How Stress Affects the Skin - The Dermatology Review

How Stress Affects the Skin

SKIN CARE REVIEWS

02.26.21DISCLAIMER

Stress is an emotion that can pop up before a job interview, when a loved one passes away, while being stuck in traffic — you name it. However, 2020 kicked up a bit more dust than usual, leaving the nation more stressed than ever. According to a survey by the American Psychological Association, “Americans have been profoundly affected by the COVID-19 pandemic, and that the external factors Americans have listed in previous years as significant sources of stress remain present and problematic. These compounding stressors are having real consequences on our minds and bodies.” Nearly eight in ten adults (78%) say the coronavirus pandemic is a significant source of stress in their lives, and two in three adults (67%) say they have experienced increased pressure throughout the pandemic.

But the pandemic isn’t the only cause of stress. More than three in four adults (77%) are stressed by our nation’s future – up 11% from last year. While feelings of angst can have side effects such as muscle tension, poor sleep, lack of sex drive, or a short temper, the skin is also affected by stress and anxiety. 

In some cases, stress aggravates a current condition, and in others, it’s the root cause. “Nearly everyone has some form of stress in their life, so it’s difficult to determine whether stress can make the skin diseases worse,” said Dr. Richard Granstein, chairman of the department of dermatology at Weill Cornell Medical College and a member of the National Rosacea Society’s Medical Advisory Board. “However, it’s been known for a long time that the nervous system, which processes our stress, has an impact on conditions such as psoriasis and rosacea.”

When we’re stressed, certain parts of the nervous system are activated with improved delivery of neuropeptides (a member of a class of protein-like molecules made in the brain) and neurotransmitters, the molecules used by the nervous system to transmit messages from neurons to muscles. This reaction can affect how the body (and skin) responds to chronic stress, including inflammation, an overproduction of oil, and dilated blood vessels. 

Let’s take a closer look at the adverse effects of stressed skin, as well as what you can do to keep your anxiety under control. 

Eczema

Eczema is the all-encompassing name for a group of skin conditions that cause dry, itchy skin patches and irritation. There are seven different types of eczema, including: 

  • Atopic Dermatitis: The most common form of eczema, the skin becomes extremely dry and cracked. 
  • Contact Dermatitis: Occurs when the body comes in contact with a particular substance such as a harsh detergent. 
  • Neurodermatitis: Raised, rough patches of scaly skin that are incredibly itchy. 
  • Dyshidrotic Eczema: Small blisters on the palms of the hands.
  • Nummular Eczema: A chronic form of eczema that causes itchy, cracked, and swollen circular or oval patches.
  • Seborrheic Dermatitis: Red, scaly patches on scalp, ears, eyebrows, and the sides of the nose.
  • Stasis Dermatitis: A chronic form of eczema that causes itchy skin, inflammation, and ulcers, on the lower legs

Eczema and Stress

While allergies, low humidity, heat, harsh detergents, materials like wool, and certain foods can cause an eczema flare-up, emotional stress is also a contributor. When stressed, the body releases a hormone called cortisol, which increases inflammation in the entire body, leading to an eczema outbreak. 

Psoriasis

Psoriasis is a skin condition that occurs when the immune system causes certain areas of the skin to produce new cells more quickly than average. Psoriasis symptoms include: 

  • Dry, cracked skin that that’s prone to bleeding and/or itching
  • Red patches of skin covered with thick, silvery scales.
  • Itching, burning, tenderness. 
  • Small patches of scaly skin
  • Thickened, pitted, or ridged nails.
  • Swollen and stiff joints

Psoriasis and Stress

The cause of psoriasis is not clear, but scientists believe that most people with psoriasis inherit one or more specific genes that can affect the immune system to make them prone to psoriasis. According to these experts, the most common cause of a flare-up is stress. As with eczema, mental stress causes the body to release chemicals that boost the inflammatory response. 

