Skin & Emotions

Books by Dr Pradnya Manwatkar delve into understanding how the emotional landscape can lead to better outcomes and healthier, more radiant skin.

“Emodermatology helps you counsel the patient and give them therapeutic insight in as little as 10 minutes. ”

In the world of dermatology and aesthetic medicine, the pursuit of flawless skin has always been the primary focus. However, as the field continues to evolve, a new approach is emerging – one that delves deep into the intricate relationship between our emotions and the health of our skin. Dr Pradnya Manwatkar, Head of Cosmetic Dermatology and Emodermatology, Skin Mantra Clinic, Mumbai and Thane, has been at the forefront of championing this novel perspective, known as ‘emodermatology’.

Her two groundbreaking books, ‘How to Tell Your Skin to Heal Itself’ and ‘From Skin Breakouts to Skin Breakthroughs’, have illuminated the profound connection between mental well-being and our skin’s vitality.

In this exclusive interview with Shriyal Sethumadhavan, Dr Manwatkar shares her insights into the world of emodermatology and how it is transforming the way dermatologists and aesthetic plastic surgeons approach patient care.

How does emodermatology differ from traditional dermatology?

Emodermatology deals with the emotional impact of various dermatological conditions and the need to have ‘perfect’ skin (in cosmetic dermatology) and also vice versa: the contribution of emotions in the causation of the dermatological disease. Psychodermatology is more about dermatological pathologies and disorders that need oral antipsychotics or antidepressants. And, traditional dermatology deals with only medical prescriptions and cosmetic or dermatosurgery treatments.

In your book ‘How to Tell Your Skin to Heal Itself’, you emphasise the connection between mind and skin. Share some key insights from the book regarding how emotions impact skin conditions and healing?

The skin is a smart organ, as I like to call it. During embryonic development, the entire nervous system, the skin, and the sensory organs emerge from a single sheet of cells known as the ectoderm. So here we establish the skin-brain connection. We also have the central HPA axis that affects the skin, and going a step further, we have the peripheral HPA axis where keratinocytes are known to secrete CRH that goes and causes changes in melanin and causes immune cell changes in the skin. The book explains how each and every thought that is conscious, suppressed, and repressed causes a change in these axes that leads to skin diseases. For every dysfunctional thought that exists, there is an unhealthy negative emotion that is triggered that further leads to the stimulation of theNICE-Neuro immune cutaneous endocrine system.

For example, if one thinks of a favourite food – think of its colour, aroma, and texture on the tongue – one salivates. That is a direct response to one thought, and most of us have experienced it.

Through a case-based approach, the book explains how to identify harmful dysfunctional thoughts and unhealthy negative emotions and change them so that we end up giving our patients better treatment outcomes using emodermatology -that is REBT-Rational Emotive Behaviour Therapy applied to dermatology.

Your second book ‘From Skin Breakouts to Skin Breakthroughs’ hints at transformative approaches. How can emodermatology techniques lead to breakthroughs in addressing skin issues?

This book leans towards a technical approach and not a case-based one. It discusses the ABC model of Rational Emotive Behaviour Therapy discovered by psychologist Dr Albert Ellis. It gives tips on how one can achieve thinking awareness in real-time (not retrospectively) and change that harmful dysfunctional thought so that we respond to stressful situations and not react to them.

If I am able to identify the dysfunctional thought as it happened in real-time, then I am its master and not vice versa. This means that I can change that thought and therefore change the negative emotion that comes from it. This would lead to better control of my Peripheral and central HPA axis and thereby lead to a decrease in pigmentation or autoimmunity or prevent acne flares and hair loss in real time.

Both books highlight the importance of patient empowerment in the healing process. How can dermatologists empower their patients to take an active role in managing their skin conditions from an emodermatology perspective?

By helping them understand how the skin and mind are connected. By not endorsing medical or procedural interventions only. To be clear, all creams and procedures are needed. However, only depending on them to give results to patients is now passé. Counselling patients and giving them that moment of ‘therapeutic insight’ is one way of adding to this medical or procedural way of treatment we take for the patient. Emodermatology helps you counsel the patient and give them therapeutic insight in as little as 10 minutes.

“It is not about beauty, but it is also about emotionally healthy beauty. ”

“The next decade will be focused on emotional health.”

Emodermatology is a relatively new concept. What resources or training opportunities would you recommend for dermatologists looking to better understand this approach?

It is a new concept, and I do have an introductory three-day course for dermatologists to understand and implement it on their patients as they speak to them. No need for 30 min Freudian talking sessions. It’s all about the first 10 minutes that you spend with the patient. There are advanced courses that span for 15 hours over three months. This is in collaboration with psychiatrists.

Do you foresee the inclusion of emodermatology in dermatology curricula in the future?

Yes, I do, or so I hope it is. Psychodermatology has existed but it deals with pathologies and includes the use of medicines like antipsychotics and antidepressants for which most of us are not trained in our PG course. And rightly so because we have psychiatrists for that! With Emodermatology, I am dealing with the psychology of the patient: identifying personalities, identifying distress, identifying Body Dysmorphic – and most of our patients will have some underlying issue. Knowing how to tackle such basic issues without resorting to oral medicines is a safer option and gratifying because we see results in the wellness of the patient immediately. Improving self-worth and a sense of wellness leads to better healing and a healthy rapport. And I need not mention how the ‘feedback’ culture has taken over medicine as well. So, establishing a sense of rapport and trust is what emodermatology helps us do. It helps the patient achieve results faster and more importantly helps the patient sustain those positive results. Happy patient = healthy patient = happy dermatologist: isn’t it? Remember it can take as little as 1 minute for a patient to get therapeutic insight and start healing and responding to our treatment in my experience of six years.

Where do you see emodermatology heading in the coming years, and how might it continue to evolve within the field of dermatology?

I see it evolving or would like for it to evolve in the field of cosmetic dermatology; where it helps us get rid of the toxic beauty culture, the quick-fix skincare culture, the no-filter/filter look culture that exists. All of us have the right to look beautiful. But weighing what is the mental/emotional cost the patient is paying needs to be addressed. It is not about beauty, but it is also about emotionally healthy beauty. I also see it evolving as a tool that we can apply to all our cosmetic dermatology patients and be able to tailor-make their treatments for better treatment outcomes.

“If a dermatologist is able to help give the patient therapeutic insight in 10 min or less, then why not become an emodermatologist from the start of practice! ”

A message or advice would you like to share with your fellow dermatologists?

Considering emotions and psychology in dermatological care is the need of the hour, and the next decade will be focused on emotional health. The trend has already started. And if we can provide an additional service to our patients that gives a cent per cent chance of a better treatment outcome – then why not? And especially if a dermatologist is able to help give the patient that change and therapeutic insight in 10 min or less, then why not become an emodermatologist from the start of practice!

To book your copy of the book, connect with Dr Pradnya Manwatkar on Instagram @drpradnyamanwatkar