We’re all aware of our diet’s impact on our skin, but what about our mind? The human mind is the most complex structure in the universe, and throughout our life, we will experience a vast array of emotions that can affect our health in many different ways. The growing field of psychodermatology explores the complex relationship between the brain and our biggest organ – the skin – to reveal how our emotions can impact a range of skin disorders such as acne, eczema and rosacea.
With so many of us now battling stress and anxiety in our daily lives, what are the dermatological consequences, and how can we manage them effectively?
What is psychodermatology?
Psychodermatology is a relatively new concept that describes the interaction between the mind and the skin. The idea is that your emotions can impact the health of your skin and vice versa, meaning that psychological treatment can help you cope with and treat a skin disorder alongside traditional medication.
The field of psychodermatology is becoming increasingly understood after originating here in the UK around a decade ago. Since then, psychodermatologists have been working hard to develop our knowledge of how our emotions and the nervous system interact. Psychodermatology empowers patients to recognise and manage their emotions at the same time as treating their skin condition.
How does your mood affect your skin?
To put it simply, tricky feelings go hand-in-hand with skin issues. Thanks to the body’s hypothalamic-pituitary-adrenal (HPA) axis (our central stress response system), it will trigger the production of hormones such as cortisol when the body senses stress. The skin has its own HPA system, which can trigger it to produce hormones including cortisol, adrenaline, and testosterone, all of which can cause a cascade of reactions that lead to an inflammatory response, increase oil production, delay healing and disrupt the delicate skin barrier.
Research has also shown that cortisol can lower the energy metabolism of your skin cells by up to 40%, and therefore reduce their ability to respond to stress and the resulting damage.
What impact can this have?
Stress is linked to a wide range of skin disorders such as acne, eczema, psoriasis, rosacea and premature ageing, but these conditions can also damage your mental health, creating a vicious cycle. For this reason, psychodermatology is so important because the less we can stress, the better our skin health will be.
Let’s look at how stress can trigger some of the most common skin disorders and how we can combat them for healthier skin and a healthier mind.
Rosacea is commonly misconceived as a scattering of red patches on the forehead, nose, cheeks and chin, but it can also be accompanied by dryness, burning, stinging, and small red bumps known as papules. It’s a chronic condition that affects approximately 10% of the population and is more common in women aged 30 to 60 and in individuals with fair skin or blue eyes.
While the root cause isn’t fully understood, dermatologists believe that a disrupted immune system and genetic predisposition can make you more susceptible. Too much exercise, temperature changes, spicy foods and stress can also cause rosacea to rear its head. Learning and avoiding your triggers is key. Keep a diary so you can track yours, see a professional for your skincare, and take supplements such as probiotics, collagen and omega-3.
Around 2% of the UK population suffer from this chronic autoimmune condition, in which the immune system attacks healthy skin cells by mistake. A typical skin cell cycle lasts three to four weeks, but in those with psoriasis, the skin regenerates up to five times faster. This results in visible redness and scaling of the skin, commonly affecting the elbows, knees, buttocks and scalp.
Stress can play a role in triggering psoriasis, as cortisol can suppress the effectiveness of an already compromised immune system. It can be controlled but not cured. Minimising stress and other external triggers like alcohol consumption can help to ease it. Other options include:
- Light therapy.
- Synthetic vitamin D cream.
- Immunosuppressants to reduce inflammation in the body depending on the extent and severity of the condition.
Atrophic dermatitis, as it’s officially known, is an inflammatory condition that leaves the skin red, itchy and abnormally dry. Caused by an overactive immune system and abnormal skin barrier, eczema most commonly affects the backs of the knees, the neck and the insides of the elbows, as well as the scalp and face.
The exact cause of the condition is unknown, but it’s thought to be linked to an overactive response by the body’s immune system to an irritant. When this occurs, cortisol levels usually increase, ramping up inflammation throughout the body, including the skin. To manage eczema effectively, targeting stress is crucial, as well as identifying any other triggers, such as pets, pollen, dust, and food sensitivities.
Topical treatments like calming moisturisers, prescription medications and light therapy can all help.
According to the NHS, 95% of people will be affected by acne between the ages of 11 and 30 to some extent. It appears as whiteheads, blackheads, cysts and under the skin spots on the face, back, neck and shoulders, and can also lead to post-inflammatory hyperpigmentation and pitted scars.
Acne is mainly genetic but can also be triggered by stress, hormones and diet, or using products that block the pores. Like other visible skin conditions, it can have a significant impact on emotional wellbeing. As acne and stress can reinforce each other, breaking the cycle is crucial.
Skin hygiene is critical, and any routine must include cleansing morning and night using medical-grade cosmeceutical products. Topical treatments such as retinol, salicylic or glycolic acid can be excellent for treating acne as they each work to speed up skin cell renewal and reduce oil production. If the acne is severe or products fail to bring spots under control, the next step is usually to explore medication prescribed by a dermatologist or GP.