Skin. It's where our inside meets the outside. A defense against the
external world, but it's also a way to explore new sensations and to
caress what we find desirable.
There's a connection
between the mind and the skin, says Ted A. Grossbart, PhD, a
psychologist at Harvard Medical School in Boston and author of Skin
Deep: A Mind/Body Program for Healthy Skin.
How Do Your
Emotions Really Suit You?
"All parts of the
body react to our emotions, but the skin is the one suit we never take
off. Because it's the border between the inside and the outside, it's
full of all the intrigue and byplay that accompanies being on the
border," says Grossbart.
Because mind and
skin are intimately connected, Grossbart and others are encouraging
people to use mind-body relaxation and stress-reduction methods in
addition to conventional medicines when dealing with skin problems.
respond to an imagined situation as if it were real," Grossbart
says. "If you picture yourself sitting by the fire, your toes
actually get warmer. Since some skin conditions respond to external
conditions, visualizing an image of dry sunlight or cool moisture may
help your skin feel more comfortable."
seem to be a relationship between the mind and the skin, though proving
this scientifically can be quite difficult," says Derek H. Jones,
MD, a dermatologist in private practice in Los Angeles and clinical
assistant professor at the UCLA school of medicine. "It's
well-known that when someone has psoriasis, stress tends to make the
Skin Needs You to Take It on Vacation
When Jones trained at
Columbia-Presbyterian Medical Center in New York City, people with a bad
case of psoriasis were often admitted for two or three weeks of
"We gave them a
variety of treatments, including topical and light therapies, and we saw
rapid improvement," he says. "We did believe that taking them
away from the stresses of their everyday lives was a definite factor in
this improvement, though it's impossible to prove. Nowadays, insurance
won't cover inpatient treatment for psoriasis."
psoriasis in particular are exquisitely sensitive to increases in
stress," says Audrey Kunin, MD, a dermatologist with a special
interest in cosmetic dermatology, who practices in Kansas City, Mo.
"It is so
common for my patients to report when they leave town on some relaxing
vacation, their psoriasis or eczema almost magically resolves. It is not
uncommon for new patients to report they are 'allergic' to something in
their environment, when in fact they are responding to an increased
level of stress in their environment," says Kunin, who also hosts a
dermatology web site called DERMAdoctor.com.
People with cold
sores often say they flare up when they're under stress. "The
reason is that stress really does alter immune-system responses,"
Jones says. "The herpes virus responsible for cold sores is present
all the time, but most of the time, the immune system has it
Acne flares are
notorious before a big date or special event, Kunin says.
"This may have
something to do with elevated cortisol levels," she says. "I
encourage my acne patients to exercise regularly and try to keep stress
down, especially when there is a planned event."
Byproduct of Aging ... and Stress, Too?ฃShingles is a
painful skin problem caused by the same virus that's responsible for
chickenpox. The virus remains inactive in nerve root cells for many
years, until something rouses it, causing inflammation of the nerve. The
patient experiences pain and a rash with small blisters in a narrow band
on one side of the body.
"While it has
long been suggested that stress may aggravate this condition, I have not
found it to be true in the real world," Kunin says. "The
dermatology community now feels that as people live longer, the majority
of adults will eventually experience a bout of shingles. This is
normally a one-time event. You can get it again in a different part of
the body, but most people aren't that unlucky."
treats shingles with oral antiviral agents to reduce the risk of
post-herpetic neuralgia, a painful condition that sometimes remains
after the rash goes away.
believes stress can tip the balance between the virus and immune system,
and lead to an outbreak of shingles.
"We know the
immune system is exquisitely sensitive to a range of emotional issues.
We know the shingles virus lives in the body for decades. Why is it
activated at a particular time? Because the person is under
stress," he says.
Grossbart has found
that hypnosis is particularly effective in dealing with pain control if
pain persists even when the rash has disappeared.
Feel Emotions in
In many cases, skin
problems may be intimately linked with emotional issues the person is
like other symptoms are often well-intentioned but doomed attempts to
make our lives better," says Grossbart. "They are doomed
because we're trying to use our skin to do things the skin is not
designed for. I tell my patients, 'try to feel your emotions in your
heart, not in your skin.'"
Grossbart recalls one patient who was caring for a difficult baby, with
a rash on her hand, on her ring finger, and it was so severe her wedding
ring had to be cut off," he says. "Meanwhile, she was wearing
similar rings on other fingers with no problem. This is a kind of body
poetry, a physical metaphor."
One way to deal with
stress is to use mind-body techniques, forming mental images of a safe,
nurturing environment. Hypnosis and self-hypnosis can be effective too,
you're dealing with stress, the problem may not be the stressful
situation, as much as the effort to avoid that situation and the
feelings it arouses," he says.
patients to use focused psychotherapy to explore and deal more
effectively with situations that trigger skin symptoms.
"When you look
at what's going on underneath, most often we find unacknowledged anger.
Next, we often find people crying out for more love and caring."
How, and whether, to express these emotions will depend on each person's
particular situation. "The first thing is to feel what you feel.
Experience your emotions and don't kid yourself," Grossbart says.