THE INVISIBLE SIDE OF SKIN CONDITIONS: MENTAL HEALTH AND THE ROLE OF HYPNOTHERAPY

Our skin is the largest organ of our body. It is not just the physical barrier to protect us from the world; it also influences how we are perceived in society. Our self-esteem, our ability to exercise or be intimate, to wear clothes, sleep and who we see when we look in the mirror. Our identity. As a hypnotherapist who has struggled with eczema and been bed bound with TSW (topical steroid withdrawal), I realised that finding the right products to promote physical healing was only half the battle. Skin conditions can cause invisible scars. The anxiety of people’s stares, the depression of isolation and low body image, the fear of potential flares and triggers. Eczema sufferers are 44% more likely to experience suicidal thoughts! (1) It is not just a cosmetic issue. 60% percent of people with psoriasis reported it causes a large problem in their everyday life. (2) The lack of specific mental health support for the skin community caused me to change careers and go from marine biologist to hypnotherapist. Hypnotherapy offers a powerful tool to address the hidden mental toll caused by skin conditions.

THE PSYCHOLOGICAL IMPACT OF SKIN CONDITIONS

Skin conditions such as acne, eczema, psoriasis, and rosacea can severely impact a person’s self-esteem and body image. They are often hard or painful to hide. Trying to do so also encourages the notion that it’s something that should be hidden, which creates a barrier to accepting the condition. Individuals with skin conditions often experience social anxiety and may withdraw from social interactions to avoid judgement.

Over 70% of people with eczema say it impacts their social life. This isolation can lead to feelings of loneliness and depression (3). The fear of being judged based on their appearance can make individuals avoid social situations altogether, impacting relationships and increasing stress. In fact, a 2022 research review indicated that people living with psoriasis are 1.5 times more likely to experience depression and anxiety than people without psoriasis (4).

Skin conditions impact sleep too. Unable to get comfortable, people lack good quality REM, which decreases our emotional regulation, focus and motivation. This can lead to irritability, poor memory and self-control. This can impact people’s ability to work, leading to more stress, or burnout if they force themselves to work while mentally exhausted. Stress is known to trigger or exacerbate many skin conditions. For example, psoriasis flare-ups are often linked to periods of high stress. The relationship between stress and skin conditions can become a vicious cycle; the skin condition causes stress, which in turn worsens the skin condition.

WHAT DOES STRESS ACTUALLY DO?

When the body is stressed, it releases cortisol, a stress hormone. These high cortisol levels evolved to be short-term, helping us escape threats or predators. Elevated cortisol levels for an extended time can trigger inflammatory responses in the body, worsening inflammatory skin conditions. They will also cause the body to release neuropeptides, which are chemicals that communicate with the nervous system. These neuropeptides can affect the skin's nerve endings, leading to sensations of itching and discomfort. This can trigger a vicious itch-scratch cycle, especially in conditions like eczema and psoriasis, where scratching can worsen the condition and lead to further inflammation and damage.

Stress suppresses the immune system, making it harder for the body to fight off infections and heal wounds. The skin barrier can become impaired, making it less effective at keeping out irritants and allergens, which can exacerbate conditions like dermatitis.

As the period of stress, pain or discomfort goes on, it leads to behavioural changes. For example, stressed individuals may neglect their skincare routine or medication, sleep less, or eat an unhealthy diet, all of which negatively impact the skin. People also then develop unhealthy coping strategies such as skin picking or hair pulling.

HOW HYPNOTHERAPY CAN HELP

I work with clients worldwide with various skin conditions and mental health issues, offering solution focused hypnotherapy. It’s a gentle, positive, forward focused therapy, providing many benefits:

• Reducing stress and managing it more effectively. This balances the hormones in the body and helps with healing and inflammation. 
• Improving sleep and pain management. This strengthens the immune system and our ability to cope mentally. 
• Building mental resilience. It provides a ‘mental health toolbox’, improving people’s problem solving, and reacting more rationally and logically to issues, rather than emotionally.
• Developing acceptance and a healthy relationship with their skin, body and appearance. By reframing negative beliefs and focusing on the future, rather than the past, it can grow self-esteem and confidence.
• Address unresolved trauma, anxiety, panic, depression and more. Hypnotherapy accesses the subconscious mind and can resolve root causes.
• Stopping coping habits. The itching becomes a habit over time, just like the skin picking, and these can be difficult to address alone, without strategies, especially if people come across stress again in the future.

During sessions, I train the brain to view flare-ups as non-threatening, which helps reduce cortisol levels. By focusing on positive aspects each week, we boost serotonin and dopamine levels, leading to increased happiness, courage, and pain tolerance.

Skin conditions can have a profound impact on mental health, affecting self-esteem, social interactions, and overall quality of life. Hypnotherapy provides individuals with coping mechanisms to deal with the challenges of having a skin condition. It can’t get rid of your condition, but it can help you grieve for lost time, then accept the condition and where you are now. It shows people the strength and resources they already have within them, and how to live life despite the flares. Techniques such as visualisation, guided imagery, anchoring and mindfulness can be taught during hypnotherapy sessions, but I also explain how the brain works and the neuroscience behind everything we do.

For hypnotherapy to be most effective, it’s important to adopt a holistic approach to skin health. This means focusing on not just the mind, but also the body and lifestyle factors that can influence skin conditions. I had hypnotherapy myself, but I also worked with a dietitian and a dermatologist for patch testing. Addressing my mind, body and triggers. Hypnotherapy can help individuals not only improve their mental health but also potentially alleviate the severity of their skin conditions, through relaxation, education and goal setting.

Want to heal your skin and mind this Psoriasis Awareness Month? Sorted Skin and Jennifer Austin Hypnotherapy have teamed up to bring you the ultimate dry skin saviours bundle to restore the calm in your skin and mind. Sorted Skin’s Intensive Rescue range is formulated to break the itch-scratch cycle and nourish very dry skin, while JAH’s 90 minute Hypnotherapy consultation & session, and bundle of 7 audio tracks will help you regain control of your sleep, manage your pain levels and more! Head over to our Instagram to enter and for T&Cs.

SOURCES:

1.     JAMA Dermatol. 2019, Association Between Atopic Dermatitis and Suicidality: A Systematic Review and Meta-analysis
2.     National Psoriasis Foundation (NPF)
3.     National Eczema Association (NEA)
4.     General Hospital Psychiatry, Vol 75, 2022, Associations between psoriasis and mental illness: an update for clinicians