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.
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"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.
"Our bodies 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."
"There does 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 problem worse."
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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 inpatient treatment.
"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."
"Eczema and 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.
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 controlled."
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."