasons behind a skin condition, scientists are now agreeing that your own mind can be one of the culprits.
Exploring the connection between mental health and skin conditions is a relatively novel field of interest. It is even given the fancy name: psychodermatology. Psychodermatology has three main areas of focus.
- How mental health conditions can cause skin diseases
- How mental health conditions can worsen existing skin conditions
- How skin deformities can cause stress and anxiety
For those who are reluctant to believe that something as simple as your emotions can affect the skin, here is a simple example. When you are embarrassed, the colour of your skin changes with the dilation of small blood vessels near the skin, a phenomenon we call blushing. In a similar manner, emotions and mental health can affect the appearance and health of your skin. Your mind literally controls every single organ in your body, and the largest of them, the skin, is no exception.
Science behind mind – skin connection
Especially mental conditions like stress and depression are reflected through skin. It is known that these mental health conditions are capable of exerting an adverse effect on the immune system. Scientific research shows that depression can cause increased inflammatory activity of the immune system.1 Inflammation is a protective mechanism in the body that helps the immune system to fight against harmful stimuli such as pathogens and irritants. It protects body tissues from them. It is mediated via release of substances called inflammatory cytokines. Even though this process is helpful under normal conditions, it can be harmful when excessively or unnecessarily activated.
Furthermore, stress hormones such as adrenalin and cortisol, which are released in anxiety play an important role in dermatologic conditions. A recent study proves both these facts result in deformities of immune cell membranes, altering the structure and function of them.2 Especially the hormone cortisol can suppress the immune system. Being the main stress hormone of the body, it has the ability to impair normal function of the skin and the body’s ability to keep inflammation under control. Consequently, it paves the way to different diseases, including skin conditions.
Common skin conditions can be:
Is acne a result of stress?
Acne is a condition we all have experienced at some stage of life. While it is more common among teenagers, it is not restricted to a certain age group. Most commonly, it can be seen on the face, but it is not rare to find acne on upper back, shoulders, neck and arms.
Acne is a result of blocked pores, most commonly hair follicles stuck with oil or dead skin cells. There is a wide range of factors that can cause acne, including hormonal changes and bacteria. Stress and anxiety are two factors that directly affect the hormonal levels of the body. Therefore, the psychological status of a certain individual could be the major contributor to acne.
It is more significant how acne can result in deteriorating the emotional wellbeing of patients who are chronically or severely affected. Most struggle with reduced self-esteem and self-confidence, while a minority can develop depression and more severe mental health issues. Especially, when fully grown adults are subjected to this, they express feeling insecure among their peers who have become free of the typical acne outburst of the young age. It can cause a setback in the social involvement of these people, ultimately reducing their quality of life.
Most people tend to use home remedies and as a result they may end up causing even more harm to their skin. To get rid of acne, it is important to modify your lifestyle in a way that gives you less stress, and do not hesitate to consult your doctor if the acne is uncontrollable or abnormally long lasting.
Acne Excoriee des jeunes filles
Acne Excoriee des jeunes filles or excoriated acne are a type that is especially noteworthy, not only because of the very fancy name it has, but also because of the very strong mind and skin connection it shows. In mundane terms, this happens when you repeatedly pick at your acne. This leaves you with scarred or scratched skin, red bumps and sores.
People tend to do this because of various reasons. The simplest one is, human urge to pick at imperfections, which in this case is the skin lesions. In some people, this might be a direct result of anger, self-loathing or rebellion, while in others there can be more severe psychopathologies such as borderline personality disorders. In this condition, the treatment plan is largely based on correcting the underlying psychiatric condition.
This is another perfect example for your mind causing your skin trouble. Patients are under the false belief that they are infested by organisms such as fleas and fungi. They feel a crawling sensation under the skin and misinterpret scabs and skin lesions as parasites. In a desperate attempt to get rid of these imaginary parasites, they scratch and tear at the skin, and some even use insecticides and antiseptics.
The result is ulcers, excoriated skin and wounds in various body parts. Even though the condition is not common, when present it can even be suicidal.
