ORIGINAL PAPER
Beyond skin deep: Self-compassion mediates the link between body shame and psychopathology in people with alopecia and psoriasis
1
Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Porto, Portugal
2
Instituto Superior Miguel Torga, Coimbra, Portugal
3
Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
Submission date: 2025-05-23
Final revision date: 2025-12-04
Acceptance date: 2025-12-06
Online publication date: 2026-03-12
Corresponding author
Diogo Carreiras
Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Porto, Portugal
Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Porto, Portugal
KEYWORDS
TOPICS
ABSTRACT
Background:
Alopecia and psoriasis are autoimmune dermatological conditions that significantly impact body image. Individuals living with these conditions often experience body shame, which has been linked to increased symptoms of anxiety and depres-sion. Self-compassion refers to the capacity to be sensitive to one’s own suffering and the motivation to alleviate it, and may act as a protective factor against psychological distress. This study aimed to compare psychological outcomes between the general population and individuals living with alopecia or psoriasis, and to test the mediating role of self-compassion in the relationship between external shame and symptoms of anxiety and depression among those with these dermatological conditions.
Participants and procedure:
Participants included 377 adults from the general population, 78 individuals with alopecia, and 67 individuals with psoria-sis. All participants completed self-report questionnaires measuring symptoms of depression, anxiety, internal and external body shame, and self-compassion.
Results:
The results showed that the general population generally experiences lower levels of body shame and depressive symptoms and higher self-compassion than people with alopecia and psoriasis. Also, in both groups with dermatological conditions, self-compassion was moderately to strongly negatively correlated with internal and external shame and depressive symp-toms, and moderately negatively correlated with anxiety symptoms. Mediation analyses showed that self-compassion me-diated both relationships between external shame and depression and anxiety, with models explaining 50% and 22%, respec-tively.
Conclusions:
This study highlights the potential utility of compassion-focused therapies to mitigate body image shame and associated psychopathology in individuals living with visible dermatological conditions such as alopecia and psoriasis.
Alopecia and psoriasis are autoimmune dermatological conditions that significantly impact body image. Individuals living with these conditions often experience body shame, which has been linked to increased symptoms of anxiety and depres-sion. Self-compassion refers to the capacity to be sensitive to one’s own suffering and the motivation to alleviate it, and may act as a protective factor against psychological distress. This study aimed to compare psychological outcomes between the general population and individuals living with alopecia or psoriasis, and to test the mediating role of self-compassion in the relationship between external shame and symptoms of anxiety and depression among those with these dermatological conditions.
Participants and procedure:
Participants included 377 adults from the general population, 78 individuals with alopecia, and 67 individuals with psoria-sis. All participants completed self-report questionnaires measuring symptoms of depression, anxiety, internal and external body shame, and self-compassion.
Results:
The results showed that the general population generally experiences lower levels of body shame and depressive symptoms and higher self-compassion than people with alopecia and psoriasis. Also, in both groups with dermatological conditions, self-compassion was moderately to strongly negatively correlated with internal and external shame and depressive symp-toms, and moderately negatively correlated with anxiety symptoms. Mediation analyses showed that self-compassion me-diated both relationships between external shame and depression and anxiety, with models explaining 50% and 22%, respec-tively.
Conclusions:
This study highlights the potential utility of compassion-focused therapies to mitigate body image shame and associated psychopathology in individuals living with visible dermatological conditions such as alopecia and psoriasis.
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