Psychological trauma and dermatology

Psychological trauma is the result of an extraordinary and distressing event. Intense emotions and high stress levels overwhelm and exceed a person’s ability to cope, leading to changes in the ecological stress response.¹

Traumatic events tend to be both physically and psychologically threatening and are often unexpected or unpreventable.¹ These include natural or manmade catastrophic events, such as war or a car crash, and other causes of significant psychological trauma, such as relational/complex traumas like assault, rape and kidnapping (especially in childhood). The break-up of a significant relationship, a humiliating experience or the onset or relapse of a life-threatening illness or disabling condition can also be a cause of psychological trauma (see Box 1). It is not only the event per se that determines whether something is traumatic, but also the individual’s experience and symbolisation of the event. For years, there has been a notable association between psychological stress/trauma and the onset or worsening of a variety of skin conditions.^2,3 This article will review the published literature on psychological trauma and skin disorders and aim to raise awareness of this important topic which is perhaps neglected in clinical practice.