Psychology can help with skin conditions

Skin conditions could be prevented with the help of psychological interventions, new research has suggested. Published in the British Journal of Dermatology, the report revealed techniques such as relaxation, cognitive behavioural therapy and habit reversal might prove beneficial for individuals suffering from psoriasis and atopic dermatitis.

Investigators from the Department of Psychology at the University of Sheffield analysed 22 studies on the subject and discovered interventions of this type can have a medium-sized effect on skin conditions, but factors such as intervention and outcome type, as well as the time interval between the end of the intervention and the follow-up session, can influence success rates.

It was shown that group therapies can be as effective as sessions on a one-to-one basis, yet differences were discovered with regard to age, with techniques proving less effective for older individuals.

The researchers pointed out, however, that further specific techniques need to be developed, while a more rigorous evaluation of these practices is also required.

Chartered Psychologist Dr Christine Bundy said: "Cognitive based psychological interventions are effective at reducing the distress associated with skin conditions and improving the symptoms of the skin condition itself. Previous research has shown that CBT can improve not just the associated distress but also the clearance rate of psoriasis once a flare up has started.

Psoriasis is an immune modulated skin condition and the proposed pathways from cognitions to skin pathology include the hypothalamic Pituitary (HPA) Axis. It is likely that stress affects pro- inflammatory hormones and psychological based interventions moderate the stress response affecting these inflammatory mechanisms.

There is no evidence that psychological interventions can prevent skin conditions but they can improve the course of the disease. Further work is needed to establish the mechanisms of action.
The time is right for a large scale, well conducted trial of psychological interventions and this systematic review provides a good basis on which to develop such a trial."