You know that your emotional health can affect your physical health. Stress can lead to heart disease, high blood pressure and lower your immunity and make you more susceptible to infection. But did you know that your emotions can also affect your skin? Psychodermatology is a branch of medicine that looks at the connection between your mind and your skin and works to treat both in order to improve skin disease.
There are three main ways that your emotions affect your skin:
- Skin diseases that are physiological in nature but can worsen during times of stress. This includes psoriasis, acne, eczema, alopecia areata and rosacea. Stress and emotional distress can not only affect the progression of the skin disease but how you respond to treatment.
- Skin diseases or cosmetic disfigurement that causes emotional distress. Some skin diseases, such as psoriasis, can cause embarrassment and feelings of shame. These, in turn, can cause anxiety or depression.
- Skin conditions which are symptoms of psychiatric illnesses, such as trichotillomania, chronic hair pulling.
As many as one-third of those with skin disorders have underlying psychological problems. Some doctors believe the best way to treat these types of conditions is to work together. Psychodermatology is not meant to replace traditional treatment for skin conditions, it is meant to recognize that treating emotional issues can help. According to an article on Harvard Health, "It's important to evaluate and treat a skin problem medically before looking into its psychological aspects. But sometimes, a drug of other medical approach that doesn't work on its own becomes more effective when combined with psychological strategies." 
Stress Reduction Is an Important Part of Psychodermatology
Skin conditions, such as psoriasis, eczema and acne, often worsen during times of stress. One of the main goals, therefore, in psychodermatology, is to work with patients in stress reduction. Lowering stress or better managing stress can help reduce the symptoms of a skin condition. A therapist can work to reduce stress through cognitive behavioral therapy and relaxation strategies. For some, treatment with anti-anxiety medications may be needed. Lifestyle changes, such as a well-balanced diet and exercise have also been shown to reduce stress levels.
Because dermatologists specialize in diseases of the skin and not psychotherapy, it is beneficial if the dermatologist works in conjunction with a therapist, psychologist or psychiatrist. There is a dermatology-psychiatry liaison clinic at Stanford University and according to Harvard Health, there are some additional clinics throughout the United States.
How Effective is Psychodermatology?
Psychodermatology is a relatively new field of medicine. Studies looking at the effectiveness have shown links between the emotions and skin diseases, for example, one study showed that somewhere between 50 and 90 percent of those with chronic skin conditions have emotional triggers to their disease. [2007, Jafferany] Even so, this type of medicine is not readily accepted in the mainstream medical community. Some are concerned that studies rely on anecdotal evidence rather than scientific studies. Some critics believe that because traditional medications and treatments for skin conditions are used simultaneously with the psychiatric care, there is no way to know if the patient is responding to the traditional care or the combination of therapy and skin medications.
Despite the disagreement, most people agree that using psychodermatology doesn't cause any harm as long as doctors and patients both keep in mind that this type of therapy doesn't replace traditional skin care and treatments.
"Psychodermatology: A Guide to Understanding Common Psychocutaneous Disorders," 2007, Mohammad Jafferany, The Primary Care Companion
"Psychodermatology: An Overview," 2013. Argentina Leon, Ethan C. Levin, John Y.M. Koo, Seminars in Cutaneous Medicine and Surgery
 "Recognizing the Mind-Skin Connection," 2006, Staff Writer, Harvard University, Harvard Health