Mental Health Articles

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* Understanding Pyschodermatology - how skin conditions can affect body image*

You are a Consultant Clinical Psychologist, when and why did you start to relate psychology to skin?

My interest in skin conditions started when I was completing my clinical psychology training back in the 1990s. I was interested in understanding how the stigmatisation of visible conditions might affect social confidence. Over time I have become quite passionate about supporting people living with a range of skin conditions, and I have worked with a number of charities and professional bodies to do this.

You were involved in supporting a parliamentary report looking at psychological aspects of skin conditions, can you tell us a little bit about what it found? 

I worked with a team to collect and analyse data on the effects of skin conditions on adults and children, it evidenced that troubled skin is a key source of distress. The report also found that access to support across the UK is very limited and not fairly distributed - a challenge which has faced the system for at least the last ten years. As a consequence, the report called for urgent improvements in services which went on to be raised in the House of Commons. 

Has awareness of psychodermatology increased throughout your career? Why do you think this is?

I think research into the relationship between the skin and the mind has grown over the last twenty-five years. This is very positive and has been a result of excellent multi-disciplinary research carried out by a number of NHS and University centres. Increasing awareness has also been driven by patient groups and charities, such as Changing Faces, which have raised awareness of the wider impacts of skin conditions.

How can skin conditions affect people's mental health?

Skin conditions can affect mental health for a variety of reasons. The impact of the conditions themselves can be the source of stress, whether it be as a result of worrying about the visible nature of the condition, or concerns about other symptoms such as itching and pain. In addition, people can experience actual discrimination, bullying, and stigmatisation due to their skin condition which can be the main trigger for decline in mental health. 

How do you teach people to value their skin, despite having skin conditions?

Where a skin condition is affecting self-esteem, people can benefit from a range of simple self-help techniques which can boost confidence and challenge unkind thoughts associated with skin-related-low mood. 

Arousal reduction techniques can also be useful in managing stress, and techniques such as mindfulness and learning how to be compassionate towards oneself can also be immensely helpful. 

Finally, we know that both anxiety and depression can be managed with psychological therapy. People shouldn't be shy about seeking support from a clinical psychologist or other mental health professionals when needed.

Why is a more holistic approach to skin management so important?

The relationship between the mind and skin is complex. Patients must have the full impact of their skin condition assessed and, where necessary, have access to additional psychological support. Core dermatology staff are interested in supporting their patients' holistic needs and can use a range of psychological techniques to help. So, patients must not be reticent to be honest about the full impact of their condition.

What are your top three tips for being more self-compassionate when it comes to skin management?

• Realise that you are not alone: Lots of people feel the same way about their skin condition as you do. Why not check out some of the skin charity websites and forums and join a conversation about your skin and how it makes you feel? 
• Notice and recognise your skin-critical thoughts: These thoughts are not facts. Ask yourself 'Would I say this to a close friend?', and try to treat yourself more fairly. 
• Shift your thinking: When you realise you are being particularly critical of your skin, take a step back and acknowledge the other great things your body does for you and replace the critical thoughts with positive ones. 

It's easy to be critical about being critical, becoming more self-compassionate towards your skin takes time, so make sure you give yourself time to adjust.