Rosacea

Rosacea is a common skin condition that causes excessive redness (almost like a bad sunburn) and visible blood vessels in your face. Small, red, pus-filled bumps may also be present. There are four types of rosacea, including: 

  • Erythematotelangiectatic Rosacea: Chronic redness and visible and enlarged blood vessels worsen when there’s a flare-up. 
  • Papulopustular Rosacea: Along with facial redness and flushing, there’s also the appearance of pus-filled blemishes and red, swollen nodules. This type of rosacea is often mistaken for acne, as there can be many imperfections present at once — including on the neck, chest, and scalp. 
  • Phymatous Rosacea: Thicken skin that’s prone to scarring, resulting in a swollen, bumpy, and often discolored appearance. It’s a rare form of rosacea that mainly affects the nose and is more predominant in men than women. 
  • Ocular Rosacea: This form of rosacea affects the eyes, causing them to look bloodshot and watery, which is also accompanied by dryness, sensitivity, and a burning sensation. It’s also possible that cysts may form on the eyelids. 

Rosacea and Stress

Studies suggest that rosacea is linked to autoimmune disorders such as type 1 diabetes, celiac disease, multiple sclerosis, and rheumatoid arthritis — especially in women. Men are only connected to rheumatoid arthritis. However, anything that causes rosacea to flare-up is called a trigger. Hairspray, sunlight, heat, alcohol, and spicy foods fall into this category. 

While emotional stress is one of the leading causes of rosacea flare-ups, stress management (more on that in a bit) can be highly effective in reducing its impact, according to a recent survey conducted by the National Rosacea Society. In a study of more than 700 rosacea patients, 91 percent reported that emotional stress caused or sometimes caused their rosacea to flare up. Stress reportedly led to frequent flare-ups for 45 percent of the survey respondents and occasional outbreaks for 42 percent. Only 10 percent indicated that stress rarely affected their rosacea.

Dryness

Dry skin is a common condition that causes flakiness, scaly patches, itching, and irritation. It’s also normal for the skin to feel tight and have a dull appearance. In severe cases, cracks and fissures can develop. While dry skin can be a standalone skin type, it can also accompany other skin conditions such as: 

  • Eczema (atopic dermatitis)
  • Contact dermatitis
  • Athlete’s foot
  • Seborrheic dermatitis

Dryness and Stress

Age, climate, genetics, health conditions, and occupation (perhaps you work outdoors in a cold environment or around chemicals), can cause dryness. However, when the body is stressed, it experiences a spike in adrenaline and cortisol (do you see a theme here?). The adrenaline increase causes the body to sweat more, so you become dehydrated because you’re losing water at an expedited rate. 

Wrinkles

Wrinkles are the lines and creases that form in your skin. Some forms — such as wrinkles on the forehead —  can develop into deep crevices or furrows. With age, they can become increasingly noticeable around the eyes, mouth, and neck. There are five different types of wrinkles, including:

  • Expression Wrinkles: These wrinkles are caused by repeated movements over time, such as smile lines or puckering from smoking. 
  • Gravitational Wrinkles: Wrinkles that are accompanied by sagging skin due to a breakdown of collagen and elastin.
  • Atrophic Wrinkles: Deep parallel lines that appear between the eyebrows (known as the 11s) are furrowed.  
  • Elastic Wrinkles: Small wrinkles that pop up on the lips, cheeks, and neck due to an overabundance of sun exposure. 
  • Compression Wrinkles: Creases that appear on your face, neck, and chest from poor sleep habits like sleeping on your stomach. 

Wrinkles and Stress

By now, it should be no surprise that stress can cause wrinkles due to the overabundance of cortisol, which breaks down collagen and elastin in the skin. Chronic stress can also increase inflammation, which accelerates the aging process. 

Acne

Acne is a skin condition that occurs when the hair follicles become clogged with dead skin cells, dirt, oil, and bacteria, resulting in pimples, whiteheads, and blackheads. Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually. There are three different types of acne:  

  • Acne Vulgaris: Acne vulgaris is an umbrella term for the most common of the three main types of acne. This variation boasts several different kinds of pimples, including blackheads, whiteheads, papules, pustules, nodules, and cysts. 
  • Acne Mechanica: This form of acne is provoked by excess heat, pressure, and friction on the skin. Because of this, athletes are prone to getting acne mechanica.  It’s characterized as small bumps that appear as tiny comedones or larger inflamed lesions.
  • Acne Fulminans: Though rare, this severe form of acne (seen predominantly in male teens) appears as inflamed nodules on the chest and back. It can lead to acne scars, fever, and joint pain. 