Psoriasis is a condition where you get dry, scaly and raised patches of skin, called plaques, which often tend to be sore or itchy. The white flakes commonly seen on the surface are a result of rapid multiplication of skin cells that gets accumulated on the skin without being shredded. They most often appear in knees, elbows, scalp, and lower back, but they can also appear in other parts of the body. Genetic depression and stress are known triggers of this condition. How does it happen? Well, the explanation is simple.
Psoriasis is a long-lasting inflammatory condition. Normally, your body can keep this inflammation in check by careful balancing of certain hormone levels. But stress disrupts this balance by releasing a lot of stress hormones. This leads to increased inflammation, which can cause, or exacerbate the existing psoriasis.
Furthermore, psoriasis patients tend to get dispirited by their skin condition, which adds up to the stress level. And that way it goes on in an unending vicious cycle, causing the condition to become worse and worse.
While eczema might look similar to psoriasis to the untrained eye, they are two different skin conditions. Eczema causes the skin to be dry and itchy, often on the face, back of the knees or inside the elbows. Also, this is more common in babies and toddlers. This happens when your skin is excessively responding to minor irritants, causing inflammation.
Recent studies have shown the involvement of emotional stress and psycho-neuro-immunologic factors in the evolution of eczema.3 To understand the mechanism of this, you need to know a concept named ‘the barrier function of the skin’. The barrier function of the skin is what helps us keep water from excessively vaporizing out from the body through skin. Both internal and external stressors can impair the barrier function of the skin. As a result, in this condition the skin gets dry and consequently, prone to inflammation.
Hives are another type of rashes that can appear on the skin. It can be identified by the raised welt-like patches of reddened skin that tend to be itchy or stingy. Urticaria is another name for hives. Most of the time they arise because of allergies. But among a lot of other factors, stress is also an inevitable cause for this skin problem.
The substance called histamine is responsible for most of the symptoms of hives, and that is how it is linked to mental health. Histamine secretion increases stress. This trigger hives.
Rosacea is another dermatology related condition that could arise because of extreme emotional conditions. If you have following symptoms, you might have rosacea: flushed or blushed skin especially at the center part of the face, burning sensation and tenderness of the area that is affected, and damaged small vessels close to the skin that become visible called as spider veins. And also, there can be small bump-like swellings which may or may not be filled with pus that can be easily mistaken as acne. Up to 58% of rosacea patients also experience various degrees of eye problems.3
Stress is a well-known trigger for rosacea. It has been reported in several clinical surveys that there is a direct connection between rosacea and extreme emotional states.5 The mechanism is through increased inflammation.
Anxiety and skin burning
The burning sensation of the skin is one of the common signs of anxiety and stress. People suffering from continuous panic attacks also experience this. It is important to note that burning sensation can be triggered from other causes as well, such as menopause.
The mechanism of how anxiety leads to this condition is similar to other conditions we have discussed before. Anxiety is an internal stress, and it turns on the fight or flight mode of your body. That is the normal response to any kind of stress, regardless of whether it is physical or emotional. That causes a surge of the hormone called adrenaline, which is a stress hormone capable of worsening the burning sensation.
Malignant melanoma is a rare type of skin cancer. It has a strong genetic predisposition, which means if your parents or ancestors had melanoma, there is a risk of various triggering factors causing the disease in you too. There is evidence melanoma is more common in individuals with stressful occupations. In a case study conducted among melanoma patients, all subjects had encountered psychological stress factors briefly before being diagnosed with the condition.6
The hormone called norepinephrine is involved in causing melanoma. Norepinephrine release is increased without proper regulation in stress. This hormone can increase substances called cytokines, especially the subcategory: interleukins 6 and 8, which promote tumor growth. Therefore, both formation and progression of this disease is unarguably linked with poor mental health.
How does it affect a patient’s quality of life?
One can argue that skin conditions are the worst type of disease to bear. Unlike most other diseases, skin conditions are out in the open for everyone to see. As a result, it is surrounded by an alarming degree of social stigma.
