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Stress is a common response to skin conditions.  It may also be making those skin conditions worse.

“Stress often gets forgotten about,” explains dermatologist Peter Lio, MD.  While patients with conditions like eczema may try dietary changes to help their condition, stress could be the real culprit.  “Stress worsens the skin, and bad skin causes stress,” Dr. Lio emphasizes. Conditions such as eczema, acne and psoriasis are responsive to stress and anxiety.

A recent survey of U.K. physicians underscored the link between stress and skin.  Nine out of 10 dermatologists agreed that the psychological effects of skin conditions were overlooked.  And 87% said people with skin conditions needed better access to psychological support.

But it’s not just symptoms that worsen patients’ stress and anxiety.  For some, seeking treatment for their skin condition presents still more stressors.  

In the United States, a shortage of dermatologists can require patients to wait months for an appointment.  As they wait, their condition – and their anxiety about symptoms – can worsen.  And with dermatologists scrambling to help as many patients as possible, appointments may be brief.  When a patient finally sees the dermatologist, schedule constraints may not leave time to discuss mental health.

Health insurance can introduce yet another stressor, barriers to treatment.  Innovative medicine offers dramatic relief for patients with conditions like atopic dermatitis, a severe form of eczema.  But through a practice known as step therapy, health plans may withhold coverage for a prescribed medicine until the patient first tries an insurer-preferred drug.  Dubbed “fail first,” the practice can entail weeks of ineffective disease management and disruptive side effects.  

Proper treatment could bring patients with skin conditions relief from a variety of stressors, from discomfort to pain to the inability to sleep.  But too often, access barriers and misguided health plan policies instead make treatment a source of what patients already have in spades – stress.  

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