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The Role of Mindfulness Meditation in Dermatology: Enhancing Patient Care and Provider Well-Being

By Keri Holyoak, PA-C, MPH, and Jason Evans, PA-C

Introduction

Dermatology is a demanding specialty that requires attention to detail, strong clinical decision-making skills, and a high degree of empathy—all while managing a substantial patient workload. The growing complexity of cases, the need for accurate diagnoses, and the emotional challenges of treating chronic or severe skin conditions place dermatology advanced practice providers (APPs) at an increased risk of burnout, compassion fatigue, and stress.

Patients seeking care in dermatology clinics present with a variety of skin diseases. These conditions are often highly visible and may be accompanied by intense pruritus, leading to social anxiety, embarrassment, and diminished quality of life (QOL). Studies show that patients with psoriasis, acne, and atopic dermatitis (AD) experience higher rates of anxiety and depression, highlighting the psychological impact of dermatologic disease.

Mindfulness meditation offers a proven, non-pharmacologic approach to support both dermatology providers and patients. For providers, mindfulness alleviates stress, builds emotional resilience, and enhances clinical effectiveness. For patients, mindfulness can mitigate the impact on stress-exacerbated conditions while improving overall well-being.

 

The Science Of Mindfulness Meditation

Mindfulness is defined as a state of present-moment awareness of one’s thoughts, feelings, and bodily sensations without judgment. Rooted in ancient Buddhist teachings, mindfulness has been secularized in modern medicine through structured programs like Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). Research supports its role in psychological and physiological regulation.1

1. Neurocognitive Benefits

Regular mindfulness practice strengthens the prefrontal cortex while reducing amygdala activation, leading to improved cognitive flexibility, memory retention, and emotional regulation.2 These benefits enhance clinical focus and efficiency in managing complex patient cases for dermatology APPs.

2. Stress Reduction

Mindfulness meditation is associated with reduced levels of cortisol, the hormone associated with the body’s stress response. A meta-analysis by Goyal et al. demonstrated that mindfulness interventions significantly lower stress and anxiety across healthcare professions.3 Dermatology APPs often face high patient demands and can benefit from mindfulness techniques to build resilience and maintain well-being. For dermatology patients, mindfulness has also been linked to reduced psychological distress and improved QOL. One study found that higher mindfulness levels correlated with decreased stress in patients managing chronic skin conditions. 4

3. Emotional Regulation and Empathy

Mindfulness fosters non-reactive awareness of emotions, allowing providers to navigate challenging interactions with greater composure. Furthermore, mindfulness has been linked to enhanced empathy and compassion. A study by Spinelli et al. linked mindfulness training to improved patient-provider communication and a more positive clinical environment.5

Patients with pruritic conditions often experience “itch catastrophizing,” a heightened psychological distress response to itching. This can be categorized as a negative way of thinking about the body. Mindfulness can help patients detach from their symptoms, reducing their reactivity and distress.

Applications Of Mindfulness Meditation In Dermatology

1. Reducing Provider Burnout and Compassion Fatigue

Dermatology APPs are at risk of burnout due to the emotional toll of patient care. Mindfulness serves as a protective buffer, fostering resilience and emotional balance. By incorporating mindfulness practices into daily routines, APPs can create a mental space to recharge, reflect, and restore their emotional resources. A study by West et al. found that mindfulness meditation significantly reduced burnout rates in healthcare providers.6

2. Improved Patient-Provider Interaction

Mindfulness can improve active listening and empathic communication, ensuring patients feel heard and understood. By fostering present-moment awareness, APPs can strengthen therapeutic relationships and improve adherence to treatment plans. Four days of mindfulness meditation training enhanced the ability to sustain attention, which may aid patient-centered decision-making.7

3. Mindfulness in Psoriasis Management

Psoriasis patients experience higher rates of depression and anxiety. A systematic review by Bartholomew et al. found that mindfulness interventions improved psoriasis outcomes, enhancing response to phototherapy and reducing psychological distress.8 Moreover, mindfulness has been shown to accelerate healing and lower disease severity.

4. Mindfulness in Atopic Dermatitis and Other Dermatologic Conditions

Psychological distress is a major factor in atopic dermatitis, contributing to increased disease severity and impaired QOL. MBSR programs have demonstrated reductions in itch intensity, improved sleep quality, and fewer flare-ups.9 Similarly, mindfulness-based approaches have shown promise in managing stress-exacerbated conditions like rosacea and acne, reducing autonomic nervous system hyperactivity.10

Integrating Mindfulness Into Dermatology Practice

Daily Mindfulness For APPs: Incorporating Mindfulness Into Daily Routines Can Be Seamless

Here are some tips for getting started:

  • Breathing Exercises: Take brief, mindful breaths between patient encounters.
  • Body Scan Meditation: Perform a body scan meditation, which involves bringing attention to each part of your body, starting from your toes and working upward.
  • Observational Awareness: Whether it’s an itch, a noise, or a distracting thought, practice observing these sensations or occurrences without judgment or immediate reaction. Let them pass naturally.
  • Gratitude Practice: Before ending your day, take a moment to appreciate the time you spent in this practice. Reflect on one or two things you’re grateful for, which can foster a positive mindset.

