“Mind over matter,” they say. Very true, if one were to look at the many ways in which the mind decides how bodies should behave, especially when it comes to several psycho-somatic ailments that are commonplace these days. Dr Swati Watwani, noted Cosmetologist-cum-Ayurveda Practitioner, analyses the psychological dimensions associated with certain skin conditions and the need to address them.

During my professional career as a Cosmetologist, I’ve dealt with scores of patients having various skin and hair concerns and about 60 per cent of them were suffering from stress-related issues. People with persistent Eczema (cracked, dry and itchy skin), stubborn Acne (pimples), chronic Psoriasis (scaly and flaky skin), Recurrent Herpes (shingles) and Vitiligo (white patches) present me with their underlying skin conditions. They are treated with the best of emollients, lotions, creams and the wonder drugs like steroids and Vitamin A derivatives to cure the ailments. But despite making recovery, the trauma lingers on in the minds of some of them.

Just as stress can make your heart beat faster and the blood pressure to shoot up, fear or embarrassment can make your skin turn pale. One’s skin is often utilized consciously or subconsciously as an outlet to relieve tension. Emotional conflicts, anxieties and other stresses can trigger and aggravate your skin problems. No one is immune to emotional stress.

Mind and body functions as a unit and a holistic well-being means both should be robust. To treat one and ignore another is often fraught with failure. Hence a combined therapeutic approach is often needed to get complete relief from many chronic skin disorders.

Here are a few psychological and psycho-social impacts reflected in patients with chronic skin ailments:-

1. Acne and Social phobia

 The age of adolescence is a time of identity formation. Some tend to develop severe Acne Excorie (a form of acne which develops specifically after picking up pimples on a day-to-day basis) at this stage. Skin under stress produces more sebum (oily discharge) which results in clogged pores and aggravates Acne. For a teenager, the condition isn’t just a cosmetic issue, but one that can affect their self-esteem (especially among females). Apart from the social phobia, these persons often tend to be annoying and express symptoms of social withdrawal.

2. Eczema and strained family relationships

Family relationships often get complicated in persons suffering from Eczema. A lot many attach importance to physical appearance. The chronically inflamed, crackled, dry and itchy skin can cause much anxiety and depression in them. Sleeplessness due to scratching, which worsens at night, leads to fatigue and increased psychological distress. These patients are burdened with thoughts on how to hide their disorder through make-up or clothing. All these result in strained relationships.

3.  Vitiligo and the fear of social rejection

Vitiligo leads to a serious sense of disfigurement and disempowerment. In Asian societies, patients are not only found to face rejection from family and society, but also develop a ruined or weakened sense of identity. In Saudi Arabia, Vitiligo is still considered as contagious. In India, vitiligo is considered as one of the major barriers to marriage, due to which many do not disclose the disorder to their spouses before marriage for fear of rejection. There are many cases when patients, especially females from rural areas, are encouraged to divorce if not cured of the condition. Such patients could soon suffer from depression and may exhibit suicidal ideation.  

 4. Coping with Psoriasis at work

Patients of Psoriasis face both physical and psycho-social impairment, which affects their work life. This is more so in the case of those suffering from Palmoplantar Psoriasis (a chronic form of Psoriasis which mainly affects the palms and soles). Their day-to-day activities are affected due to the pain felt while using their hands and feet which affects their productivity. This again causes stress. The misconception in society that the condition is infectious often results in social alienation of such patients. The multidimensional impact of the disease encompasses work difficulties and social limitations along with family dysfunction.

Here are a few tips to tide over the mental trauma associated with skin disorders:-

Proper sleep – A good sleep is vital to a healthy immune system, and also key to treat skin conditions.

Take in more water and less sugar. Also pile your plate with plants, veggies, fruits and fish to keep mood disorders, depression and chronic skin issues at bay.

Spend your time well -- spending some time doing things that you enjoy the most like chatting with a friend or visiting your favourite place, enjoying your favourite meal and the like can tame tension and raise levels of feel-good brain chemicals called endorphins.

Exercising at least thrice a week lifts spirits which in-turn helps to ease the symptoms.

Mindfulness and guided relaxation sessions can help you build skills to manage stress and explore ways to deal with physical and emotional pain.

Yoga and breathing exercises – powerful tools for preventing the onset of depression and anxiety.

Journaling – writing is a powerful way to focus your thoughts.

Habit reversal – it mainly involves the process which helps to reduce or break habits that worsen your skin conditions such as over scratching of skin or picking up the skin lesions. (preferably to seek the help of a therapist)

Visual imagery –visualizing positive emotional scenarios elicits stronger and more positive reactions in mind.

Cognitive behavioural therapy – a form of talk therapy with focus on monitoring negative thought patterns and to effect a change in your feelings and behaviour. You can also ask your doctor to recommend a therapist for the same.

(Dr Swati Watwani is the Medical Director and Chief Consultant at Persianlily - Skin /Hair /Cosmetology /Ayurveda), Esthetician, Cosmetologist and Ayurveda Consultant. She can be contacted at swatiwatwani92@gmail.com; Ph- 7020793108)