Title : Dermatology and phenomenology: How lived experiences of dermatological conditions should shape our practice
Abstract:
Background: Dermatological conditions are widely recognized for their significant impact on self-esteem and mental well-being, yet their psychological dimensions are often overlooked in clinical practice (1). Chronic and visible conditions such as eczema, psoriasis, acne, and alopecia frequently leave patients grappling with not only physical discomfort but also emotional burdens stemming from societal stigma and personal dissatisfaction. Care Opinion UK, a platform that facilitates anonymous patient feedback on healthcare experiences, provides valuable insights into these lived realities (2). The philosophical framework of Edmund Husserl’s phenomenology (3), which prioritizes the exploration of lived experience and subjective consciousness, offers a novel lens through which to examine these narratives. When applied to dermatology, phenomenology reveals the emotional and social burdens that are inseparable from the biological manifestations of skin conditions. Psychodermatology—a field integrating dermatology, psychiatry, and psychology—presents an opportunity to incorporate this phenomenological understanding into practice, thereby addressing both physical and psychological needs in a holistic manner.
Objectives: The objectives of this study were:
1. To explore patient dissatisfaction and emotional impact in the context of dermatology appointments.
2. To analyse how societal norms and stigma shape self-perception and mental health in individuals with dermatological conditions.
3. To demonstrate the value of phenomenology in understanding dermatological conditions and enhancing empathetic, patient-centred care.
Methods: This study conducted a systematic thematic analysis of five patient narratives sourced from Care Opinion UK. Each narrative focused on individuals with visible dermatological conditions such as eczema, acne, alopecia, or psoriasis. The analysis was guided by Husserl’s phenomenological approach, which emphasizes the subjective meaning of experiences, and was further contextualized through Foucault’s sociological framework of normalization to investigate the influence of societal and institutional pressures. Recurring themes were identified and analysed to illuminate the intersection of individual, social, and clinical dimensions in dermatological care.
Results: The analysis revealed three major themes:
1. Dissatisfaction with Clinical Encounters – Patients frequently reported feeling dismissed, judged, or inadequately supported during consultations. These negative interactions were attributed to clinicians’ emphasis on efficiency and clinical objectivity at the expense of empathy and emotional understanding.
2. Societal Stigma and Self-Esteem – Participants described the alienation and embarrassment associated with visible skin conditions. Societal norms around beauty and “normal” skin compounded feelings of shame, with some individuals internalizing these judgments as personal failure.
3. Impact on Mental Health – The psychological toll of dermatological conditions was evident, with patients reporting experiences of anxiety, depression, and diminished self-esteem. The cyclical nature of these conditions often exacerbated their distress, as flare-ups intensified both physical symptoms and emotional burdens.
Conclusion: This study underscores the importance of adopting a phenomenological approach in dermatology to better understand and address the emotional and psychological experiences of patients. By incorporating psychodermatology into routine clinical practice, clinicians can bridge the gap between mind and body, offering holistic care that attends to both physical symptoms and mental well-being. This approach has the potential to not only improve patient satisfaction but also enhance treatment compliance and overall quality of care.
Keywords: Phenomenology, Psychodermatology, Mental Health, Self-Esteem, Eczema, Acne, Alopecia, Psoriasis, Care Opinion
