How psychodermatology could totally clean up your complexion

So long, complexion woes.

07 Feb 2019

“Imagine 80% of your body being covered in tiny, red insect bites. That’s what my psoriasis felt like for 14 years.” Now 29, Holly, from southwest London, has spent five years living with healthy, on-the-mend skin. How? She talked herself into it. “At 23 I began cognitive behavioural therapy (CBT) to help me cope with anxiety after a bad car accident I was in. It gave me the tools to relax and restore my mindset, and my therapist and I were curious to see if it could help heal my skin in the same way. It really worked.”

What happened in those sessions is a phenomenon that experts are calling Psychodermatology: the field of medicine for treating the connection between the mind and the skin. By using psychotherapy, such as CBT, you can understand the way in which the skin responds to emotional and environmental stressors and learn new ways of thinking to stop the skin’s responses. Given that right now 13 million of us in England and Wales visit our GP with a skin problem such as acne, rosacea or eczema each year*, quite frankly we’ll try anything. So if your current skincare plan is going nowhere fast, it could be time to up your routine with mindfulness. Here’s how.

Happy Mind? Happy Skin

“During one appointment my therapist said: ‘how does it feel living with psoriasis?’ Throughout the nine years I’d had it, I’d never been asked that before,” says Holly. ‘Together we tried to make sense of how and why my skin flared as a surface reaction to internal mental stress. It was definitely an ‘aha’ moment to how both could be linked.” Holly found herself unbottling anxieties, stressors and thought patterns during her weekly sessions over the course of a year, and hasn’t taken her medication since. To help others find the same mental space she did, she created an Instagram campaign, #GetYourSkinOut, in the hopes it would keep the conversation going online. With CBT you keep a diary to track why your thoughts and behaviour make you feel bad. Your therapist helps you replace negative, irrational and illogical thought patterns with helpful ones and put them into practice in your daily life so that they become ingrained.

“It was only after talking about it that I realised I had an issue with control and when I felt like I had none – over my work pressures, my personal life or even the weather – my skin got worse. Now that my mind can recognise and process those triggers, my skin isn’t always the channel for my stress.”

Skin Superheroes

So how exactly does psychodermatology work? Imagine an Avengers Assembles team of dermatologists and psychologists working together to treat the skin in the same way psychotherapists decode behaviour. There are seven NHS psychodermatology clinics in the UK, which your GP can refer you to.

The weekly 1hr sessions provide support and therapy (mostly CBT) to address the way you feel about your appearance, how you cope with your skin disorder and how it affects your self-esteem and social interactions. You might just need one or two sessions, while some patients need a full course of 12. Dr. Anthony Bewley, consultant dermatologist at Barts Health, launched the first clinic in 2002 when he spotted a void for one doctor’s office where you could address your skin and the emotional turmoil that comes with it. “I see patients who have been told by their GP that it’s “only eczema” or it’s “just acne”,” says Dr. Bewley. “But that makes them feel disempowered and helpless and it adds to the problem rather than de-constructs it. We should never underestimate or trivialise a skin condition.”

Generation: Stressed

Skin problems caused by stress are a growing epidemic,” says Dr. Justine Kluk, the Harley Street go-to for acne. In fact, results from a 2018 Mental Health Foundation Study showed that 74% of us in the UK have felt so stressed we’ve been overwhelmed. “Whether the pressure’s coming from work or home or social media, those anxieties are lowering your threshold for flare ups,” says Dr. Kluk. Your body reacts to these pressures by releasing a flood of cortisol and adrenaline, the two main stress hormones. “These can change the immune functions of the skin and its protective barrier (which helps keep the skin healthy), leading to increased oil production and pore clogging bacteria that cause spots.” And to top it all off? The cells that regulate your immune system are activated by stress and also produce stress hormones – leading to a vicious problem-skin cycle.

“While there’s no cure for an autoimmune disease like psoriasis, I would do talking therapy all over again to get that emotional and physical relief,” says Holly.

Retail therapy

If talking about your complexion can unlock its potential for healing, think of adaptogenic-rich products as psychotherapy in a jar. Adaptogenic what?! They’re medicinal herbs such as turmeric, CBD and chamomile, which regulate cortisol levels to help your body to cope with stress.

Traditionally, adaptogens are brewed in teas or taken in supplement form, but now brands such as the new London-based natural skincare company Disciple are adding them to skin-salving lotions. “The idea grew from seeing my patients’ skin improve after an emotional breakthrough in therapy,” says founder and psychotherapist Charlotte Ferguson.

“I also had stress-induced acne at the time and was curious about the stress-skin link beyond talk therapy, so I started mixing my own products at home.” The 400-strong wait list for Disciple’s CBD oil launched in January is proof that psychoderm skincare can really work, so it’s no surprise there’s a flood of brands on its heels. “People want more autonomy concerning their health and the state of their skin is a big part of that,” says Ferguson. The future of skincare is in your hands and your head, where mindfulness is just as valid as a great moisturiser.

These adaptogenic skincare brands will see you now

Miracle Drops 1% CBD Oil, £22, Disciple Skincare

Applied topically this pure cannabidiol oil in hemp oil tackles acne, redness and inflammation. Added to your morning latte it helps with anxiety by activating endocannabinoid receptors in our brain which connect to every part of the body. And, NO, it won’t get you stoned – it doesn’t contain THC, the psychoactive part of the cannabis plant.

4tify, £58, Marie Reynolds London

A hearty mix of cinnamon, spinach, chlorella, acai berry, beetroot, Montmorency cherry, black pepper and adaptogenic turmeric - this face mask is food porn for skin.

Anti-Stress Super Hero, £150, Aena

Think of this serum as your therapist in a bottle (it might help justify the pricetag). Wild indigo extract helps stop cortisol production and bathes stressed-out skin in soothing neuropeptides, a protein family that are said to work a bit like Botox.

Triple Hyaluronic Antioxidant Hydration Serum, £74, Allies of Skin

Licorice root extract – a potent adaptogen - protects, calms and brightens stressed-out skin.

My Balancing Cream, £52, Quantum Botanika by Nataliya Robinson

Cooling aloe vera has a natural “Om’ effect on rosacea, acne and easily irritated complexions. Use it for instant relief on any post-tweakment redness, too.

RASA Restorative Potion, £TK, Khus + Khus

Before bed, massage this botanical-infused oil packed with nerve-calming California poppy and Reishi mushrooms – a traditional herbal remedy for insomnia.

Turmeric Cream Moisturiser, £7.99, The INKEY List

Great for tackling spots (anti-inflammatory benefits target pores and acne scars) - and preventing UV damage (it’s also a potent antioxidant), turmeric brings life back to lackluster skin.

[* according to a report by the All Party Parliamentary Group on Skin]

Check out Holly Dillon’s #GetYourSkinOut campaign , which she created off the back of her psoriasis to help others.