Your emotions and stress levels affect the way your skin looks. Emotional upheavals can cause numerous skin problems; conversely, skin imperfections can lead to a gamut of emotional disturbances like depression, social withdrawal and poor self-esteem.

Studies show that at least one-third of all patients who approach skin clinics need to be emotionally treated as well, as part of their disease management. Here's how you can understand how your skin reacts to stress and mental turmoil so that you can recognise the signs and seek help at the right time.

Are you fiddling with your pimples?

This is a condition called 'Acne Excorie' and it affects several teenagers. It consists of a compulsion to pick, scratch and peel your pimples, thus causing permanent scarring. It is usually accompanied by depression and withdrawal from friends and society, as you feel your face is not worth showing in public. This condition requires a dermatologist-prescribed drug called 'Isotretinoin' and psychological support.

Do you itch all over without any obvious reason?

This condition is called 'Psychogenic Pruritus' in medical terms, and is categorised by severe itching in a specific area of your body, or all over, with no visible skin lesions. People use pens, brushes, combs -- anything -- to scratch this itchy area violently.

This happens due to a need to relieve everyday frustrations, as itching sets off the release of certain pleasurable hormones (endorphins) in the brain. This problem is seen in introverts, those who have suffered psychological trauma or severe stress recently. This condition requires a combination of psychological and dermatological treatment.

Do you pull your hair?

The medical term is 'Trichotillomania'. In simpler words, you have an irresistible urge to pull out your hair and there is a sense of relief once you've actually done it. This usually affects adolescents (about 0.6 per cent of all college students are affected), but adults too can suffer from it. More women -- about 10-15 times more -- than men are affected by this condition.

It is accompanied by anxiety, depression, substance abuse and even eating disorders. Pulling hair relieves stress in those who have this disorder and they come to dermatologists seeking treatment for hair loss. Behaviour therapy, stress management and parental support are needed by those who suffer from this condition.

Do you bite your nails?

Compulsive nail picking and biting are such a common stress relieving activity that most people don't even realise it's a problem/ disease. It makes your susceptible to infections and destruction of the nail. Such people usually have feelings of insecurity, anxiety and low self-worth.

Do your existing skin diseases flare up with stress?

Eczemas, psoriasis, acne, dandruff, etc, are known to worsen with mental stress or tension. Stress can also cause non-specific rashes or redness, or a dull, blotchy complexion. Control over your stress levels can significantly help to keep your skin problem-free.

Do you always feel ugly?

'Body Dismorphic Disorders' affect mostly people in their twenties, more often women, and especially people who are unmarried or unemployed. The symptoms might include constant dissatisfaction with your appearance, and imaginary or exaggerated defects like complaining about large pores, too much hair on your face, greasy skin and bad scars, whereas the actual problem is non-existent or minor.

Your thoughts are dominated by feelings of ugliness and unattractiveness. You indulge in compulsive grooming, spend more than you can afford on beauty treatments, obsessively look into mirrors and any reflective surface, including shop windows, cutlery, the reverse side of a CD, etc. You keep asking everyone what you look like. Such people usually have low self-esteem and nearly 80 per cent of such cases suffer some degree of depression.

These are all treatable conditions and require the joint supervision of dermatologists and psychologists. With behaviour therapy, biofeedback, hypnosis, stress management and, of course, medications like antidepressants if needed, these problems can be controlled.

So pay attention to your skin, it's trying to say something to you.