The link between the brain and the skin can be difficult for some people to wrap their head around. They are two organs that seem to be anatomically very far removed from each other, but in fact, they are incredibly intertwined and talk to each other all the time.
If we go back to the beginning when we are an embryo, the brain and the skin have a strong physical connection. They are made from the same tissue layer called the ectoderm.
The skin is also highly innervated, with a vast number of nerve endings making it known as our “diffuse brain”. The skin is the primary sensing organ for external stressors in our environment, including hot, cold, pain, and mechanical stress. The skin transmits these signals from our environment to the spinal cord, which is then interpreted by the brain. The skin also responds to endogenous or internal stimuli within the body; it senses and integrates these cues and transmits intrinsic conditions to the outside world.
If you need proof of this brain-skin connection, most people can relate to feeling embarrassed and immediately having their skin flush red. If you feel stressed, your skin might start to sweat or break out into a rash or hives. When emotions are heightened, most of us can relate to break-outs on the skin, or flare-ups of existing skin conditions, such as eczema or psoriasis. The skin is essentially a large canvas that paints exactly what is going on in our mind.
Psychodermatology is an emerging field that combines psychiatry (mind) and dermatology (skin) concepts, due to the strong connection between the brain and skin disorders.
Stress causes release of stress hormones from the brain, but also localised within the skin. It becomes a vicious cycle, where stress will make skin problems worse; and then the pain, disfiguration or social issues caused by the skin condition can further increase anxiety and stress levels.
Not surprisingly, psoriasis patients commonly report a significant decrease in quality of life, and display a range of negative psychosocial consequences. There are reports of high rates of depression, suicidal thoughts, increased perceived stress levels, social stigmatisation, and employment problems.
The mind-body connection is not a new concept. We must branch out of symptomatic based or single-system treatment approaches. Interventions for skin disorders must have a large focus placed on stress management and improving the psychological well-being of the individual.