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The Mind-Skin-Health Connection.

Shingles: Byproduct of Aging ... and Stress, Too?

Shingles is a painful skin problem caused by the same virus that's responsible for chickenpox. The virus remains inactive in nerve root cells for many years, until something rouses it, causing inflammation of the nerve. The patient experiences pain and a rash with small blisters in a narrow band on one side of the body.

"While it has long been suggested that stress may aggravate this condition, I have not found it to be true in the real world," Kunin says. "The dermatology community now feels that as people live longer, the majority of adults will eventually experience a bout of shingles. This is normally a one-time event. You can get it again in a different part of the body, but most people aren't that unlucky."

Kunin routinely treats shingles with oral antiviral agents to reduce the risk of postherpetic neuralgia, a painful condition that sometimes remains after the rash goes away.

Grossbart, however, says he believes stress can tip the balance between the virus and immune system and lead to an outbreak of shingles.

"We know the immune system is exquisitely sensitive to a range of emotional issues. We know the shingles virus lives in the body for decades. Why is it activated at a particular time? Because the person is under stress," he says.

Grossbart has found that hypnosis is particularly effective in dealing with pain control if pain persists even when the rash has disappeared.

Feel Emotions in Your Heart

In many cases, skin problems may be intimately linked with emotional issues the person is dealing with.

"Skin symptoms like other symptoms are often well-intentioned but doomed attempts to make our lives better," says Grossbart. "They are doomed because we're trying to use our skin to do things the skin is not designed for. I tell my patients, 'try to feel your emotions in your heart, not in your skin.'"

For example, Grossbart recalls one patient who was caring for a difficult baby, with little help.

"She developed a rash on her hand, on her ring finger, and it was so severe her wedding ring had to be cut off," he says. "Meanwhile, she was wearing similar rings on other fingers with no problem. This is a kind of body poetry, a physical metaphor."

One way to deal with stress is to use mind-body techniques, forming mental images of a safe, nurturing environment. Hypnosis and self-hypnosis can be effective too, Grossbart says.

"But when you're dealing with stress, the problem may not be the stressful situation, as much as the effort to avoid that situation and the feelings it arouses," he says.

Grossbart urges patients to use focused psychotherapy to explore and deal more effectively with situations that trigger skin symptoms.

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