The psychological impact of Chronic Skin Disease

Difficult illnesses such as relapsing chronic skin disease, a global health problem causes an immense amount of physical, mental & emotional disabilities. As per the British Association of Dermatologists, 85% of skin disease suffering gets impacted by psychosocial challenges & dysfunction causing a lot of mental discomfort. 
Through psycho neuro-immuno-endocrine & behavioural mechanisms, skin disorders affect the body’s psychological makeup, lowers self control, increases distorted thought processes, affects self esteem, and lower the quality of life. 

Common chronic skin diseases & related psychological problems:

Atopic eczema

Provokes fearful anticipation developments, depressive symptoms & reduces psychological well being interest. 

Acne 

Increases psycho-traumatic nature, shamefulness, worthlessness, embarrassment, chances of getting bullied, irritability & short-temperateness. Also reinforces depression, anxiety, social avoidance and loneliness. 

Atopic dermatitis

Makes patients feel anxious, frustrated with doctors & family members. Increases eagerness to find remedies at any cost. Reduces work productivity, enhances absenteeism from work & expenditure on alternative medicine practitioners, inauthentic treatment methods and advice. Simultaneously initiates sleep disturbances & negatively affects work life balance. 

Psoriasis 

Induces chances of social isolation, loneliness, disturbed quality of life & overall health. Continuous scratching & flaky skin physical appearance ignites depressive, embarrassment, secretiveness, & helpless, stigmatized feelings. 

Vitiligo 

Significantly affects leisure activities, housework & going out for socializing.

Alopecia 

Generates shame, depression, anxiety and inferiority complex and attempting to hide hair loss with wigs & hats. 

Psychosocial adaptation for patients with skin disease

It should include disease related theoretical & practical data & interventions provided by the doctors & caregivers.

Empathy

Appropriate validation of patient concern right from initial diagnosis of skin disorder. 

Education

Availability of correct scientifically driven disease related medical & non medical information, query solving, dissolving misconceptions.

Medical management

Usage of emollients, creams, and oral medications for management of skin pathology & psychotropic medications to address comorbid psychiatric illnesses.

Stress management

Creating awareness about the ill effects of stress on skin disease progression & providing simple stress management techniques. 

Psychotherapy:

Cognitive-behavioral therapy (CBT): 

Altering the underlying cognition & understanding the dysfunctional thought processes. 
Acceptance and commitment therapy (ACT): 

Changing the patient's relationship with their symptoms & strengthening psychological flexibility. 

Mindfulness-based stress reduction (MBSR): 

Adding meditation, exercise, and yoga to encourage living in present reality and discouraging strong bonds towards emotional beliefs which causes emotional imbalance and disrupts well-being.

Habit reversal therapy (HRT): 

Giving neutral action therapies like awareness training, competing response & positive continuous motivation. 

Family support: 

Proactively initiating disease related education, its impact on life & prioritizing various therapeutic options.

Conclusion

Medical fraternity & patient caregivers should always be inquisitive to find, assess & screen mental health disturbances in patients. Simultaneously the patient's detailed orientation regarding skin disease & mental health disturbances should be a part of pre & post routine dermatological interventions.