Consultant Psychiatrist

Sometimes in clinic we talk about how the skin can become a battleground.
Perhaps as a territory that is the boundary between ourselves and our surroundings, it is easy to see how this can be. The scratching, picking, rubbing, biting, plucking and squeezing that we can inflict on our skin, hair and nails, represents an emotional energy that is not only a build of frustration, but sometimes is something close to anger. Certainly the damage that gets done as a consequence leaves a scene reminiscent of a battlefield:


Blood is drawn, sometimes with a sense of satisfaction and relief – but this is quickly followed by dismay and guilt as we survey the scene, and an inventory of the damage done is totted up.

Some are perhaps more prone to do all this than others. Add then a condition like atopic eczema, and the recipe is written for habitual scratching, and chronic eczema – a miserable outcome.

Fortunately, like any battlefield, the skin will recover and revert to its previous state if and when peace is allowed to break out. Mother nature can then establish again it’s preferred equilibrium. The skin is resilient. It is an organ that is constantly regenerating itself.

In a few weeks all can be well again. After a few months there can be hardly a sign of what took place. There may not even be a memory of what happened.
A sense of well-being reinforces the new status quo.

Relief all round, especially for the skin!

More about a behavioural approach to atopic eczema with habit reversal at



Dr Christopher Bridgett (DrB) is a specialist in Adult General Psychiatry who has also worked in Dermatology since being first introduced to Psychodermatology by Arthur Rook in 1971. Together with dermatologists Richard Staughton (London) and Peter Norén (Uppsala) he co-authored Atopic Skin Disease - A Manual for Practitioners, which sets out a behavioural approach for the successful management of atopic eczema. Now retired from both NHS and private practice, he continues to teach and advise at Chelsea & Westminster Hospital, London and runs an online community for both practitioners and patients interested in The Combined Approach to the treatment of atopic eczema:

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