The condition of our skin can make a tremendous difference in how others perceive us as well as how we perceive ourselves and has been linked to profound impact on psychological health. According to Psychology Today, Americans spend more on their appearance than on social welfare, health, and education combined.1 While many people may scoff at this as pointless and tragically shallow, the desperation to look good may be rooted in something much deeper than vanity. Body image accounts for about one-quarter to one-third of your self-esteem, a major influence on your overall psychological health.1

The connection between skin and psyche is so deep that multiple studies have shown significant associations between skin disorders and psychiatric based conditions like depression, anxiety, and even suicidal ideations.2 What is interesting however, is that the severity of the skin condition is only weakly related to the severity of the psychological condition.1 This means that someone who has a relatively mild skin condition may take a deeper psychological hit. Large-scale international studies have shown that those with skin conditions such as eczema, acne, psoriasis, have higher incidences of depression, with 10% of those with psoriasis carrying the more severe diagnosis of clinical depression.2.3 Similar large-scale population studies have further shown significant associations between acne, eczema, and psoriasis with suicidal thoughts. In fact, a German study showed that 16% of patients with atopic dermatitis had suicidal ideation compared with 1% of the controls.4 The psychological scars can remain even after the skin condition has resolved.1

The naturopathic approach takes into consideration the mind, body and spirit. NDs will work with patients to uncover the root of skin issues and to mitigate impacts in other organ systems.

Uncovering the root cause skin issues

Naturopathic physicians have many tools to aid in the treatment of skin conditions and its overall cause and effect on the whole person. Because the practice of naturopathic medicine is rooted in finding and removing the cause of the problem, the issue of chronic and ongoing “flares” and “break outs” may be less common with a naturopathic approach. Utilizing a holistic, whole-person perspective means that the entirety of the individual will be addressed, not just the symptomatic area of concern. Some of the most common ways that naturopathic physicians approach treating skin conditions include:

Support digestion and gut health

Most people have heard of the “mind-body connection” but what about the “gut-skin connection?” The gut and skin are uniquely related in structure and function. Serving as our primary interface with the external environment, both have a dense vascular network and extensive nerve supply that is core to its role in neuroendocrine and immune function.5 A mounting pile of scientific evidence has confirmed the depth of the connection between the gut and skin, and multiple studies link GI health to skin health, particularly for inflammatory skin conditions like acne, eczema, and psoriasis.5 Naturopathic physicians have long been aware of this link and will take steps to assess, measure, and treat gut health as part of the approach to dermatological care.

Address food allergies and sensitivities

The digestive tract is home to about 80% of the human immune system.6 Since the gut regularly interacts with bacteria, yeast, viruses, and other microbes from the external environment, the job of this immune system is to help protect us from the onslaught of microbial invaders. Sometimes the immune system can become a little too vigilant in its protective role and can mistakenly start to attack normal food that we have eaten, resulting in food allergies and food sensitivities. This immune reaction sets off an inflammatory cascade that can manifest on the skin in the form of various breakouts and blemishes as well as inflammatory skin conditions like acne, rosacea, and eczema. Fortunately, there are blood tests that can assist in the identification of foods that may be causing the body to mount an inflammatory response. Knowing which foods are problematic and avoiding those foods in the diet for a time can help control a variety of skin conditions and allow the skin to heal.

Mitigate inflammation pathways

Inflammation is a normal and beneficial facet of immunity. In the short term, it helps drive the appropriate cells to the area where they are needed, supports removal of damaged tissue components, and advances the healing process. However when inflammation becomes long-term and chronic, the consequences can be quite serious.7 Inflammatory conditions of the skin can be impacted by local inflammation and reactivity of the cutaneous immune system as well as to inflammation in other areas such as the gut and overall systemic inflammation. Taking steps to minimize inflammatory activity in the body through any number of means can be a key feature of managing skin conditions. Moving to a more plant-based diet, avoiding food sensitivities, utilizing anti-inflammatory herbs, spices, and other nutrients are all ways that naturopathic physicians seek to curb inflammatory activity.

Balance detoxification pathways

There are multiple pathways by which the body utilizes to eliminate waste and toxins. Collectively, these organs and body parts are known as emunctories. Among these are the lungs, liver, kidneys, GI tract, and of course, the skin. A pace of detoxification commensurate with the ability of the emunctories to freely discharge toxins is essential for efficient elimination of toxins.8 When any one of these pathways is blocked or impeded, the others must take up the slack. The result is that they can become congested and overloaded from managing the increased workload. This can lead to the skin becoming a veritable wasteland for excess toxins and blemishes, rashes, acne, and inflammation can increase. Naturopathic physicians are well-versed in the emunctory system and in how to encourage its proper and balanced function through a variety of methods that promote elimination of toxins and toxic metabolic byproducts.

Utilize herbs and supplements

Naturopathic physicians are experts in the use of supplements and herbs as therapeutic agents in disease management. The internal and external use of nutrients can also be an important part of the management of skin conditions like psoriasis, eczema, and acne. Vitamins such as A, D, and E play crucial roles in skin health, integrity, and immune function. Low levels of some vitamins, such as vitamin D have consistently been observed in serious skin conditions like psoriasis.9 Other fats like omega 3 and gamma-linolenic acid (GLA) can also be important supplement considerations. Omega 3 fats have been shown to mitigate inflammatory pathways in the skin and aid in balancing an overactive immune response in cases of psoriasis.10,11 GLA is found in high concentrations in evening primrose oil as well as borage oil. Research has revealed that supplementing with evening primrose oil standardized to contain 40mg GLA led to significant improvements in eczema severity scores.12

Many minerals are also important for skin health. Deficiencies in minerals such as zinc, copper, selenium, and iron may result in cutaneous abnormalities. For example, scientific research has revealed a correlation between low serum zinc levels and the severity and type of acne lesions.13 Further research demonstrated that deficiencies in zinc and selenium could exacerbate eczema lesions.14

Herbs can also play a vital role in supporting skin health. Studies of multiple botanical acne treatments have reported favorable results, and several showed equal or superior treatment to standard therapies.15  Herbs like Curcuma longa have also been found to significantly inhibit inflammatory factors as well as reduce T cell proliferation in cases of psoriasis.16 Topical botanical therapeutics are also an option. Studies have shown topical application of Mahonia aquifolium, indigo naturalis, and Aloe barbadensis to be among the most efficacious in the treatment of psoriasis lesions.17

The skin is the largest organ of the body, with a total area of about 20 square feet. It protects us from microbes and the elements, helps regulate body temperature, and permits the sensations of touch, heat, and cold. The skin can also be the site of a number of medical conditions and clue us in to other underlying conditions. Dermatology and the treatment of cutaneous conditions can be extremely complex and notoriously difficult to treat. In conventional care, individualizing therapies can be extremely challenging, and pharmaceutical regimens may confer side effects that may be more unpleasant than the disease itself. Naturopathic physicians are uniquely trained to use a multitude of techniques and therapies to manage health. Click here to find an ND near you in the US and Canada.

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