Understanding Self-Stigmatization in Chronic Skin Diseases

Chronic skin conditions, such as psoriasis, atopic dermatitis, vitiligo, and hidradenitis suppurativa, can significantly impact individuals’ lives not only physically but also psychologically. Those suffering from visible skin disorders often wrestle with stigmatization—both from society and themselves. This article delves into the nuances of self-stigmatization in chronic skin diseases, highlighting key findings from a recent comprehensive review.

The Nature of Stigmatization

In the realm of skin diseases, stigmatization manifests in two main forms:

• Social Stigma (External): Negative perceptions from society that affect how individuals are viewed and treated.
• Self-Stigma (Internal): Internalized negative beliefs that contribute to decreased self-esteem and quality of life.

While much research has centered on social stigma, a growing body of evidence emphasizes the critical role of self-stigmatization in the lives of those with chronic skin conditions.

Recent Insights from the DEVISE Project

A recent review stemmed from the DEVISE project, which aims to assess and develop online interventions aimed at reducing self-stigma among individuals with chronic skin diseases in Germany. This initiative uniquely focuses on understanding the mechanisms contributing to self-stigmatization, grouping five conditions: psoriasis, atopic dermatitis, vitiligo, hidradenitis suppurativa, and alopecia areata.

Key Findings

“Our findings shed light on how social stigma can encourage internalized self-stigma,” stated researchers involved in the review.

Researchers undertook a comprehensive analysis of scholarly articles spanning four databases: PubMed, OVID, Web of Science, and PsycINFO. The goal was to gather peer-reviewed studies related to self-stigma among individuals diagnosed with chronic skin diseases.

Methodology Highlights

• Study Criteria: Inclusion required adherence to specific criteria:

  • Participants diagnosed with one of the five specified skin conditions.
  • Studies focusing on self-stigma or associated psychosocial predictors.
  • Publication in English or German.
• Search Outcomes: The search yielded 76 articles. After rigorous evaluations, including the removal of duplicates and irrelevant studies, researchers narrowed it down to 27 significant studies.

Notable Findings on Self-Stigmatization

The review uncovered several critical insights about self-stigmatization:

• Sociodemographic Factors: These factors, such as age, marital status, and race, generally played a minimal role in predicting self-stigmatization. Gender showed inconsistent results.

• Disease Impact: The severity and visibility of skin lesions correlated with higher self-stigmatization levels.

• Psychological Distress: Elevated feelings of anxiety and depressive symptoms significantly related to self-stigma.

• Coping Strategies: The use of effective coping strategies, especially social support and acceptance, was consistently linked to reduced self-stigma.

The Role of Social Support

Strong evidence suggests that individuals having greater social support report lower levels of self-stigma, emphasizing the need for supportive environments.

Conclusion: Addressing Self-Stigmatization

The findings from this review underscore the importance of tackling both psychological and social issues when addressing self-stigmatization in individuals living with chronic skin conditions. Key areas discussed include:

• Psychological Interventions: Develop interventions focusing on coping strategies and social support systems.

• Further Research Needs: Future studies should refine measurement tools for self-stigmatization and utilize longitudinal designs to explore causality effectively.

Further Exploration: It’s crucial to continue exploring the complexities surrounding self-stigmatization in chronic skin conditions to develop targeted interventions that can alleviate this burden.

For additional insights into the psychological burden of skin diseases, visit Journal of Investigative Dermatology.

Image Credit: © Siam – stock.adobe.com

References

1. Dalgard FJ, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015;135(4):984-991.
2. Ongenae K, Dierckxsens L, Brochez L, et al. Quality of life and stigmatization profile in a cohort of vitiligo patients and effect of the use of camouflage. Dermatology. 2005;210(4):279-285.
3. Stuhlmann CFZ, Traxler J, Paucke V, et al. Predictors and mechanisms of self-stigma in five chronic skin diseases: A systematic review. J Eur Acad Dermatol Venereol. 2024; 00: 1–9.

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