Relaxation techniques and mindfulness for chronic pruritus

How do I integrate relaxation and mindfulness into my everyday life with pruritus?

Dr. Christina Schut, psychologist and expert in chronic pruritus, answered these and many other questions at our lecture series for patients with chronic pruritus.

Studies have found that there is a connection between biopsychosocial factors and itching: internal factors - e.g. anxiety - and external factors - e.g. stress or time pressure - can trigger or intensify physical factors such as itching or neurodermatitis.
The itching in turn can fuel internal and external factors, creating a vicious circle that unsettles those affected and increases the level of suffering.

The relationship between stress and itching shows a correlation between the intensity of itching and the degree of emotional stress prior to an episode. Scratching behavior and everyday stressors are also related.

Various relaxation techniques can be used to influence this.

One possibility is the Mindfulness  - a special kind of attention, defined by Kabat-Zinn in 1994 as follows: "Mindfulness is focused on the present moment, non-judgmental and goal-oriented".
Being mindful means observing your own body, your own surroundings, your own thoughts and feelings - without judging them. Low mindfulness, on the other hand, leads to reflexive and automatic actions in combination with a perceived lack of control.

Mindfulness-based training involves a cognitive change in behavior with the aim of,
to learn a different response to symptoms instead of changing the symptoms. Common training courses last about 8 weeks with one session of 2.5 hours per week.
Here, the patient learns to be mindful of breathing, walking or movement in general and body scans are carried out to focus on the body.
Studies have shown that mindfulness-based training has positive effects on the skin condition of patients with chronic itching, e.g. skin improvement during phototherapy.
The training sessions also have a positive effect on psychological parameters: Anxiety and depression are reduced and self-confidence in social interactions is strengthened.

Other relaxation options are Progressive muscle relaxation (PMR) and autogenic training.
The idea of PMR is that it is necessary to first experience tension in order to be able to experience relaxation afterwards.
Various studies have shown that two weeks of progressive muscle relaxation training already has positive effects on itching and sleep in patients with chronic itching due to atopic dermatitis. A 12-week relaxation training program with PMR + suggestion shows positive effects on itching in patients with psoriasis.

The aim of autogenic training is to experience relaxation by concentrating on imagined body perceptions. Short suggestion sentences on calmness, heaviness of arm and leg muscles, warmth, breathing and heartbeat are read aloud. Depending on the symptom, the standard exercises are adapted: for patients with chronic itching, the sentences relating to warmth should be avoided, instead: "My skin is pleasantly cool".
Studies show positive effects of autogenic training in combination with PMR in patients with psoriasis.

Meta-analyses conducted on psychological treatments as described above show moderate to large effects on itching and scratching behavior and larger effects on skin disease severity and anxiety and depression in patients with chronic skin diseases.
(Read more here: https://pubmed.ncbi.nlm.nih.gov/22924999/ and here https://pubmed.ncbi.nlm.nih.gov/26073701/)

Conclusion:

  • Biopsychosocial factors are relevant when it comes to itching and scratching behavior in chronic itching
  • Various psychological trainings (PRM, autogenic training) are effective in the supportive treatment of chronic itching
  • Mindfulness-based training and relaxation training are a useful addition to the treatment of patients with chronic itching
  • Further studies on itching and mindfulness are needed

When asked, Dr. Schut recommended the book "Die Haut und die Sprache der Seele: Hautkrankheiten verstehen und heilen" by Uwe Gieler, Klaus-Michael Taube, Kurt Seikowski, Gabriele Rapp.

Many thanks to Dr. Schut for the valuable information and the time you took and a big thank you to all participants for your keen interest and questions.

We look forward to the next lecture on 05.03.2024 on the topic of "Tips and tricks for chronic pruritus" - for the sake of your skin.❤️


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