This short questionnaire will take 10 to 15 minutes to complete and will ask you a range of questions about your psychological and emotional well-being associated with your skin condition(s), and your experiences of treatment.

The questionnaire is for people in the UK who have been diagnosed with a skin condition – if you need help to fill in the questionnaire, the answers should be given from your point of view.  We are interested in your experience even if your skin condition has now been successfully treated, or is in remission, please do complete the survey in order to help us improve services.

The anonymised results will be used to support the production of a new report by the All-Party Parliamentary Group on Skin on the psychological, emotional and mental health impact of skin conditions. Please note that comments may be reproduced in the report and the results of this survey may also be published in an academic journal.
About your skin condition

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* 1. Which skin condition(s) do you have?

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* 2. Please describe the physical symptoms of your skin condition(s)

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* 3. It is hard for people that haven't had a skin condition to understand the effect of these symptoms, please in your own words describe your symptoms and their impact.

Impact of your skin condition

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* 4. Has your condition(s) affected your emotional or psychological wellbeing?

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* 5. Has your condition(s) affected your self-esteem?

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* 6. Has your condition(s) negatively affected your intimate relationships?

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* 7. Has your condition(s) affected your social-life or leisure and sporting activity?

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* 8. Has your condition(s) affected your work or education?

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* 9. Has your condition(s) affected your sleep?

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* 10. Please list any other aspects of your life that your skin condition affects

Accessing treatment / therapies

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* 11. Did you know that in some areas of the UK there are NHS psychological services for people with skin conditions?

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* 12. Have you sought help in connection with your psychological or emotional wellbeing associated with your skin condition(s)?

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