While we all know the saying ‘beauty is only skin deep’, the reality is that many of us deal with real skin conditions that affect our everyday life. With 60% of us in the UK dealing with skin conditions, and more than two-thirds of sufferers saying it knocks their confidence, how can we deal with the emotional impact of living with a skin condition?
Almost all of us deal with bouts of problem skin – whether that’s skin breaking out before our period, or being plagued by flaky, dry skin in the winter months. But for some of us, skin problems are more permanent, like eczema, which affects 10% of UK adults and one in five children, according to the National Eczema Society. Or perhaps you’re one of the 1.1 million people in the UK who live with psoriasis, a chronic skin condition that causes flaky, scaly skin. Keeping on top of these may require various treatments, such as steroid creams or light therapy, impacting your day-to-day life. However, what about the emotional impact of living with a lifelong skin condition?
Skin conditions and our self-esteem
First up, there’s no doubt that having a skin condition can massively impact overall self-esteem, which can have a knock-on effect with many parts of life, such as relationships and socialising. One study in Nursing Research and Practice found that just under half of people with psoriasis felt that others scrutinised and judged them, worrying that people would think their condition was contagious or due to poor hygiene.
“Having a skin condition can have an impact on almost every part of daily life. It can cause feelings of loneliness, shame, and low self-worth, which can, in turn, lead to social isolation,” counsellor Ali Harper, who works with adolescents and adults living with chronic conditions, explains. “As well as often involving the lengthy process of applying multiple creams throughout the day, it can also affect choices around clothing, food and drink, work, socialising, and exercise.
“Skin conditions can have a big effect on romantic relationships, including not approaching potential partners for fear of being rejected, and avoiding being intimate (both because of self-consciousness, and because some people find their condition is exacerbated by close physical contact).”
The role of stress in skin conditions
Whether it’s stress in our lives triggering common skin conditions, or the resulting stress from a flare-up, it’s clear that stress plays a huge role in skin health. It can be a common trigger for lots of skin conditions, including psoriasis and eczema, but with many of us living busy lives, it’s not always easy to keep under control.
The stress can quickly become a destructive cycle, as it can cause a flare-up which can, in turn, also make us even more stressed. And then, of course, this worsens the already inflamed skin – and so the cycle continues.
There are many reasons why living with a skin condition is so stressful. Firstly, it makes life really uncomfortable, whether that’s due to scratching, itching, or dryness. Plus, itchy skin can make it difficult to sleep, which can worsen stress and anxiety, as counsellor Ali Harper notes. “Many skin conditions disrupt sleep which can contribute to impaired memory and cognitive ability, as well as a reduced capacity to regulate emotions.”
Others stress about the consequences of a skin flare-up, whether that’s due to low body confidence and fretting about exposing skin on holiday, or practical implications like missing work.
And it’s these practical implications that shouldn’t be underestimated. For example, a 2021 study of patients with severe eczema, published in the Journal of Dermatology, reported decreased work ability, while other research has found psoriasis considerably influences things like making new friends, travelling, or taking part in leisure activities.
The connection between skin conditions and mental health
Sometimes, the impact on our mental health is more than just feeling stressed. A 2021 report in the Journal of Allergy and Clinical Immunology: In Practice, for example, found that adults with atopic eczema are more likely to develop depression and anxiety, with the severity of the eczema having a stronger impact on depression in particular. Additionally, a study in the journal Cureus reported that an increase in the severity of psoriasis symptoms has also been linked to an increase in depression, with women particularly vulnerable to this. As with any mental health symptom, it’s important to reach out to your GP if you suspect you may have a mental health condition, or are in need of more support.
How to deal with the emotional impact of skin conditions
Finding yourself struggling emotionally due to your skin condition? These tips may help.
Look to others for support
Sometimes, living with a skin condition can feel incredibly isolating, but we promise that you’re not the only one going through it. Finding others in the same boat can be a positive step.
“Join an online forum or group,” Ali recommends. “Seeing pictures of skin that looks like yours, and hearing from others who are experiencing similar challenges can be incredibly helpful.”
Both the National Eczema Society and Psoriasis Association have information about support groups that you can join to connect with others. Similarly, being open with those in your life about your condition and how it impacts your life can help too.
Tackle your stress triggers
While stress is unfortunately inevitable, finding ways to cope with it can be beneficial. Sometimes, that’s as simple as telling someone how hard you find it when your skin flares up.
“Having a good cry, or offloading with someone you trust, is an important way of reducing the stress chemicals that build up in your system, and can help to dampen the inflammatory response,” says Ali, who also recommends exploring other avenues of stress relief as well. “Try something physical (if your skin can’t tolerate sweating, try small bursts of exercise), or jump around to loud music. These are things that take you out of your thoughts, and either connect you with your body, the world around you, or with other people.”
Seek professional help
“The APPGS (All-Party Parliamentary Group on Skin) found that only 18% of those who suffered distress due to their skin condition received psychological support,” says Ali Harper. Yet, if your skin condition is impacting your daily life, reaching out to relevant services – such as talking therapies – can help. “Recognising that what you are managing is hard and that you don’t have to manage it alone can be a huge step.”
While skin conditions are not usually life-threatening, they certainly can be life-altering. There’s no doubt that having a long-term skin condition can impact your mental health, so recognising the role stress has on your skin health, along with finding support and stress-busting strategies that work for you, could be transformative.
Visit eczema.org for support from The National Eczema Society, and psoriasis-association.org.uk for further help related to psoriasis.
