City Research Online

Abstract

This study explores the lived experience of remission in chronic skin disease (CSD), a clinically significant but underexamined phase of the chronic relapse–remission cycle. Although the psychological burden of active CSD is well established, far less is known about how individuals experience periods of skin improvement or clearance. Using interpretative phenomenological analysis, semi-structured interviews were conducted with six participants previously discharged from a London-based National Health Service (NHS) psychodermatology service. Four themes were developed: (1) More than meets the eye captured a dissonance between physical and psychological recovery, with ongoing shame, vulnerability, and treatment burden despite visible improvement. (2) A wordless experience reflected the difficulty of accessing, naming, and retaining remission experiences, in contrast to vivid accounts of flare-ups. (3) All-consuming: overwhelmed by fear and powerlessness described remission as marked by sustained vigilance, anticipation of relapse, and vulnerability to withdrawal of care; within this, the study introduces the concept of ‘Relapse Anxiety’ to capture the persistent expectation of symptom recurrence. (4) Unsolvable dilemmas of remission captured treatment-related harms, attempts to regain agency, and harsh self-judgements surrounding the pursuit of relief. Remission was not experienced as a straightforward endpoint of recovery but as a psychologically active and poorly understood phase of adjustment. Visible improvement coexisted with ongoing distress, identity-level impacts, and treatment burden. Greater conceptual and clinical attention to remission may support more nuanced, patient-centred understandings, with further qualitative research needed to inform measurement and intervention.

Publication Type:	Article
Additional Information:	© The Author(s) 2026. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY NC). The non-commercial use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Publisher Keywords:	qualitative analysis, chronic skin disease, dermatology, interpretative phenomenological analysis, remission
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > R Medicine (General) R Medicine > RL Dermatology
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Psychology & Neuroscience
SWORD Depositor:	Symplectic Administrator

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