Skin Diseases Aggravated By Stress
Role of stress in skin ailments
Any force that threatens to disrupt an individual's homeostatic balance is perceived as a stressor. According to a study from the Archives of Dermatology, whereas short-lived (acute) stressors are known to enhance immunity, chronic stress favors the progression of infections and increases the risk of cancers. Up to 50% of females with acne suffer flares during stress. Other skin problems, such as warts, alopecia areata, seborrheic dermatitis, lichen planus and pemphigus have their symptoms triggered or exacerbated by emotional stress. The common skin problems that get aggravated during severe physical, mental or emotional stress include the following :
1. Atopic Eczema
Atopy or skin allergy is a chronic recurring eczema that occurs most commonly in infants and children. It exemplifies the delicate balance between inherited factors, environmental influences and psychosocial problems. Up to 70% people suffering from atopic eczema have had severe emotional stress prior to the first episode of dermatitis, and most suffer from an increase in disease activity following episodes of mental stress. These people have increased anxiety, altered coping mechanism and a close connection between severity of symptoms and stressful events in life. Disease severity is also affected by abnormal family structure and altered mother-child relationship. Symptoms in children suffering from atopy improve following psychological treatment of their mothers. Behavioral therapy, biofeedback, stress reduction regimes, psychoanalysis, hypnosis and relaxation techniques help to improve this condition.
This is a chronic, relapsing skin disease with erythrosquamous lesions, having salmon colored (pinkish-red) plaques along with micaceous (mica-like) scales predominantly found on elbows, knees, lower back, scalp and umbilical area. Stressors mostly precede the initial onset and subsequent flare ups in psoriasis. Individual or group psychotherapy, behavioral approaches, biofeedback, hypnosis and meditation that allay stress, result in a significant improvement in this problem.
3. Herpes Simplex
This is a virus induced infection that causes grouped blisters around the mouth and throat infection. Herpes virus never gets completely eliminated, but becomes latent after treatment and hides in the nerves. Persistent chronic stress leads to reactivation of this virus and increases the frequency of recurrences. Psychosocial interventions lead to a reduction in the number of episodes of herpes infection per year.
4. Urticaria or Hives
These are circumscribed, raised, reddened itchy swellings on the skin. Individuals with adrenergic form of urticaria suffer from worsening of symptoms following acute stress. Those with hereditary angioedema also have their symptoms triggered by emotional stress.
5. Malignant melanoma
It is a cancerous transformation of melanocytes, the pigment forming cells in our skin. Chronic long term stress leads to increased secretion of hormone alpha-MSH (Melanocyte Stimulating Hormone) from the brain that suppresses the local immunity of skin. This can lead to rapid progression and spread of malignant melanoma.
Interventions to reduce the intensity of skin problems affected by stress
Skin diseases aggravated by stress
Therapies to reduce disease severity
Behavioral therapy, biofeedback, psychoanalysis, hypnosis
Meditation, biofeedback, hypnosis
Skin problems - a cause of stress
Any physical or perceived disfigurement of skin can lead to significant stress on physical, social and psychological well-being. Skin diseases are a source of social stigmatization, and now we can quantitate their effects on quality of life with instruments like Dermatology Life Quality Index (DQLI) and the Skindex 16. Psoriasis affects socio-economic functioning; atopy can lead to anxiety, sleep and mood disturbances; people with urticaria suffer severe distress. Children with alopecia areata, a patchy loss of scalp or body hair, have high levels of anxiety, depression, decreased concentration and increased aggression or withdrawal. Those suffering from acne suffer from similar distress.
Need For A Destress Program
Psychosocial interventions and a destress program could lead to a better adherence to medical treatment, provide social support and help with self-image or distorted body perception and cure the stress induced disorders.
Reference Sources :
- Tausk FA, Nousari H: Stress and the skin. Arch Dermatol 137:78, 2001.
- Faulstich ME, Williamson DA : An overview of atopic dermatitis: Toward a bio-behavioral integration. J Psychosom Res 29:647, 1985.