Acne and Stress

Studies revealed that while stress isn’t the direct cause of acne, being stressed can worsen the condition. Acne heals at a slower rate when you’re under pressure, which means pimples stick around longer, thus running the risk of a breakout spreading to a different area of the face.

How to Relieve Stress and Anxiety

Even if you’re taking care of your stressed skin with a solid skincare routine, you’ll likely see little improvements until you get a hold of your stress levels. Also, skin aside, stress is no joke from a health perspective. According to the American Institute of Stress, 33% of Americans feel that they live in extremely stressful conditions — it’s the leading premature cause of death. Here are a few ways you can reduce your cortisol levels so you can keep your mind, body, and skin as healthy as possible. 

  • Meditate: Even five minutes a day can help you clear your thoughts and manage your stress levels. Find a quiet, distraction-free place to meditate. Up the ante by lighting a candle, dimming the lights, and playing some soft, peaceful music. Need inspiration for your practice? Download one of these meditation apps
  • Make Time for a Hobby: No matter how busy you are, make time to do something you love. While stress can make you feel overwhelmed, if you push yourself to take that cooking class, engage in something artistic, or even start working on a side business you’ve been dreaming about, you’re apt to lift your spirits while distracting yourself from your troubles. 
  • Journal Your Thoughts: Every time you have a stressful or anxious thought, write it down in a journal. This exercise can help you feel less overwhelmed, provide clarity, and give you an outlet to release negative thoughts and feelings. 
  • Eat Stress-Relief-Type Foods: The foods that relieve mental stress are also those that reduce bodily health issues as well. We’re talking about leafy greens, turkey breast, oatmeal, yogurt, pistachios, blueberries, salmon, avocado, seeds (flax, sunflower, etc.), dark chocolate, milk, eggs, seaweed, cashews, oysters, beets, turmeric, chamomile, and green tea. In short, the way you fuel your body is the way you’re going to look and feel — and nobody wants to feel like a sodium-laden, processed frozen dinner. 
  • Invest in a Few Stress-Relief Products: Stress can be relieved by the senses, too, so enhance your lifestyle with items like an essential oil-infused pillow spray, a white noise machine to help you sleep, CBD beauty, and/or supplements (speak to a doctor first if you have any underlying health conditions), a weighted blanket, an acupuncture mat, essential oil diffuser, or a gel mask. 
  • Adopt an Animal: Providing you have the financial and emotional resources, adopting a pet can distract you from your troubles while giving you a companion who provides unconditional love. Not to mention, an animal like a dog will force you to be more physically active — exercise is another effective stress-buster. 
  • Exercise: Speaking of movement, it’s one of the most critical stress-busters you can engage in because it effectively reduces cortisol — the number one cause of stress-related skin issues. Improved sleep and increased self-confidence are just two of many additional benefits. Make it easy to incorporate exercise into your life by taking advantage of streaming workouts and YouTube videos. Even taking a walk around the block can alleviate some stress. 

In Conclusion

It can be concluded that the rise in the stress hormone cortisol is the most significant contributor to stress-related skin disturbances that accompany pre-existing issues such as eczema, psoriasis, rosacea, dry skin, wrinkles, and acne. According to a survey by the American Psychological Association, our nation’s pandemic and the future are two major issues that stress Americans in 2020 on top of typical stress-related concerns in the previous year. Along with a solid skincare routine (perhaps accompanied by prescription products from a dermatologist), stress management has been proven to alleviate the flare-ups associated with chronic anxiety. 

Resources:
Stress in America 2020,” American Psychological Association.
A Deeper Look at Psoriasis,” Harvard Health Publishing, November 2018.
Stress,” Rosacea Review.
More Evidence of Rosacea, Autoimmune Link,” Dermatology Times, April 2016.
Skin Conditions by the Numbers,” American Academy of Dermatology Association.
The Response of Skin Disease to Stress,” JAMA Dermatology, July 2003.
Slowing of Wound Healing by Psychological Stress,” The Lancet.
Can Stress Cause Hair Loss,” Mayo Clinic.
Stress is a Leading Cause of Premature Deaths,” Stress.org, October 2019.

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