Practicing Active Listening Techniques During Patient Encounters

Mindfulness can also be applied during patient interactions through active listening. Dermatology providers can:

  • Focus on the patient’s words, tone, and body language without formulating responses prematurely.
  • Repeat or paraphrase key points to show understanding and encourage open communication.
  • Practice nonjudgmental observation of patients’ concerns, especially when discussing sensitive topics.

By being fully present, healthcare providers can build trust and make patients feel valued, fostering a stronger therapeutic relationship. It can also help providers pick up on subtle clues and provide a clear mind in helping to formulate effective working differential diagnoses for complex cases.

Journaling

Journaling can be a valuable mindfulness tool for dermatology providers and patients alike. This allows APPs to:

  • Identify Stressors: Document specific situations or triggers that provoke stress during the day.
  • Track Emotional Responses: Write about emotional reactions to difficult patient encounters or challenging situations, allowing for reflection and emotional processing.
  • Set Goals for Resilience: Use journaling to set personal or professional goals, focusing on areas where mindfulness can help build resilience.

Encouraging patients to journal about their skin condition, triggers, and emotional responses can also provide insights for both patient and provider, enhancing care and understanding.

Incorporating Mindfulness Management Into The Patient Encounter

The perception of a complicated discussion may be a barrier to adopting mindfulness management with patients. Taking some extra time to bring the option of mindfulness to our patients can improve outcomes in dermatological diseases.
Here are a few suggestions:

  • Suggest mindfulness apps, such as Calm and 10 Percent Happier, or guided exercises on smartphones.
  • Briefly educate patients on the stress-skin connection and the role of mindfulness.
  • Integrate mindfulness discussions into routine care as a holistic approach to treatment.

Conclusion

Mindfulness meditation offers a transformative tool for dermatology providers and patients alike. For dermatology APPs, mindfulness enhances well-being, reduces burnout, and strengthens patient relationships. For patients, it offers a non-pharmacologic strategy to manage stress-related dermatologic conditions. By incorporating mindfulness into clinical practice, dermatology providers can deliver patient-centered care while fostering their own professional growth and resilience.

REFERENCES

  1. Teper R., Segal ZV, Inzlicht M. Inside the mindful mind: How mindfulness enhances emotion regulation through improvements in executive control. Current Directions in Psychological Science. 2013; 22(6):449–454. https://psycnet.apa.org/record/2013-43009-005
  2. Hölzel BK, Carmody J, Vangel M, et al. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res. 2011 Jan 30;191(1):36–43. https://pubmed.ncbi.nlm.nih.gov/21071182/
  3. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014 Mar;174(3):357–68. https://pubmed.ncbi.nlm.nih.gov/24395196/
  4. Montgomery K, Norman P, Messenger AG, Thompson AR. The importance of mindfulness in psychosocial distress and quality of life in dermatology patients. Br J Dermatol. 2016;175(5):930–936. https://pubmed.ncbi.nlm.nih.gov/27169607/
  5. Spinelli C, Wisener M, Khoury B. Mindfulness training for healthcare professionals and trainees: A meta-analysis of randomized controlled trials. J Psychosom Res. 2019 May;120:29–38. https://pubmed.ncbi.nlm.nih.gov/30929705/
  6. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016; 5;388(10057):2272–2281. https://pubmed.ncbi.nlm.nih.gov/27692469/
  7. Zeidan F, Johnson SK, Diamond BJ, et al. Mindfulness meditation improves cognition: evidence of brief mental training. Conscious Cogn. 2010;19(2):597–605. https://pubmed.ncbi.nlm.nih.gov/20363650/
  8. Bartholomew E, Chung M, Yeroushalmi S, et al. Mindfulness and meditation for psoriasis: A systematic review. Dermatol Ther (Heidelb). 2022;12(10):2273–2283. https://pubmed.ncbi.nlm.nih.gov/36103011/
  9. Kishimoto S, Watanabe N, Yamamoto Y, et al. Efficacy of integrated online mindfulness and self-compassion training for adults with atopic dermatitis: A randomized clinical trial. JAMA Dermatol. 2023;159(6):628–636. https://pubmed.ncbi.nlm.nih.gov/37163257/
  10. Shenefelt PD. Mindfulness-based cognitive hypnotherapy and skin disorders. Am J Clin Hypn. 2018 Jul;61(1):34–44. https://pubmed.ncbi.nlm.nih.gov/29771216/

 

ABOUT THE AUTHORS
Keri Holyoak, PA-C, MPH, is a Physician Assistant at the Dermatology Center of Salt Lake City, UT.
Jason Evans, PA-C, is a Physician Assistant at Utah Valley Dermatology in Lehi, UT.

DISCLOSURES
Keri Holyoak, PA-C, MPH, and Jason Evans, PA-C, report no relevant financial disclosures.

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