From acne and rosacea to eczema and pigmentation, if you have experienced any kind of skin issue, you'll know that the effects are more than just skin deep. Research highlights the distinct link between mental health and skin problems, and for many of us, the emotional toll is often one of the most difficult symptoms to deal with. Especially when it feels as though no one is listening or even understands.
Recently, however, professionals are shining a light on skin and mental health and pushing for positive change. A new survey undertaken by the British Skin Foundation found that nine in 10 dermatologists agree that not enough importance is placed on the psychological effects of skin conditions, acknowledging that patients often feel that they are "not listened to or understood by their healthcare providers."
According to Dr Anjali Mahto, consultant dermatologist and British Skin Foundation spokesperson, people who experience skin conditions suffer with greater stigma and discrimination. Unfortunately, that's not all. "Acne, for example, is associated with depression, low self-esteem, poor body image, bullying, shame, exclusion in the work place and even suicidal ideation," she wrote on Instagram recently.
GP and aesthetic doctor Zoya Diwan of Trikwan Aesthetics believes that the pathway to feelings like these is always multifactorial but that they can affect our day-to-day lives significantly. "Many patients complain about difficulty in leaving the house, lack of confidence in their jobs and relationships and the daily effect skin can have on their mood," she said.
Dr Mahto continued that even though it is 2019, skin conditions are commonly overlooked as simply a cosmetic problem, with Dr Diwan agreeing that skin is often seen as a 'vanity issue' by many. "This is such a shame, as studies show that medical treatment for acne can improve many of these mental health symptoms," said Dr Mahto. If you follow Dr Mahto on social media, you'll know that she has had acne for many years herself, and has experienced firsthand just how skin issues such as these can be detrimental to one's mental health. "Even when your skin clears up or is going through a 'good period' you live with uncertainty and fear about when your next flareup will occur," said Dr Mahto. "As an adult, people tell you how well you are doing professionally, but you judge your own success by the state of your skin that day."
This is something rosacea beauty blogger and British Skin Foundation ambassador, Lex Gillies seconds. "After my first GP appointment, I felt devastated," she told R29. "I left with little to no information, a medicated gel (which felt like it was burning through my skin and subsequently made everything worse), and feeling like I’d wasted the doctor’s time with something so superficial."
What can be done to ensure that the emotional implications of skin issues are taken seriously? "Clearly, we need more research that looks to develop effective psychological treatments or support for both children and adults living with skin conditions," said Dr Andrew Thompson, reader in clinical psychology and practitioner clinical psychologist at the University of Sheffield, Sheffield Health and Social Care NHS Foundation Trust. Dr Mahto, who believes it is a large part of her role as a dermatologist to ask how a client's skin actually makes them feel, says that we need to be much more open when discussing skin. "We need to get better at recognising mental health issues associated with skin disease. There are good treatments, understanding GPs and dermatologists who can and are willing to help you."
Early referral and treatment is key, says Dr Mahto, not just to treat the issue but also to deal specifically with the negative psychological effects that untreated skin disease can cause. Dr Diwan added: "People really need to feel that talking about their skin concerns is okay. There should be no stigma or judgement."
Dr Alexandra Mizara, consultant psychologist and British Skin Foundation spokesperson advises that if you suffer with a skin condition that has impacted adversely on your life, talking openly about it to your doctor and asking them to refer you to a psychologist should be your first port of call.
Speaking openly and truthfully about your skin with a qualified dermatologist (always research their credentials on the General Medical Council register) is also recommended, but going private is often expensive. In that case, it might be helpful to visit your GP first to request a referral if they are unable to suggest treatment. You can read more about how to talk to your GP about skin issues and how they may be affecting your mental health here.