What is Psychodermatology and How Can You Integrate It in Your Life?
Two dermatologists and psychiatrists weigh in on the holistic approach to skin care.
Keeping up with the surge of “cure-all” wellness fads is a job in and of itself. In our column Wellness Inspector, we do the work for you, closely examining these trends to see if they’re worth your hard-earned pennies—or whether they’re just hype.
When you think of the word skincare, what comes to mind? Is it a gleaming aisle of products at the drugstore? Is it the collection of cleansers, scrubs, and serums that sits atop your bathroom shelf? What if I told you that skincare encompasses more than that—much more than that? It encompasses things like sleep and exercise, stress management, and even something as simple as spending time in nature. In other words, skincare goes beyond the products you use. It also means cultivating healthy lifestyle habits and maintaining your physical and mental health.
That’s where psychodermatology comes in. If you’ve never heard of it, you’re definitely not alone. It’s a small and relatively new field of study that’s as interesting as it is important.
What is psychodermatology?
Psychodermatology is a field of study that’s situated squarely on the overlap of psychiatry and dermatology, and it’s all about studying the link between the mind and the skin. “I think there are hundreds maybe thousands of different ways that the mind and the skin interact,” says Amy Wechsler, M.D., a double board-certified dermatologist and psychiatrist. “That connection works both directions: mind affects the skin, skin affects the mind, both positively and negatively.”
Strong emotions such as stress and anxiety, sadness, grief, and anger, can all affect the skin. For proof, just think of back to a time when you felt particularly embarrassed by something. It’s likely your cheeks flushed pink at the very memory. Sure, this is a rather simplistic example, but it demonstrates how the mind can influence a reaction in the skin, even on a basic level.
How are the mind and skin linked?
The mind and the skin are connected via multiple pathways in our vascular, nervous, and endocrine systems, and that link is forged before birth. “It stems from the fact that when we’re embryos, during embryologic development, skin and brain are made from the same layer of cells, so they’re connected from the very beginning,” Dr. Wechsler explains.
The overlap remains throughout our entire lives, even if it’s not always acknowledged. In fact, according to board certified dermatologist Sapna Palep, M.D., founder of Spring Street Dermatology, in more than one-third of patients, consideration of psychologic factors is necessary when effectively managing a skin condition. Research back that number up. Various studies estimate that the prevalence of psychological factors that affect skin disease are anywhere from 25-33%.
How does stress affect the skin, specifically?
Let’s look at psychodermatology through the lens of stress, specifically, since that’s something we all experience on some level or another. One of the most common skin conditions caused by stress is acne (yes, stress-induced breakouts are real). Dr. Wechsler recalls studies conducted on college campuses, in which pimple counts went up during stressful final exam periods and then back down again during periods of low stress. Because stress causes inflammation in the skin, acne can result, as well as other conditions like eczema and psoriasis, dryness, and temporary sensitivity.
“The skin becomes more sensitive, because it actually leaks a little bit more water than usual when there are stress hormones circulating,” she explains. “So, someone might be using a product that they’ve used forever, the ingredients don’t change, but all of a sudden they get a rash from it.” As if that’s not encouragement enough to keep stress levels in check, stress can also cause accelerated signs of aging to appear in our skin. This, according to Dr. Wechsler, is a phenomenon called stress aging.
Aside from acne, sensitivity, and signs of aging, other skin conditions can result from stress. According to Dr. Palep, those other skin conditions include alopecia (otherwise known as hair loss), prurigo (a condition characterized by intense itchiness), and rosacea, among others.
What about inhalable beauty?
Inhalable beauty is often discussed in relation to psychodermatology. The theory goes like this: by inhaling certain ingredients, especially those that are vitamin and mineral-rich, we can target our nervous system directly, thereby encouraging a calmer mental state, and through that, better skin, too. Inhalable beauty encompasses everything from aromatherapy to inhalable supplements.
When it comes to the former, Dr. Wechsler says there’s something to it. “Certain fragrances and scents evoke certain emotions in people,” she says. So, for example, if you find lavender calming, the scent of lavender essential oil may have a relaxing effect on you, thus reducing your stress levels. When it comes the latter, though, she’s not sold on the science behind it (or lack thereof). “I don’t think you can inhale a vitamin and that gets to your skin—no way. Things we inhale, if they get into our body, get into the bloodstream, and the things that get into the bloodstream circulate around to the other organs.” In order to endorse this as a legitimate practice, Dr. Wechsler says someone would need to prove that the vitamin reaches the skin in any measurable concentration, and that hasn’t happened. “I’m sure it doesn’t,” she says.
Dr. Palep agrees. “This major beauty trend is brand new and is still being weighed for important pros and cons—most importantly, how safe it can be,” she says. “Even though it’s in development stage it claims to reduce stress levels.”
How can you utilize psychodermatology at home?
Psychodermatology is all about caring for our skin through caring for our minds, which makes stress management an important piece of the puzzle. That’s especially true, today, when we’re coping with the consequences of a global pandemic on top of all of our other daily stressors. That means that habits and rituals that help you manage stress, whether that’s meditation, exercise, or journaling, become effective preventative skincare measures. That’s right, because less stress can mean less breakouts, dullness, dryness, and sensitivity, stress reduction is skin care.
When it comes to skincare products specifically, Dr. Wechsler recommends cultivating a routine that’s based in positivity and enjoyment. “If you’re putting a product on your face, you should have a positive experience with it. I think skincare routines should happen twice a day and should be enjoyable. Nothing should hurt. Everything should feel good. If something has a fragrance, you should really like the fragrance. It should be really enjoyable, and I think that lowers stress levels.”
In other words, use products you like. Use products that make you feel good. Don’t make your skincare routine stressful.