Thirty-two million Americans deal with some form of eczema, and 7.5 million have psoriasis. While these conditions come with obvious physical symptoms, the mental impact of dealing with a chronic skin condition can be just as severe. With August being National Psoriasis Awareness Month, it’s important to understand how skin conditions can affect our mental health.

Research has shown that stress and mental struggle are significantly associated with skin issues. One study conducted across 13 European countries evaluated the burden of skin disease and found both psoriasis and hand eczema diagnoses had a significant association with depression and anxiety, and psoriasis was significantly associated with suicidal ideation. Psoriasis is also linked to other difficult emotions. One study found that increased anger levels and reduced self-esteem are remarkable in individuals with psoriasis. As research shows, the relationship between skin conditions and negative emotions is cyclical, as distress can spark flareups in skin conditions, which can then fuel further distress. There is also a neuroimmunological link between psoriasis and depression through immune system mechanisms and melatonin. While this biological connection is clear, some of the ties between the two have more to do with self-perception.

Psychological Impact

While Liia Ramachandra, PharmD, acknowledges that there is a physiological link between skin conditions and depression or anxiety, she also notes a psychological connection, as well. Having lived with psoriasis herself for many years, she understands the mental impact firsthand. “Every time I would look at myself in the mirror, I would feel sad seeing the spots and no matter what I did, they were always staring at me in the face,” Ramachandra says. “I would make matters worse by not liking what I would see in the mirror and even hating myself for that.” Lauren, who deals with eczema breakouts, says that because the physical pain of the condition alone can keep you from doing things you love, feelings of hopelessness and worthlessness can creep up, as well. “It can make you feel jealous of people around you,” Lauren says. “Having an ugly skin disorder is embarrassing to be out in public, especially around people you don’t know. You feel uncomfortable, like people are judging you or they’re worried you could spread a disease to them. You feel alone, no one can really understand your physical and mental pain you are going through.” Ramachandra’s lifelong battle with psoriasis led to the creation of her company, Epilynx, a medically clean, gluten-free, hypoallergenic skincare and beauty brand she created with her husband. As a pharmacist and analytical chemist, Ramachandra began making her own products and sharing them with friends after being repeatedly disappointed by the available options. “I could not find any products out there that did not make my red spots worse,” she says. “Even the super expensive, labeled ‘clean’ products, started to give me a rash and redness. At certain times, I could not use anything on my face.” Lauren, who finally found some relief in natural skin health solutions, feels the beauty industry actually adds to the anxiety and pressure felt by people with skin conditions, especially when that condition is severe or painful and can’t be covered with makeup. Social media has a similar effect. “It can be hard scrolling through the internet seeing nothing but flawless photos, thinking you’ll never look or be like that person, even though you know in reality that most of it is all photoshop filters,” she says.

Tools To Cope

On the other hand, Lauren notes, certain corners of the internet can be great sources of support. Online support groups and Facebook groups dedicated to certain conditions can be helpful when feelings of depression or anxiety creep up. “It helps talking, venting and reading comments from people all around the world who are going through the same thing you are,” she says. “It helps knowing you are not alone.” Using the internet as an educational tool can be helpful, as well. Learning as much as possible about your condition via credible sources, Lauren says, can lead to a feeling of greater control. And you may discover new solutions to the issues you’re experiencing. Focusing on what you can control is important. For example, Ramachandra starts each day with yoga and swimming in order to start the day in a positive state of mind. She also recommends positive self-talk and surrounding yourself only with people that love and accept you as you are. “It is a constant struggle and every day is a new day,” Ramachandra says. “Stress relief and self-acceptance is something that is definitely helping with psoriasis but that is sometimes hard to achieve.” Depending on the severity of a condition, meeting with a specialist should also be on the list of self-care practices. Professionals can help determine potential triggers and provide further solutions and coping mechanisms. But it’s important to keep in mind that some fixes aren’t quick or permanent, so be realistic with your expectations. “Recognize you’ll have good days and bad days,” Lauren says. “Try not to be hard on yourself on the bad days, let yourself rest when you need to.”