Atopic dermatitis and stress: What role does the psyche play?

Atopic dermatitis is a chronic inflammatory skin disease that progresses in phases. Different triggers are associated with the occurrence and severity of these flare-ups. In addition to nutrition or allergic reactions, psychological stress, such as stress, is also discussed again and again as a trigger factor for neurodermatitis. Is there a connection between mental health and neurodermatitis, and if so, what can those affected do to influence it positively?

Relationship between skin and psyche

Because of its diverse and complex tasks, the skin is the largest and one of the most important human organs alongside the brain. A healthy complexion contributes to physical well-being and increased quality of life, and it plays a significant role for many people for aesthetic reasons. If the skin’s appearance is disturbed by a disease, this can also negatively affect a person’s psyche – and vice versa.

A link between skin health and mental health was also confirmed by a European study from 2014. As part of this, 3,600 participants with skin diseases were examined. The result: 29 per cent had psychological problems in addition to their skin disease. Skin and psyche are, therefore, closely interrelated.

 

Why does the psyche influence the skin?

This is related to our developmental history because the skin develops in the embryo from the same germ layer, i.e. tissue cluster, as the nervous system. It also represents the boundary and the connection to our environment. This is noticeable in many areas: Touching the skin, for example, when scratching or stroking, can evoke positive feelings; we are a bit embarrassed, we blush, and we are excited or anxious, and we get goosebumps.

Significance of psychological factors in neurodermatitis

It has not yet been scientifically clarified whether psychological problems can contribute to the development of neurodermatitis. As already mentioned, however, there can be a mutual influence between the psyche and the occurrence and severity of the symptoms.

It has been proven that stress can trigger or exacerbate flare-ups in neurodermatitis. This is probably due to immunological reactions. Stress often increases the number of white blood cells and certain immune messengers, so-called cytokines. Both are involved in the development of inflammatory processes in neurodermatitis.

People also tend to react to itching more when stressed or in other emotionally stressful situations. If those affected with neurodermatitis scratch themselves, this mechanical irritation increases the inflammation, which in turn causes more itching – a vicious circle is created.

There is also the aesthetic aspect: people with neurodermatitis often feel less attractive because of inflamed areas of skin and self-inflicted scratches. Those affected are also repeatedly confronted with the fear of fellow human beings of a supposed infection. Itching and inflammation can also cause insomnia and restlessness, which further increases the negative psychological consequences of neurodermatitis, such as irritability, lack of concentration and mood swings.

 

Stress-related neurodermatitis: what helps?

Since we now know that psychological stress situations can intensify neurodermatitis, every good therapy concept must also address the psychosomatic factors.

The following tips can help to keep the effects of negative psychological factors on the course of neurodermatitis as low as possible:

• Seek therapeutic help: Psychotherapeutic counselling can help reduce or better manage stress and other negative emotions. Alternative behaviours to scratching can also be trained.
• Use relaxation techniques:  Methods such as yoga, tai chi, or autogenic training can help to reduce stress in everyday life.
• Keep a scratch diary:  A diary can be used to note when the itching occurs more intensely. This makes distinguishing between psychological and other triggers (such as food allergies ) easier.
• Do not put pressure:  Those affected often build up pressure and feelings of guilt when the neurodermatitis worsens. However, this can happen even if all treatment recommendations are followed. Again, therapy or a self-help group can help to process these feelings better.