Addressing Mental Health Impacts of Skin Disease in Adolescents and Young Adults

Announcer:
You’re listening to DermConsult on ReachMD. On this episode, we’ll hear from Dr. Nicholas Brownstone, who will be discussing the mental health impacts of acne, psoriasis, and eczema on adolescents and young adults. Dr. Brownstone’s a chief dermatology resident at Temple University Hospital in Philadelphia, Pennsylvania.

Here he is now.

Dr. Brownstone:
Skin conditions like acne, eczema, or psoriasis impact self-esteem and mental health in adolescents and young adults in a unique way because these diseases are coming about at a time in a very special time in these patients’ lives. For example, acne rears its ugly head around adolescence, when patients are starting to develop their self-identity. At this time, the patient is worried about going outside of the house, worried about how they look, and this is obviously worsened in today’s era of social media, so one pimple on an adolescent or young adult’s face could be the end of the world for them, and that’s pretty unique for that disease. Furthermore, with atopic dermatitis, this disease is very common in school-aged children, a time in their life when they have to be learning in school, interacting with teachers, and interacting with their peers, and they may be itching, because the itch drives them totally insane. This is a unique aspect of atopic derm. This may cause these children to miss school, or when they’re in school, have an issue paying attention or socializing. This is called presenteeism. And finally, psoriasis is a lifelong disease with no known cure, so when an adolescent or young adult is diagnosed with psoriasis and learns it’s a lifelong disease, they may have trouble coping with this diagnosis. So these are some of the ways that these common diseases may impact adolescents or young adults in a more unique aspect.

Sometimes it’s difficult for dermatologists or other providers to effectively screen for and address the emotional burden of skin disease during their clinic visits. We all work in very busy clinics, obviously, but I’m going to break it down easily for everybody who’s listening, and I make this very simple. I ask the patient one question. “Is this disease significantly affecting your mental health or quality of life?” And if you ask this question, this one question, you have already done your patient great service by opening up the conversation.

Now, I understand you may not want to address it on the first visit, but at some point after you get to know the patient a little bit, it’s a great question to bring up. And again, you might not want to do it on the first visit, but you certainly can. Asking this one question will open up the conversation and the patient will feel like it’s appropriate to address the negative psychological impact. A lot of times they don’t. They think that the skin doctor—the dermatologist—wants to see my skin; they don’t care about how my mental health is being affected. This one question—a simple and easy question—will help open up the conversation during any busy clinic visit.

So if you’re in a very busy clinic or in a clinic visit and you ask the patient “Is this condition significantly affecting your mental health or quality of life? Are you being affected mentally?” and the patient says, “Yes,” there are two things you can do to help this patient who is suffering from skin-related emotional distress. And number one is to offer more aggressive therapy, or number two is to get the patient mental health counseling or referral to support groups. These are the two strategies that are quickly, easily implemented in the office to help patients suffering mentally from skin-related emotional distress. Now, I know you’re not going to fix it in that visit, but at least going down one of these two paths will set the patient up for success. 

Announcer:
That was Dr. Nicholas Brownstone talking about how we can address the mental health burdens of skin conditions in adolescents and young adults. To access this and other episodes in our series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!