Perhaps this is the very reason why people who are experiencing depression or despondency feel a need to conceal it from the world. Even though mental health issues are illnesses just like any other physical illness, you feel the need to hide it. For people like that, mind – skin connection is very inconvenient. Besides, it can be extremely annoying when every stranger you meet starts commenting on your acne or eczema and suggesting new treatments that worked really well for their relatives.
Dr. Ted Grossbart, a psychologist at Harvard Medical School explains the impact of rosacea on patients saying, “especially because this condition is not widely understood, it can leave its victims feeling isolated and even alienated from society.”
So, these patients tend to distance themselves from society. This causes a major setback in their lives in general. They lose self-satisfaction about their own appearance, and in some cases might even generate a negative outlook on life. So, it is very important to seek professional aid if you feel burdened by your skin conditions. Because worrying about your skin is only going to make it worse.
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Can treating your mind help with your skin?
Research shows approximately one third of patients with dermatology problems are suffering from some sort of mental health issue.7Therefore, scientists have accepted the possibility of curing the skin by treating the mind.
In fact, recent scientific studies have proved that stress management methods are effective in treating and controlling the flares of different skin conditions, including dermatitis and psoriasis.8 As a result, various psychological and stress relieving treatments have now come in to play as effective means for treating dermatology problems.
What can you do?
The best solution would be to avoid stress altogether, but it is next to impossible to do that. But you can find ways to reduce stress and minimize the effect it has on your skin. There are simple methods that you can practice reducing stress, such as meditation, yoga, talking about your problems, relaxing and getting your beauty sleep every night. Proper exercise and adequate hydration are also important to keep your skin healthy. They activate and properly regulate the natural immune mechanisms that protect your skin.
Finally, remember that it is only the scar outside you can see. But it is possible that you are scarred both physically and mentally. Most of the time, what you cannot see is the more severe of the two. So, take good care of both your skin and your mind. And most importantly, never let some acne or a simple rash decide how you live your life!
- Lee, C. H., & Giuliani, F. (2019). The Role of Inflammation in Depression and Fatigue. Frontiers in Immunology, 10, 1696. https://doi.org/10.3389/FIMMU.2019.01696
- Walther, A., Mackens-Kiani, A., Eder, J., Herbig, M., Herold, C., Kirschbaum, C., Guck, J., Wittwer, L. D., Beesdo-Baum, K., & Kräter, M. (2022). Depressive disorders are associated with increased peripheral blood cell deformability: a cross-sectional case-control study (Mood-Morph). Translational Psychiatry, 12(1). https://doi.org/10.1038/S41398-022-01911-3
- Arndt, J., Smith, N., & Tausk, F. (2008). Stress and atopic dermatitis. Current Allergy and Asthma Reports, 8(4), 312–317. https://doi.org/10.1007/S11882-008-0050-6
- Knox, C. M., & Smolin, G. (1997). Rosacea. International Ophthalmology Clinics, 37(2), 29–40. https://doi.org/10.1097/00004397-199703720-00004
- Stress Management Can Play Key Role in Rosacea Control | Rosacea.org. (n.d.). Retrieved January 1, 2023, from https://www.rosacea.org/rosacea-review/2017/winter/stress-management-can-play-key-role-in-rosacea-control
- Sinnya, S., & De’Ambrosis, B. (2013). Stress and melanoma: increasing the evidence towards a causal basis. Archives of Dermatological Research, 305(9), 851–856. https://doi.org/10.1007/S00403-013-1373-2
- Connor, C. J. (2017). Management of the psychological comorbidities of dermatological conditions: practitioners’ guidelines. Clinical, Cosmetic and Investigational Dermatology, 10, 117. https://doi.org/10.2147/CCID.S111041
- Graubard, R., Perez-Sanchez, A., & Katta, R. (2021). Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatology Practical & Conceptual, 11(4), 2021091. https://doi.org/10.5826/DPC.1104A91
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The Specialist doctor from the University Hospital in Gothenburg, alumnus UC Berkeley. My doctoral dissertation is about Digital Health and I have published 5 scientific articles in teledermatology and artificial intelligence and others.