Introduction
Skin problems and mental health have a strong correlation. Due to the apparent nature of skin problems, which may also induce inferiority complexes, embarrassment, and low self-esteem, people with skin conditions are more prone to experience anxiety and depression. Skin diseases can cause physical discomfort and anguish, which can result in social isolation and a reduced quality of life.
According to the American Academy of Dermatology, acne can result in despair, anxiety, and low self-esteem. An increased chance of getting depression has been associated with psoriasis.1
Sometimes, the psychological discomfort brought on by skin diseases can result in suicidal thoughts or self-harm. Both the physical and mental health effects of skin diseases call for medical attention.
What are the most common skin conditions?
According to the British Skin Foundation, more than 60% of people have skin disorders. Some of the most common skin conditions are fungal skin infections, acne, atopic dermatitis or eczema, psoriasis, contact dermatitis, and rosacea.2
Acne
Acne is a skin condition that occurs when the pores on the skin become clogged with dirt, germs, sebum, or dead skin cells. Although acne can appear everywhere on the body, it is most frequently found on the chest, back, and face. Since the condition is more noticeable on the face, the affected person may have low self-esteem and consciousness as a result. It can present in a wide range of ways, including blackheads, whiteheads, cysts, nodules, papules, and pustules.
A rise in depression, anxiety, negative self-esteem, and poor self-image are all linked to severe acne.3,4 More severe acne cases and late-stage puberty are more likely to experience psychiatric issues including depression and anxiety.5
Eczema
Eczema is a skin disorder that results from inflammation and is characterised by dry, itchy skin that frequently has a red and bumpy appearance . It can also manifest as rashes, scaly patches, and blisters. Since the skin barrier function is compromised, eczema often leads to skin infections.
In the UK, it is estimated that 1 in 5 children and 1 in 10 adults have this chronic skin condition. Eczema, like acne, affects various body areas, especially the face and extremities. The affected person may experience severe distress during the flare-up periods. It has been recognized as a risk factor for the emergence of anxiety and depression.6 Regardless of the severity of their atopic eczema, those who had it were more likely to experience despair and anxiety.7
Psoriasis
The general public frequently confuses the two and uses the terms "psoriasis" and "eczema" interchangeably because of how similar their presentations are, leading many to believe that they are different manifestations of the same disease. On the basis of symptoms and appearance, medical professionals, particularly dermatologists, can distinguish between the two.
Despite having a similar appearance, psoriasis lesions are scaly patches that are thicker and more clearly defined. Psoriasis has a slight itch but a painful, severe burning sensation, unlike eczema which causes intense itching. According to the American Academy of Dermatology, psoriasis is a physically and mentally torturous condition. The vast majority of patients experience severe emotional distress as a result of the disease and report feeling lonely or alienated because of it.8
Effects of chronic skin conditions on mental health
Since they affect emotional well-being and quality of life, chronic skin problems and mental health are closely related and further give rise to the concept of psychodermatology.9 Along with mental health disorders, the documented rise in suicide ideation and intent in people with skin conditions is particularly worrisome.10
Increased prevalence of anxiety and depression
According to the British Journal of Dermatology, compared to 27.3 percent of adults without eczema, 50 percent of adults with eczema have had anxiety or depression diagnosed within the past 12 months or exhibit symptoms of these mental health issues. Anxiety and depression are common mental health issues among adults in the US, but a similar study found a strong correlation between the severity of eczema symptoms and the risk of these conditions.
Decreased self-esteem
Patients with dermatological conditions experience significant anxiety, particularly when acne and skin conditions affect portions of the body that are visible, such as the face.11 As a result, the affected individual suffers from low confidence and shattered self-esteem which lead to social exclusion and isolation.
The problem of sociocultural idealism
The societal ideal of flawless skin and the rise of social media, including the use of filters, have made the stigma and stress even worse, raising grave concerns about mental health. Skin diseases often impact the face, are unappealing, and leave scars that may last a lifetime. Comparing acne patients' levels of social, psychological, and emotional issues to those of patients with chronic, severe asthma, epilepsy, diabetes, joint pain, or osteoarthritis, researchers found that acne patients experienced social, psychological, and emotional issues on par with those of those with these disorders.
If you’re worried about your or your loved one’s mental health
Not just those affected by chronic skin conditions but often their loved ones also undergo significant episodes of anxiety and stress. It has been witnessed that the caregivers of children with atopic dermatitis have a high chance of suffering from anxiety and depression symptoms.12 It has been determined that those who are affected and those who care about them are both equally susceptible to mental health issues, therefore it is crucial to seek holistic treatment that addresses both your skin health and your mental health.
Since mental health issues frequently worsen pre-existing conditions by predisposing the person to flare-ups, creating a vicious cycle, it is crucial that the affected person seek help for these issues. As the state of one's skin deteriorates, so does one's mental health. Additionally, it jeopardises the caregivers' capacity to provide care for the afflicted person.
Summary
Given the substantial link between chronic skin conditions and mental health, which has given rise to the concept of psychodermatology, it is crucial to comprehend this relationship. People with chronic skin conditions and diseases are more likely to experience mental health disorders, which has a detrimental effect on treatment outcomes and terrible effects on a person's social and psychological well-being. To enhance the effectiveness of treatment and maintain a patient's psychosocial wellbeing, it is crucial to address both mental health issues and skin disorders.
References
- Sahi FM, Masood A, Danawar NA, Mekaiel A, Malik BH. Association between psoriasis and depression: A Traditional Review. Cureus [Internet]. 2020 Aug 13;12(8).
- Richard MA, Paul C, Nijsten T, Gisondi P, Salvalastru C, Taieb C, et al. Prevalence of most common skin diseases in Europe: a population‐based study. Journal of the European Academy of Dermatology and Venereology. 2022 Mar 11;
- Hazarika N, Archana M. The psychosocial impact of acne vulgaris. Indian Journal of Dermatology [Internet]. 2016;61(5):515.
- Gallitano SM, Berson DS. How Acne Bumps Cause the Blues: The Influence of Acne Vulgaris on Self-Esteem. International Journal of Women’s Dermatology. 2018 Mar;4(1):12–7.
- Kilkenny M, Stathakis V, Hibbert ME, Patton G, Caust J, Bowes G. Acne in Victorian adolescents: Associations with age, gender, puberty and psychiatric symptoms. Journal of Paediatrics and Child Health. 2008 Mar 10;33(5):430–3.
- Long Q, Jin H, You X, Liu Y, Teng Z, Chen Y, et al. Eczema is a shared risk factor for anxiety and depression: A meta-analysis and systematic review. Yon DK, editor. PLOS ONE [Internet]. 2022 Feb 18 [cited 2022 Jun 21];17(2):e0263334.
- Schonmann Y, Mansfield KE, Hayes JF, Abuabara K, Roberts A, Smeeth L, et al. Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study. The Journal of Allergy and Clinical Immunology in Practice [Internet]. 2020 Jan 1;8(1):248-257.e16.
- Wu JJ, Feldman SR, Koo J, Marangell LB. Epidemiology of mental health comorbidity in psoriasis. Journal of Dermatological Treatment. 2017 Nov 10;29(5):487–95.
