Stress, depression and anxiety which roots from brain can directly influence the overall health of the skin. The fact that stress can damage skin in many a ways and trigger acne and psoriasis is known to many. But it would be of interest to learn that the relationship between brain and skin is two way. Not only does the hormones triggered by brain affect the skin, but the appearance of our skin which at times can cause shame, poor self-image, and low self-esteem can significantly impact our mental health and emotional well-being. The relation between brain and skin is not just about stress alone, but this relationship starts from embryonic stage. The fact is both skin cells and brain cells develop from the same kind of embryonic tissue, called ectoderm.
The relation between these two is so complex and intriguing that it has paved way to a new discipline all together called Psychodermatology. Psychodermatology is a field of dermatology which studies about link between the mind and skin. This field brings together two major medical specialties, namely, psychiatry and dermatology. Psychiatry treats mental processes manifested internally, while dermatology treats skin diseases manifested externally.
Psychiatric factors indeed plays a crucial role in the course of skin conditions. Research says emotional triggers can spiral up skin problems from approximately 50% (acne) to greater than 90% (rosacea, alopecia areata, neurotic excoriations, and lichen simplex) to may be 100% for patients with hyperhidrosis. The most common psychiatric symptoms attributed to skin problems include problems with body image and unexpected changes in social and occupational functioning. To treat these diseases together known as Psychophysiologic disorders, it is essential to evaluate along with the skin manifestation, the social, familial and occupational issues. Stress management, relaxation techniques, benzodiazepines, and selective serotonin reuptake inhibitors (SSRIs) have been found useful to treat these problems effectively.
Primary psychiatric disorders are another class of Psychodermatology disorder. They are encountered less often compared to psychophysiologic disorders. Most of these disorders occur related to somatoform disorder, anxiety disorder, factitious disorder, impulse-control disorder, or eating disorder. Patients may hurt themselves and create wounds by rubbing, scratching, picking, cutting, punching, sucking, or biting. Trichotillomania is common among this disoders. In Trichotillomania, patients continuously pulls out one’s hair, resulting in noticeable hair loss. The challenge in managing patients with these disease is in introducing the use of an antipsychotic medication without making them feel offended.
The next class of disease that comes under Psychodermatology is Secondary psychiatric disorders.In this case the disease in itself won’t be life threatening, but the disfigurement caused by skin disease pushes one into depression, social phobia and anxiety. Vitilgo is one such disease. This disease is associated with more psychological and social embarrassment than any other skin condition.
To treat these skin diseases effectively in addition to drug, doctor must also look into improving sleep, and managing psychiatric symptoms such as anxiety, anger, social embarrassment, and social withdrawal. It is advisable to include healing therapy including psychotherapy, hypnosis, relaxation training, biofeedback, cognitive-behavioral therapy, meditation, affirmation, stress management etc.