February 12th 2015
Sense and Sensitivity
Sense and Sensitivity: The confidence-crushing reality of having bad skin
March 31st 2016 / 1 comment
Skincare reactions feel unbearable, be they itchy, hot or both - but it’s the mental side effects that are the hardest to soothe, writes Judy Johnson
It is a curse of Sod’s Law that bad things happen just in time for Bank Holidays, particularly when it comes to ill health or beauty blunders; doctors close just as you need a prescription, hairdressers are unavailable when that colour goes terribly wrong, pharmacies shut their doors early and woe betide you if you need professional help. So of course two days before the Easter break after an innocent manicure that involved a mini hand massage with hand cream, which at the time I barely paid attention to, I noticed a little red patch on my wrist that was itching slightly. The next day, my whole hand itched. The day after, both hands, wrists and parts of my forearms were covered in an angry, bumpy, INSANELY ITCHY red rash. I’d had an allergic reaction to the fragrance in the product and it was not going to back down any time soon.
The horrific, constant, prickly itching kept me awake at night no matter how many antihistamines I dutifully downed, nor how much trusty aqueous calamine cream I reluctantly rubbed onto the skin that no longer felt like my own. Strong steroid cream made no difference whatsoever - in fact, it seemed to make it worse.
My family visibly balked at the sight of them (my mum was perfectly sympathetic, but male relatives in particular just don’t get it), my fellow train passengers, I am certain, spotted them, and for days all I could think about was the ugliness of my hands and how repulsive I was. Try hiding your hands. It is hard. I don't tend to wear long sleeves and even when I did, it turns out it's impossible to make lunch/hold your phone/play with your blissfully unaware baby nephew without showing them, and attempting to hide them only draws more attention to the problem.
Throughout the long weekend all I could think to myself was that I looked like a monster
Confidence is not and has never been my strong point, but it’s usually my fears, my face or disappointingly thin hair that sees me feeling low or trying to be invisible in a crowded room. But my sensitive skin means that I’m often faced with skin reactions, on any part of my body, which if visible to others can be the biggest confidence crusher of all. Throughout the long weekend all I could think to myself was that I looked like a monster, covering up the horror of it all by joking about this to friends over a text (“Won’t be going on that date anytime soon I look like a monster LOL cry-face emoji”) and pulling at my sleeves. Every little glance in my direction from anyone, be they a relative or a stranger, made me feel embarrassed; I didn’t even want to show a pharmacist in case they recoiled in horror.
On top of feeling incredibly self-conscious, the constant irritation made me irritable, feeling agitated even as I sat down to a family dinner, unable to relax and struggling to join in with the conversation because I felt so stressed out and on edge (not to mention a renewed anger for the beauty industry’s insistence on filling product with perfume). When your skin is crawling - I’d had another reaction on my legs at the same time, so it really felt like my whole body was under attack - it’s hard to feel anything but frantic. I was the definition of hot and bothered, with skin that felt firey to the touch and which made my blood boil with both irritation and stress.
Though there’s advice and information out there on how to soothe a reaction (which I regularly share in this column and have recently written about in my downloadable ebook here), there’s little out there on how to deal with the emotional side effects of problematic skin. Whether it’s a raging red rash or hives, acne or psoriasis, eczema or even a birth mark, imperfect skin can have a huge effect on your confidence - but it’s hard to discuss this without feeling that you sound vain. The crippling self-consciousness goes far deeper than vanity, though - this isn’t about perfecting a selfie or caring about attractiveness. Being covered in a rash or other skin woe makes you feel inferior; for me, I felt like I looked dirty, as if what I had could be contagious, even - and felt uncomfortable whenever anyone looked at me (I had to go out despite wanting to do anything but). Simply put, I thought I looked disgusting, and when your confidence isn’t the greatest already, it can have a huge impact.
“As issues with the skin are so outwardly visible to others, it is not surprising that those who suffer may also feel embarrassment and psychological distress,” explains Dr Anjali Mahto, Consultant Dermatologist and British Skin Foundation spokesperson. "They may avoid participating in social activities or wearing clothing that expose affected areas; such withdrawal in behaviour can reinforce, and thereby exacerbate, the low self-confidence. Additionally, the symptoms of skin disease, which can be severe, are often underestimated by those not directly affected. The preoccupation society and social media have with self-image, and their stigmatization of perceived imperfections, only creates further pressure.”
Over 20% of those with acne have thought about or attempted suicide
The stats back this up; last year a survey by The British Skin Foundation into the wellbeing of acne sufferers found that shockingly over 20% of those with acne had thought about or attempted suicide; 95% said it had an impact on their daily lives, and 63% reported a fall in self-confidence. The figures are alarming, yet understandable given the visibility of the condition - and while there are plenty of great concealers and camouflaging foundations out there to help hide the culprits, it’s a lot harder to fix broken self esteem. It’s why psychodermatology is becoming a more common discipline; looking at the interaction between mind and skin, it focuses on the ways stress can cause flare-ups of skin conditions such as eczema and dermatitis - but of course, the link works both ways and skin conditions can in turn cause the stress itself.
“There is a lot of anecdotal evidence that stress will make inflammatory skin disorders such as eczema, psoriasis, acne, and rosacea worse,” Dr Mahto confirms. I know in my experience this is true; the more stressed I am, the worse my skin is, and I tend to be far more ‘reactive’ than usual as my whole body is essentially on high alert. Some experts have even suggested my sensitive disposition and anxious personality may be the very cause of my sensitive skin.
