Laurel Garner really believes her body
is a battlefield.
The terrible blisters on her eye, thumb, back and gums have
popped out when she has been under intense emotional or physical
stress.
A divorce, working two jobs, a car accident - even the physical
stress of a tattoo - resulted in horrible blistering that
eventually was diagnosed as a rare autoimmune disorder, pemphigus
vulgaris.
``My body sees my skin as an enemy,'' the Stuart, Fla., woman
says.
It's not such a far-fetched concept.
Garner's dermatologist, Dr. Marta Rendon, says at least 10
common skin disorders, including acne, dandruff and hives, are
either triggered by or worsened by stress.
``We don't know exactly how or why stress triggers these
diseases. And people don't have to have any psychological disorder.
It's just the way they deal with stress, how the stress affects
their body,'' she said.
``I had a patient who fell off his ladder at work and was out of
a job. His psoriasis came out after that.''
Rendon, who practices in Boca Raton, Fla., says that stress
management, biofeedback and relaxation tapes can help patients
manage their outbreaks.
``We focus on giving them emotional support, explaining the
disease and the outcome, and giving them guidance. Sometimes, that
alone helps them,'' she said.
Other dermatologists find stress management of little use in
controlling or preventing most skin disorders because, they say,
there are so many factors that lead to outbreaks.
There are psychological conditions - where patients scratch
their faces excessively, for example - where psychological
approaches are helpful, says Dr. Howard Green, division director of
dermatology for Intracoastal Health Systems in West Palm Beach.
``And biofeedback as a preventative can be good if there is a
strong correlation between emotional and physical stress and the
condition. But it's strictly individual. And it's usually not that
straightforward. I'd downplay that.''
Dr. Steven Rosenberg, also a West Palm Beach dermatologist, had
a similar viewpoint.
``It's rare that a dermatologic condition needs that approach,''
he said. ``Biofeedback would be unusual.''
Counters Rendon: ``The issue is, it's very important to
recognize how stress affects your body and these diseases. Ones who
are severely affected might need stress management to deal with and
control their disease.''
She acknowledges that she might approach diseases differently
than other dermatologists. For one thing, she is looking for a
therapist to join her practice, she said, so she can have a
``holistic approach, treating the whole patient.''
And, she adds, ``There's plenty of data, especially on psoriasis
and eczema, that shows stress management affects the outcome.''
Meanwhile, Garner - Rendon's patient of four years - says she is
happy with Rendon's approach and has discussed controlling stress
with her.
``She gives me such individual attention. If I'm hurting, she's
hurting. It's important to know she cares. The comfort she gives
you helps.''
TOP 10 STRESS-RELATED SKIN DISEASES
- 1. Cold sores: painful blisters on the lips or in the mouth.
- 2. Dandruff: common condition in which the scalp is dry and
scaling.
- 3. Hyperhydrosis: excessive sweating.
- 4. Pruritus: chronic itching that may be mild to intense, and
the scratch marks occasionally become infected.
- 5. Hair loss & Alopecia Areata (round areas of hair loss).
- 6. Acne: the general term for plugged pores, pimples, and
deeper lumps that may cause inflammation which, if severe enough,
can result in scars.
- 7. Eczema: a red, itchy inflammation of the skin characterized
by red skin patches, pimples, crusts, or scabs occurring alone or
in combination.
- 8. Psoriasis: an inflammatory skin condition characterized by
frequent episodes of redness, itching, and thick, dry, silvery
scales on the skin.
- 9. Hives (Urticaria): raised welts of various sizes on the
surface of the skin that are often itchy.
- 10. Rosacea: a skin inflammation characterized by a redness
that looks like a blush, pimples, knobby lumps on the nose, and
thin red lines due to enlarged blood vessels.
