The Mind-skin-Health Connection

[Guest guest]

Nov. 5, 2001 -- 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.

" 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 H. , 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. "

Sometimes, Your Skin Needs You to Take It on Vacation

When 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, 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, " 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. "

Shingles: Byproduct of Aging ... and Stress, Too?

Shingles 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. "

Kunin routinely 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.

Grossbart, however, 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 Your Heart

In many cases, skin problems may be intimately linked with emotional issues the

person is dealing with.

" Skin symptoms 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.' "

For example, Grossbart recalls one patient who was caring for a difficult baby,

with little help.

" She developed 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, Grossbart says.

" But when 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.

Grossbart urges patients to use focused psychotherapy to explore and deal more

effectively with situations that trigger skin symptoms.