Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, February 18, 1991 TAG: 9102160231
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: Jane E. Brody
DATELINE: LENGTH: Medium
By reading the skin's signals correctly, physicians can sometimes obtain early clues to serious physical ailments or help patients avoid futile treatment for emotionally triggered skin problems.
Unfortunately, many people waste time and money buying over-the-counter remedies and seeing cosmeticians, nutritionists and physicians vainly seeking solutions to skin disorders or reactions that are unrelated to the skin itself.
Misapplied self-treatments can make a skin problem worse.
Other problems simply do not respond to common home remedies, like the application of moisturizers to seborrheic dermatitis, which resembles red, dry skin but which requires medical treatment.
And when cosmeticians mistreat problems like facial warts, these virus-caused lesions may spread all over the face.
Even when the skin disorder is primarily a dermatological one, like psoriasis, eczema or acne, emotional factors can set off flareups that can often be prevented once their cause is properly understood.
Anyone who has ever blushed knows that inner feelings can be revealed through the skin. Similarly, excessive sweating - especially on the palms and soles, in the armpits and groin, on the forehead, nose and upper chest - can occur in response to emotional factors.
People who sweat excessively are more likely to develop fungal infections and contact dermatitis.
Some people with abnormal sweat reactions get deep-seated pinhead-size blisters, severe itching and peeling of the skin on their hands and feet.
Skin lesions can be directly self-inflicted by people with nervous habits, neuroses or psychoses. A nervous habit of rubbing or picking at a spot on the skin can cause the area to become thick or inflamed.
Compulsive habits like licking the lips and excessive handwashing can cause severe dryness and cracking of the skin. Facial scarring can result from otherwise mild acne lesions that are repeatedly picked at or squeezed.
Self-inflicted skin lesions can result from scratching in one's sleep, and the person may deny doing anything to cause the problem.
Some people have phobias or delusions that prompt them to dig into their skin, causing unsightly lesions. Most common is the delusion that parasites have invaded the skin.
Emotional factors, even when not the direct cause, are known to aggravate most skin diseases.
Especially responsive to stress are itchy dermatoses like certain types of hives and persistent itchiness in the ano-genital area (pruritis ani and pruritis vulvae).
While ano-genital itches are often the result of well-established dermatologic conditions like psoriasis or fungal infections, when no cause can be found, the emotions bear exploration.
Other dermatologic conditions in which outbreaks may be set off or worsened by stress include seborrheic dermatitis (a form of eczema that appears as severe dandruff), rosacea (extreme or prolonged facial flushing), recurrent herpes sores (so-called fever blisters), psoriasis and alopecia areata (bald spots on the scalp).
Dr. Bernard Kirshbaum, chief of dermatology at the Medical College of Pennsylvania, said atopic eczema, which results in red, crusting, scaling, itchy skin especially in the bends of elbows, behind the knees and around the neck, may represent in part the expression of emotional turmoil in children with an allergic family history.
Many adults with eczema experience flareups when they are under stress.
Kirshbaum said women with so-called housewife's eczema, which afflicts the hands and has usually been attributed to exposure to cleansing products, were often distressed about problems with their husbands, children or jobs.
Kirshbaum believes chronic tension is the direct cause of nummular eczema, characterized by coin-shaped dry, scaly lesions on the backs of the hands and feet or on the forearms or legs.
He has found that when patients with these types of eczema are encouraged to talk about their feelings, the skin problems are more likely to clear up.
If troubled by a skin disorder that has no obvious cause or that fails to respond within a few weeks to home remedies, consult a dermatologist.
The physician should ask about both physical and emotional factors that may be involved. And if the remedy prescribed does not alleviate the problem in a reasonable length of time, consider psychological counseling as an adjunct.
by CNB