One of Ahmed’s clients, Louise, doesn’t think the word does the practice justice. “It makes you think it’s for people who are imagining a problem with their skin – which it isn’t.”

For Louise, treatment was a way of learning to respect her skin and body at the same time as receiving medical advice.

Ahmed taught her to think further than skin deep – that what was happening inside her body was affecting its surface.

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Our glands produce more oil under stress, which exacerbates conditions like acne. Stress can also cause psoriasis, eczema and rosacea to flare up.

It even affects how your skin ages: stress hormones break down the collagen and elastin in skin, which means less protection against fine lines and wrinkles.

As a dermatologist, Ahmed understands that people are at a higher risk of developing poor psychological health and are “more likely to feel embarrassed, low, anxious, have body image issues and feel socially isolated” if their skin is poor.

“These feelings can impact their skin further and it can turn into a vicious cycle.”

The skin is both a target and source of stress, and many skin conditions that arise – or flare up – serve as a gauge of emotional or mental health: acne, rosacea, psoriasis, itching, eczema, pain and hives.

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All of these in turn affect how a person feels. There are numerous studies, for example, that show the link between depression and anxiety and acne.

In psychodermatology, she explains, “We recognise this link and treat not only the skin condition, but also its psychological impact”.

“For example, someone with acne feels anxious about being in a social environment because of their skin, so in addition to treating their acne, I will discuss techniques they can use to overcome these feelings and empower them to do the things they want.

“I also assess the person as a whole; we talk at length about their lifestyle, skincare regimes, work/study environment and relationships. Very few people realise how reactive their skin is to lifestyle choices.”

Ahmed, who is trained in psychology and dermatology, says psychodermatology is the perfect marriage of her passion for both. She became especially interested in the effects of stress on the skin.

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Louise says that during her sessions with Ahmed, “We spent time talking about life stressors and agreed that I would benefit from addressing the sources of this”.

Ahmed says it’s important to recognise that the site and severity of a skin condition does not necessarily match the distress it causes. For example, she says: “Someone with a ‘mild’ skin condition, or with a skin condition in a hidden area, can still be severely psychologically impacted.”

“Both facets are equally important,” says Ahmed. “There is more focus on holistic care.”

She hears regularly from clients who want to harness better mental health as part of their treatment.

Louise was perimenopausal so Ahmed suggested she consult a menopause expert about hormone replacement therapy.

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“For the hair loss, I had blood tests to rule out deficiencies, and started iron and zinc supplements,” Louise said. “We also spoke about my haircare routine and what products might help. My hair loss is now stable. I’m even seeing improvement in fullness.”

For the vitiligo, Louise underwent a course of phototherapy – ultraviolet light exposure – and supplements and creams Ahmed prescribed.

“The vitiligo responded a little but not much,” she says. After a long discussion with Ahmed, she began work on accepting her skin condition.

“I still have treatments but I am more confident about my skin. I think having the hair loss and worsening vitiligo at the same time made me feel self-conscious.”

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It is difficult to predict how long it may take for a patient’s skin condition to respond to treatment, says Ahmed, because each case is individual. But patients usually experience “a great sense of relief” after their first appointment.

“This might be the first time that someone understood the entire impact of their skin condition on their life,” she says.

A significant part of a consultation is spent asking patients to describe how their skin conditions affect aspects of their daily life, such as their mood, sleep patterns, work routine and relationships, and understanding how they cope with this.

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Supplementary treatments might include relaxation therapy, mindfulness, and other cognitive behavioural therapies. In some cases, where psychological distress is severe, she will treat a person with mood- or anxiety-managing medications.

She urges clients to remember that lifestyle affects skin.

“It is important to consider the amount of sleep people are getting, their daily fluid intake, food choices, and amount of time spent exercising.”

A psychodermatology appointment is longer than a general dermatology appointment, and may last from 45 to 60 minutes.

“This is to allow me enough time to assess both the physical and psychological health of the patient, as well as spend adequate time discussing treatment options,” Ahmed says.

Anyone with a skin condition can benefit from a psychodermatological approach, Ahmed believes.

“Just asking a patient, ‘Does your skin stop you from doing the things you want in life?’ can reveal the most enlightening information.”