The skin-stress link: why a psychologist might be what your skin needs

Heather Stephen

You might have noticed your clinic has a psychologist on the team. Heather Stephen finds out why they are becoming more common and why you might need one. 

The link between stress and skin has been known for centuries but it is only over the last 20 years that scientists have really understood the mechanics behind the mind/body connection.

We now know that hormones like adrenaline and cortisol which are released when we are anxious can lead to inflammation and lower immunity and aggravate conditions like psoriasis, acne, dermatitis and alopecia.

Dr Shawn Talbott, a Fellow of the American Institute of Stress, says cortisol can age us as he explains:  “Cortisol has a destructive effect on collagen – the most abundant protein in the human body which wards off lines and wrinkles.”

And scientists have discovered that a negative mental state can also threaten our youthful looks through damage to DNA and accelerating water loss from our skin.

So with all this evidence in mind health professionals are beginning to offer a more rounded treatment package to patients with skin problems.

The NHS has been referring patients with skin conditions to psychologists for extra support for over a decade but this service is a very recent development in private dermatology clinics.

One clinic to try this service has been the Cheshire-based Expert Aesthetics. Medical director Dr Jonquille Chantrey invited well known psychologist Kerry Daynes to join the practice a year ago and says she has been a very useful addition to the team.


“I’ve always been interested in the mind and mental health,” Dr Chantrey says. “As an undergraduate I completed a research degree in psychiatry and worked in psychiatry before progressing onto my surgical post graduate degree.

“Kerry is able to help vulnerable patients whose issues are affecting their social life, career or relationships. But I think most people benefit from simple techniques to help them with their self confidence and self-esteem – not just when they have a problem.”

Daynes, who is a patient of Chantrey’s, says the linkup came from an acknowledgement of the connection between our skin and our emotional state.

“For a long time psychologists have not wanted to work with the cosmetics industry taking the position that treatments are harmful to self-esteem but that is not psychology for the real world and I think it is important we work together to give patients a holistic, ethical service,” she says.

“We all understand the mind/body connection and psychologists can help by offering stress management advice and treatments such as cognitive behavioural therapy to help people deal with the distress caused by their condition.”

Daynes offers everything from a one-off ‘psychological detox’ workshop where you can gain an insight into subconscious bad habits which are holding you back, to a course of treatment to help deal with common issues such as anxiety, stress or depression.


She says doctors giving cosmetic treatments can bring about a positive effect on your state of mind – even with small, subtle treatments.

“Huge changes are not the best way to go. People can be transformed by ‘tweakments’ – small changes which help them to look like themselves but better.

“And giving patients access to a psychologist provides an extra layer of service and is an exciting development which can only improve outcomes for patients.”

Consultant dermatologist Adam Friedmann from Harley Street Dermatology Clinic also introduced a psychologist to his clinic a year ago because he says “we thought there was a need”.

“About half of those with a disfiguring skin disease have issues such as loss of confidence and anxiety which can lead to depression and a psychologist can help you deal with these problems.”

Dr Friedmann says, so far, uptake of the service has been slow but he hopes more patients will come forward as there is greater awareness of the benefits these therapies can bring.

“Most people come to the clinic convinced their skin is the issue when a lot of the time psychology is playing a huge role. The psychological problems caused by skin disease can impact on your social and family life and even stop you from getting a partner so a psychologist can help so much more than your skin.”


Dr Sarah Coles, a clinical psychologist who works both for the NHS and at Harley Street Dermatology Clinic, says: “There is a circular connection between skin and your psychology. Psychologists are not frequently used in clinics but are the missing link in the treatment of skin disorders.

“Culturally we have a real emphasis on appearance and looking perfect and this can be a huge stress for people.”

Dr Coles says this focus on perfection can lead to high levels of distress and even depression among people with skin conditions and a psychologist can help address these negative beliefs leading to improvements to both your skin and your whole quality of life.

At the first meeting with Dr Coles patients have the opportunity to talk through any issues and pinpoint the best therapy which could be anything from Cognitive Behavioural Therapy, which helps change negative thought processes, to relaxation techniques and coping strategies.

“The service helps challenge negative self-perception, supports patients struggling with reactions to a severe skin condition and offers therapies for skin picking and hair pulling which can be triggered by stress,” she says.

Dr Coles says some people may only need one or two sessions to get to the root of their problems whereas others might benefit from a course of meetings.

“In Western culture we have a tendency to see the mind and body as separate so it can be a bit of a leap for people to see the benefits of psychological therapy. But we must never forget that the skin is a mirror to our psychological state and addressing stress, worry and low mood can make a real difference to your condition as well as to your quality of life and relationships.”

It makes perfect sense. So next time you pop to the clinic with stress-related skin issue – or a skin-issue that’s causing you stress – you might find a chat with a psychologist could be just what you need to restore your beauty and peace of mind.

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