Perception is key, too; it’s not necessarily the severity of a condition or skin disorder that makes you suffer worse mentally. If you perceive your skin to be worse than it is (numerous people, when I’ve shown them what I consider to be one of my worst reactions ever, said they could barely notice it) or dwell on it, then you’re likely to feel far worse. How many times have you panicked about a giant spot that’s forming on your chin only for a friend to say they can barely see it? The power is in your mind.
"How does emotional turmoil cause, trigger, or heighten symptoms?” asks Skin Deep author and Harvard Medial School psychologist Dr Ted Grossbart in his ebook. "Researchers are actively exploring this mystery; a key discovery seems to be the body's ability to turn intensely experienced ideas and fantasies into physical realities. (If you imagine someone is breaking into your apartment, your body will go into high alert, even panic, just as if the threat were real.) In a classic experiment, Japanese physicians Ikemi and Nakagawa hypnotized volunteers and told them that a leaf applied to their skin was a toxic plant, such as poison ivy. The plant was harmless but the subjects' skin became red and irritated. The same experimenters applied the real toxic plant to other subjects' skin after telling them it was innocuous. The expected biological reaction did not take place."
It’s not that your skin condition is all in your mind - as someone a week into this hideous reaction, and years into my suffering of sensitive skin, I know how bad it can get and have left doctors baffled by severe reactions that they’ve never seen before. But the key is to control the emotional effects of living with a skin disorder and ensure you’re dealing with it - difficult, yes, but worth confronting given that stress can exacerbate the problem.
"Do not suffer in silence. If your skin condition is making you feel low, stopping you doing things or holding you back from the things you want, it is vital to let your family doctor or dermatologist know,” advises Dr Mahto. "They will work things through with you or enlist the help of a clinical psychologist with an interest in skin disease.”
So how can you face the world when your skin is letting you down? In the case of rosacea and acne, some well-applied makeup will work wonders (see Dr Bunting’s acne advice here and Charlotte Tilbury’s expert rosacea cover-up tutorial here), but of course reactions and drier skin conditions are harder to solve, which is why you need to work on the other issue: your mind.
Hypnotherapist and anxiety expert Chloe Brotheridge suggests a shift in focus could help. "It's important to try to focus on the things you like about yourself instead of the skin problem. Instead, make a note of other things that you like about yourself and your appearance. Maybe you have beautiful nails, or a strong, fit body, or bright eyes, or a killer fringe. Focusing on the things you like about yourself can boost your confidence and distract your attention away from your skin." And those glances I was so concerned about from strangers? Ignore them. "Remember, the people that matter don't care what your skin looks like, and if they do care, they don't matter," advises Chloe.
Ayda Koc, a life coach and yoga specialist, recommends meditation twice a day for a minimum of 15 minutes to give you a calmer outlook - try it for three weeks to see a difference. "Meditating doesn't mean to follow a particular technique,” explains Ayda, "it just allows you to withdraw your senses inwards. Breathe a deep and long breath to enter the stillness. Trust yourself and don't open your eyes - set a timer!"
Clinical hypnotherapist and life coach Jacqueline Hurst agrees it’s your mind that needs support. "Bad skin and lack of confidence can be disconnected! Ultimately, how we think creates how we feel. If we are creating negative self talk or worrying about what other people think, we will feel super unconfident,” explains Jacqueline. "Most people go through bad skin at some stage. Think of Victoria Beckham or Cameron Diaz - both these gorgeous women suffered from acne and didn’t let it stop them. Bad skin is something that doesn’t need to create a lack of confidence once you get your mind right first."
But how, practically, can you fix those unwelcome inner criticisms? “Write down your thoughts,” advises Jacqueline. "What are you thinking that is creating those negative feelings of low self esteem? Then come up with evidence to disprove those horrible thoughts!"
It’s hard at first, but this method works well - it engages the rational part of your brain and makes you realise that inner critic is out of control. For me, it was a case of opening up about how I felt to those I was most comfortable with, as well as oversharing on Twitter, to which I had some lovely replies from those who knew exactly how I felt because they suffered with it too. That in itself was a huge relief - knowing that I wasn’t a monster, I wasn’t mad, and it was perfectly normal to feel wretched at the sight of yet another horrific rash. I’m still battling it now (allergic reactions take a while to calm down - my hands are currently an interesting shade of red/purple) and have had to cancel a couple of arrangements where I knew I would just feel too self-conscious; but otherwise it’s a case of seeing it for what it is - an allergy, a health problem, essentially, and one that is largely out of my control. My methods for treating anxiety helped too - deep breathing, mindfulness and listening to music to distract me worked a treat.
Thankfully, post-Bank-Holiday-hell a sympathetic doctor has given me the strongest medication possible to solve it and gradually, the spots will die down and my confidence will crawl back up. But the aim is to get it higher than it was before - because a week of bad skin makes those Good Skin Days all the more worth celebrating.
How do you deal with your skin problems when it comes to staying confident? Let us know in the comments!
Sensitive skin? Download my Beginner's Guide to Sensitive Skin now and you'll receive a free deluxe sample set from Pai Skincare
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