Incidence of psychological stress as an etiological factor of skin

disorders- A review

Dr. Rahul K ShingadiyaM.D.(Ayu), Ph.D. Scholar

Dept of RS & BK, IPGT & RA

Acharya Charaka defines Ayu (life) as the combinedstate of Sharira (body), Indriya (senses), Sattva(psyche/mind) and Atma (soul).

The state of health represents the balance between the mental, emotional, physical and spiritual areas.

Ayurveda gives equal importance to psychosocialand psycho spiritual relationship for healthy life.

Manolache L, Petrescu-Seceleanu D. Stress involvement as trigger factor in different skin conditions. World J Dermatol. 2013; 2(3): 16-26

Introduction

Dermatological conditions are intimately related tostress.

Stress could be involved as a trigger factor for a lotof cutaneous diseases: Psoriasis, vitiligo, lichenacne, atopic dermatitis, urticaria, etc

About 80% of affections could be induced oraggravated by stress.

Benjamin Barankin, Joel DeKoven, Psychosocial effect of common skin diseases

Knowingly or unknowingly, we are not giving much

importance to the role of these basic factors in the

occurrence of a disease.

Materials and Methods

In present Study, We have summarized the possibleincidences and evidences from the dissertationworks carried out on skin disorders in department ofRS and BK, IPGT & RA and available classicalliterature and articles were reviewed to find out therole of stress in 5 skin disorders:

Eka-kushtha (Psoriasis)Vicharchika (Eczema)Shvitra (Vitiligo)Yauvanpidika (Acne) andKshudrakushtha.

Results and discussion

Sr No. Skin disease No. of Dissertation

Total Patients

1 Yauvanpidika (Acne) 2 79

2 Eka-kushtha

(Psoriasis)7 502

3 Vicharchika (Eczema) 7 339

4 Kshudrakushtha 9 247

5 Shvitra (Vitiligo) 5 252

Total 30 1419

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

Acne Kshudra Kushtha

Eka Kushtha

Vicharchika Shvitra

16-30

30-45

46-60

Age group

Demographic data

Acne Kshudra Kushtha

Eka Kushtha Vicharchika Shvitra

48.89%

57%

64.90%58.90%

55%51.11%

43%

35.42%41.10%

45%

Sex

Male Female

Sex

53.16%

28.05%

17.80%15% 14.50%

17.72%

14.39%

24.40%

16.67%

6.52%

31.65%

15%

6.52% 6.52% 6.52%

0.00%

10.79%

6.52% 6.52% 6.52%

Acne Kshudra Kushtha Eka Kushtha Vicharchika Shvitra

Psychological factors in Different Skin disorders

Anxiety tension depression sentimental

Psychological factors

Etiological factors and Skin disorders

.

Sr. No Manas Hetu Srotas Dushti

1 Bhaya Ambuvahini

2 Chinta Rasavaha

3 Krodha, Bhaya, Shoka Swedavaha

Manas Bhava in Patho-physiology of disease

psychological stress increases levels of neuro-

endocrine hormones, affects the immune system

and alters the level of neuro-peptides, which may

be the initial steps in the pathogenesis of Skin

diseases.

Patho physiology

Al-Abadie MSK, Kent G, Gawkrodger DJ. The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions. Br J Dermatol 1994; 130: 199–203.

1. Chronicity

2. Mental strength

3. Socio-economical state

4. Nature of Work/ Occupation

Factors affects the psychological stress

AcneKshudra Kushtha

Eka Kushtha

Vicharchika

Shvitra

acute 25.32% 30.43% 26.75% 43.39% 21.00%

chronic 56.96% 69.57% 73.25% 56.61% 79.00%

0.00%10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%90.00%

Axi

s Ti

tle

Chart Title

Chronicity

Somatic diseases when become chronic they grow to

be very irritating and intolerable for the patient.

In some physical disorders where pain is acute or

constant, psychological stress develops earlier and

may be intense enough to produce certain acute

psychological responses or even long-lasting

psychosomatic diseases.

Chronicity

Benjamin Barankin, Joel DeKoven, Psychosocial effect of common skin diseases

6.63% 8.39% 8.20% 7.44%

97%

74.41% 78.71%71.64% 70.12%

35%

14.22% 12.90%20.15% 22.44%

Acne Kshudra Kushtha

Eka Kushtha Vicharchika Shvitra

Satva of the patients

P M A

Mental strength

The tolerance and temperament of the patient is

most important factor.

Even the effect and degree of the emotional hazards

also greatly depend upon the mental-strength

(Satvabala) of the patient.

Mental strength

Lev Pavlovsky, Alon Friedman Pathogenesis of Stress-Associated Skin Disorders: Exploring the Brain-Skin Axis

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

Kshudra Kushtha

Eka Kushtha

Vicharchika Shvitra

Poor

Middle

Upper

Socio-economical state

1. Sleep

2. Addiction

3. Bowel habit

4. Digestion process

Factors affected by the psychological stress

The skin disease itself can induce a secondary stress for the patient, influencing his quality of life.

5.50%

17.49%

27.08%22.80%

69.33%

50.22%44.56%

40.67%

32.29%28.36%

Acne Kshudra Kushtha Eka Kushtha Shvitra

Sleep

insomnia sound disturbed

Sleep

Sleep is described as one among the threeUpastambha which are the essential factors forhealthy life.

Chronic sleep disturbance can be seen as anunspecific state of chronic stress, which affectsimmune functions and general health.

McEwen BS. Sleep deprivation as a neurobiologic and physiologic stressor: allostasis and allostatic load. Metabolism. 2006; 55: S20–S23.

Sleep

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

Acne Eka Kushtha Vicharchika Shvitra

tobaco

smoking

alcohol

tea

Addiction

100%

49% 51.28% 49.37%

72%

1%

51%48.72% 50.63%

28%

Acne Kshudra Kushtha

Eka Kushtha Vicharchika Shvitra

Area of Lesions

exposed covered

Site of the lesions

Lesions on exposed part of the body affects the

appearance of the patients and thus they became

more anxious toward the disease.

McEwen BS. Sleep deprivation as a neurobiologic and physiologic stressor: allostasis and allostatic load. Metabolism. 2006; 55: S20–S23.

Site of the lesions

Conclusion

Psychological Stress is a very important factor tobe taken in consideration as precipitating oraggravating factor in different skin conditions.

We should concentrate on both the factorsaffecting and affected by stress and their impacton patients’ life to achieve the goal of Ayurveda

-Swasthsya swasthya rakshanam

and aturasya vikara prashamanam

Thank You