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Psychodermatology is a well-established field in Europe and is offered as an outpatient service in some NHS hospitals. This specialism gets its name from psychiatry which is focused on the "internal" nonvisible disease, and dermatology, which is focused on the "external" visible disease.
This field of medicine recognises the relationship between mental health issues like stress, emotional upset, depression and other psychological problems and how they exacerbate skin problems.
Our skin can alert our brain to stress, and it can also be a target of stress responses. This two-way communication system between the brain/skin is due to the complex interaction between our nerves, hormones and immune system. This disturbance raises cortisol levels, also known as our stress hormone. High cortisol levels over long periods can cause mental and physical health symptoms.  
Psoriasis, cold sores and atopic eczema are influenced by stress mediators, which set off this chain of events leading to skin inflammation and hormonal disruption. This impairs the skin barrier function leading to dry, sensitised skin susceptible to <a title="acne" href="/conditions/acne/" target="_blank" rel="noopener">acne</a> breakouts. The resulting appearance of the skin can cause even greater stress and anxiety, leading to more serious mental health problems. 
Continued chronic stress can promote premature ageing. Raised levels of inflammation over long periods, along with a compromised immune system, lead to a phenomenon known as inflammation. The skin is under stress from both internal and external causes. This is why it is so important to consider the potential causes and treat both from the inside out with lifestyle changes and outside in with skin health strategies.

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