Stress and the Skin

Article written by Abram Beshay, MD, University of Utah Healthcare

It would be an understatement to say that 2020 has been challenging. From the COVID-19 pandemic to earthquakes, severe storms, and lockdowns—in addition to everyday life challenges—this year has been incredibly stressful. Not only can events like these lead to psychological distress, they can also manifest in your skin, triggering or worsening a wide range of conditions.

Abram Beshay, MD, with the University of Utah Health Dermatology Residency Program provides the low-down on high stress and how it may be affecting your skin’s health.

HOW DOES STRESS AFFECT YOUR SKIN?

The human body is designed to fight against perceived threats. For example, our immune system plays a crucial role in keeping us healthy, protecting us from real dangers like COVID-19 or the flu. However, sometimes our bodies overreact to “threats” that are actually harmless. Unfortunately, this overreaction can occur with stress, resulting in unwanted skin changes.

HOW ARE THE BRAIN AND SKIN CONNECTED?

When the mind or body become distressed (by a real or unreal threat), our brain secretes hormones that induce the release of cortisol, a stress hormone, from our adrenal glands. Our skin has receptors for this stress hormone, and their activation results in various changes to our skin:

• Increased inflammation
• Impaired wound healing
• More oil and sebum production
• Impaired resistance to infection

WHAT SKIN CONDITIONS CAN WORSEN WITH STRESS?

Due to increased inflammation and the skin changes mentioned above, the following are examples of skin conditions that can flare with stress:

• Acne
• Hair loss (Alopecia areata)
• Hair thinning (Androgenetic Alopecia or Telogen Effluvium)
• Eczema (Atopic dermatitis)
• Psoriasis
• Rosacea
• Scalp rash(Seborrheic dermatitis)
• Hives

WHAT OTHER STRESS-INDUCED BEHAVIORS CONTRIBUTE TO SKIN PROBLEMS?

Not only can stress cause changes in our brain and body chemistry resulting in skin changes, but our behavioral response (conscious or subconscious) likely also contributes. For example, some people touch their face when they are nervous, introducing whatever is on their hands to their face, resulting in worsening acne. Also, we tend to stray away from our healthy habits when under tremendous stress. We may spend less time taking care of ourselves by sleeping less, eating unhealthy diets, skipping exercise, and not washing our faces regularly. All these behaviors can negatively impact our skin.

IF I ELIMINATE STRESS, WILL MY SKIN CLEAR UP?

Decreasing stress may help improve your skin, but it is by no means the “cure.” Preoccupying yourself to eliminate stress in order to better your skin may backfire as you actually become more stressed. For those with diagnosed skin conditions, please continue following your dermatologist’s recommendations. Our job is to provide you with the tools and skills to alleviate your stress and prevent any flare-ups.

WHAT SHOULD I DO DURING TIMES OF STRESS?

• It’s OK to be stressed. Being stressed is a normal response; it is not a sign of weakness. Accepting this is the first step to decreasing stress levels.
• Take care of yourself. Drink plenty of water, eat a healthy diet, exercise, sleep in a dark room with no bright screens on an hour before bed, and wake up at the same time each day.
• The following are relaxation techniques that have been shown to reduce anxiety and stress:
• Breathing: Breathe slowly, in through the nose and out through the mouth, for counts of three. Practice this every day for a few minutes before bed.
• Meditation: Numerous resources online can guide you on how to meditate. You can also reach out to a professional behavior therapist for further guidance.
• Yoga: Instructors are performing classes online during the pandemic.
• Be aware of nervous habits that surface during times of stress. If you touch your face when stressed out, you can wear a bracelet to remind yourself not to pick at your face.
• Do not forget about your social life even during the pandemic. Keep in contact with your loved ones and friends via Zoom or phone during these challenging times.
• Seek professional help from a behavioral therapist. These providers are trained to equip you with evidence-based strategies to cope with stress.
• Continue taking care of your skin. Use sunscreen whenever you go outside, moisturize often—especially during the winter—and, most importantly, continue to see your dermatologist.

Thank you to University of Utah Healthcare and HealthScope for providing this article. See their other articles here.