• Gee Gahir

Holistic Health Pilot for Dermatology

Updated: Mar 22

Overview: Psoriasis Holistic Lifestyle Pilot

Barts Health Dermatology

Team : Professor Rino Cerio (Professor of Dermatopathology at the Institute of Cellular Molecular Science (School of Medicine and Dentistry) Queen Mary’s University of London) Dr Abha Gulatti Consultant Dermatologist, Angela Braeger Lead Dermatology sister, Gee Gahir (Holistic Health & Lifestyle Coach)


The Burden of Skin Disease in UK

  • Around 54% of the UK population experience a skin condition in a given twelve month period.

  • 69% self care, 14% seek further medical advice from specialist.

  • 24% of the population in England & wales visit their GP with a skin problem (2006 data)

  • The most common conditions are skin lesions, eczema, psoriasis & acne.

http://www.pcds.org.uk/ee/images/uploads/general/Skin_Conditions_in_the_UK.pdf


The effect of Stress on Skin Health

‘Stress can affect your whole body, including your hair, nails, and skin. Since stress is a part of life, what matters is how you handle it.’

https://www.webmd.com/beauty/the-effects-of-stress-on-your-skin


Cortisol triggers a catalyst of physiological changes in the body, some of which include but are not limited to; changes in your breathing rate, loss of appetite or inflammation of the digestive system, inability to sleep or restlessness, tiredness and poor skin.


Although we can not control the stressor, we can learn techniques to help manage the effects of stress, thus changing the physiological impact of stress on the body-mind-skin.


Current coping mechanisms include unhealthy lifestyle habits such as smoking and unsociable drinking.


Skin Focus Group Pilot – Objective

The objective of this pilot study was to see whether integrating healthy lifestyle education on patients with chronic psoriasis would help them to manage stress and as a result reduce PASI as a useful adjunct to current treatments.


QUALITY OF LIFE

Patient reported outcome measures (PROMS), DLQI and Global stress management scores were included throughout the duration of the pilot study (6 week program with 3 month follow up)


Patients were identified and selected based on DLQI assessment and stress scores.


FOCUS GROUP NEEDS ASSESSMENT

Patients are experts in managing their psoriasis.


The initial meeting of the focus group identified needs assessment. The focus group agreed that stress contributes to their psoriasis flare-ups.


Symptoms: overthinking, worry, sleeplessness, itchy, uncomfortable in skin, increased heart rate, short-tempered 'snappy', anxiety, low mood.


Common strategies used to overcome symptoms include: Talking therapy, smoking, and drinking.

  • No one had experienced a health & wellbeing workshop.

  • Two patients have explored complementary therapies

  • Reiki - helpful at reducing the severity of psoriasis

  • Nutrition - avoidance of diary

  • The focus group felt there was no local support for them -No place to meet like minded people to share stories

Patients identified the following areas they would like to explore further

  • Pain management (psoriatic arthritis, sore inflamed skin)

  • Relaxation techniques - to manage stress onset

  • Reassurance about the management of side effects - impact on wellbeing/focus on positives,

  • improvements in QoL

  • Make psoriasis sexy: improving relations (touch)

The original plan was to provide healthy lifestyle techniques over a 6-8week period. But logistically this proved difficult. The most beneficial workshops evolved to a once-a-month 2-hour focus group, each month with a hot topic related to skin health.



OUTCOMES

  • Attendees between 10-12 regular monthly (chronic psoriasis)

  • 100% strongly agreed the sessions were invaluable

  • 100% agreed the sessions addressed their needs and would adopt healthier lifestyle changes.

  • 80% said they would share the information and attend another healthy lifestyle session (most patients attended the days which they felt would be useful to their needs)

  • 80% agreed the techniques improved their stress levels

Methods distilled from yoga, naturopathy & nutrition, acupressure & shiatsu, 5 elements seasonal wisdom were integrated as part of the holistic lifestyle education;


YOGA & Skin Health

Acu-Yoga: yoga techniques designed off the mat with the addition of acupressure points to help reduce anxiety, stress, pain relief, and inflammation.


STRESS MANAGEMENT & Skin Health

Breathing techniques for PTSD developed by Dr Richard Brown http://www.breath-body-mind.com/richard-brown-md.php


NUTRITION & skin Health

Skin Nutrition: Gee developed a natural skincare guide based on naturopathic principles and whole-food nutrition. In addition the role of vitamin D was introduced for psoriatic arthritis patients.


Summary

The success of the pilot was articulated by the patient feedback.


(Dermatology Specialist Sister Angela Braeger, Barts Health & Gee Gahir, Lifestyle Coach)


Patient comments

  • Very invaluable – everyone should attend

  • Feel Confident being in my skin

  • Enhanced Happiness factor – stress less relax more

  • Ability to recognise and manage stress easily before it takes control

  • Incorporate me time everyday

  • Breathing techniques were very useful

  • Everything was explained well, Gee provided clear advice and I found it easy to engage


‘Thanks for organising such a great healthy lifestyle session Gee. I may need to book you in for some personal sessions!’ – Dr Abha Gulati


Although skin disease is considered a long term condition, educating and empowering patients with holistic stress management techniques offers choice in adapting healthier lifestyle habits.


Benefits include reduction of the physiological effects of stress on the body-mind.


The pilot identified a need for patient support earlier on in skin disease.


Gee provides bespoke Holistic stress management consultations specialising in skin health at SKIN55 Harley Street.

http://www.2020holistichealth.com/contact


References

http://www.pcds.org.uk/ee/images/uploads/general/Skin_Conditions_in_the_UK.pdf

https://www.webmd.com/beauty/the-effects-of-stress-on-your-skin

https://www.apa.org/news/press/releases/stress/2017/state-nation.pdf

https://www.psoriasis-association.org.uk/

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