More Than Skin Deep: The Link Between Skin Health and Mental Health

 Compared to other medical conditions that are not visible to others, such as high blood pressure and diabetes, patients with skin conditions bear their disease for the world to see, so the psychological and social impact of living with a skin illness can be severe and debilitating. 

Acne, rosacea, psoriasis, eczema, and hair loss are just a few of the skin disorders that have been associated with increased rates of depression, anxiety, and reduced quality of life.

Some of the skin conditions frequently linked to mental health include: acne, psoriasis, and eczema. Here to educate us about each of these is Dr. Lauren Karpinski at Apex Dermatology in Medina.

Acne

The impact of acne goes beyond any pain or scars it leaves. There are mental health factors to consider when seeking treatment as well.

How does acne impact mental health?

Acne can have a negative impact on mental health as it has been associated with decreased appearance-related satisfaction, self-esteem, self-confidence, as well as increased rates of internalizing problems such as anxiety and depression.1

We know people of many ages can suffer from acne. Are the mental health challenges different at different ages?

“Contrary to expectations, depression and anxiety are more prevalent among adults with acne than teenagers with acne. Adults with acne experience more distress due to their acne-prone skin because they “feel out of step with their acne-free adult peers” and because of sociocultural beliefs that acne is only a teenage problem.” 

What can parents of acne patients do to help manage their child’s acne and mental health?

Because acne, especially severe acne, can have associated psychological risks, it should be treated early and appropriately.

“Board-certified dermatologists are expertly trained to be able to provide proper treatment to help patients experience not only clinical improvement in their skin, but also improvement in these associated psychological symptoms and quality of life measures.”

Psoriasis

Psoriasis is fairly common and you may have seen an increase in people online discussing its impacts beyond the physical.

Can psoriasis cause mental health conditions? 

Psoriasis is a systemic inflammatory disease affecting 2% of the population. It products unsightly, scaly, itchy, red plaques on the skin and can also cause arthritic, inflamed joints. Many individuals with psoriasis report feelings of embarrassment, helplessness, and depression. 

They also describe difficulty sleeping, having to alter their daily routines, avoiding social activities, and difficulties with their choice of clothing due to their disease. In a recent National Psoriasis Foundation Survey, nearly 80% of psoriasis patients reported that their disease negatively affected their life. 

“All of these factors affect an individual’s ability to pursue valued life goals. The emotional burden of carrying such a stigma can lead to a significant decline in a patient’s overall well-being.”

What are the mental health conditions that psoriasis patients often suffer with?

“Similar to other inflammatory skin conditions, psoriasis has been associated with increased rates of anxiety and depression. However, patients with psoriasis also have considerable decrements in their physical functioning comparable to patients with other major medical conditions including cancer, arthritis, heart disease, and diabetes.”

They can suffer with psoriatic arthritis, which causes joint destruction, pain, and disability. Recent therapies, including biologic medications, have been shown to improve not only the physical signs and symptoms of psoriasis and psoriatic arthritis, but also patient’s mental health and health-related quality of life.

Eczema

Eczema is another skin condition that can cause difficulty for those with it.

How does stress impact eczema and other skin conditions?

Eczema is characterized by severely dry, tight, red, itchy skin that can cause sleep disturbances, loss of self-esteem, loss of self-confidence, and an overall severe “discomfort in one’s own skin”. 

“Stress, whether it be physical or emotional, can cause exacerbations of many different types of skin conditions, particularly eczema. When we experience stressful situations, our body produces stress hormones such as adrenaline and cortisol, which can in turn affect how well our immune system is able to control inflammation.” 

How do others impact the emotional well-being of patients with eczema?

Have you ever wondered why someone might choose to wear long sleeves and long pants in the middle of a heat wave in the summer? Or why a friend of yours never wants to visit the beach? 

“Believe it or not, many individuals with chronic skin diseases report having been asked to leave public places such as a community recreation center or pool when their condition was mistaken for something contagious. While you may be curious, it is critically important to be supportive of friends and family with chronic skin diseases.”

If you, your child, or someone close to you has experienced some of the following symptoms for two weeks or longer, they may have depression and should consult a health care provider as soon as possible: feelings of sadness, anxiousness, or hopelessness, loss of interest in previously enjoyed activities, loss of energy, feeling tired more often, difficulty concentrating, difficulty sleeping, weight loss, or thoughts of death or suicide.

 

Even though we have spent a great deal of time talking about how chronic skin disease and mental health issues can go hand-in-hand, it is most important to note that patients experience tremendous improvements in all of these symptoms, physical and mental, with proper treatment. If you are suffering, please don’t wait, reach out to a dermatologist close to you to discuss options. There are many. It just might change your life.

Dr. Karpinski grew up in Brecksville, Ohio and attended Miami University for her pre-medical training. During her time at Miami University, she studied Zoology and Neuroscience and received multiple awards for her research in the field of Neurobiology. Dr. Karpinski returned to Northeast Ohio to attend medical school at Case Western Reserve University School of Medicine. Her interest in Dermatology quickly became her passion, and she delved into research focusing on new and innovative techniques for pre-cancer and skin cancer treatment.

Dr. Karpinski then completed her Transitional Medicine/Internal Medicine Internship at Summa Akron City Hospital and her Dermatology Residency at University Hospitals of Cleveland. During her Dermatology Residency, she continued her research endeavors with a hospital-wide project that helped to improve the care of patients with chronic skin conditions of the lower legs. Dr. Karpinski trained with several leaders in the fields of medical, aesthetic, and surgical Dermatology. She sees both adult and pediatric patients for a wide variety of skin conditions.