The Skin Stress Connection

Skin stress. Is there a connection?

Are you feeling tired, overwhelmed, short on time? Have you noticed dark circles or bags under your eyes? Maybe a new rash, some hair loss, or perhaps it feels as though your psoriasis is always flaring?

Heed your body’s warnings. There is a powerful connection between your skin and brain. Stress-related skin conditions are real and on the rise. Stress is well known to exacerbate acne, eczema, and psoriasis through the body’s inflammatory pathways.

Chronic stress can negatively impact your health in a variety of ways. Physiological changes can lead to high blood pressure, headaches, and fatigue.  But stress can also affect the appearance of your hair, nails, and skin.

Stress can trigger psoriasis and eczema flares. If you’re plagued by adult acne, yep, it could be stress-related. Dry skin caused by stress is another sign something is off under the surface.

The good news is there is a lot in your control to help manage stress and skin conditions. Your dermatologist can offer various solutions that may include medical intervention, cosmetic treatments, or simply some self-pampering.

How stress affects your skin

Both short-term and long-term stress can trigger a variety of chemical and hormone responses in your body. When stressed, your body responds in a number of ways.

• Your sympathetic nervous system revs up and releases hormones like adrenaline and cortisol.
• Elevated cortisol signals glands in your skin to make more oil
• As a result, your skin is more prone to acne outbreaks, clogged pores, and other skin problems.
• These automatic responses can cause inflammation, weight gain and increase your skin’s reactivity and sensitivity.
• Stress triggers inflammation, which can slow down digestion in the gut. High levels of stress can affect the bacteria in your gut and lead to a “leaky gut.”
• Stress impacts your immune system, affects your sleep, and can contribute to poor food choices
• Because the body thinks it’s under attack, stress aggravates autoimmune disorders and inflammatory conditions like eczema, psoriasis, and rosacea.
• Stress can trigger mood disorders, nervousness or anxiety, and increase nervous habits.
• You may inadvertently pick at scabs or acne, scratch your skin, or bite your fingernails
• Even small amounts of anxiety can send your body’s stress response into overdrive, resulting in the skin’s burning or itching.

Signs of stress on your skin

Under stress, chronic skin conditions tend to flare up, making skin problems including acne worse. Signs and symptoms of stress-related skin conditions include:

• Acne and skin rashes
• Burning or itching skin
• Eczema, psoriasis, and rosacea flare-ups
• Hair loss or oilier hair
• Hives and red bumps
• Dandruff, redness, and flaking of the scalp
• Delayed wound healing
• Dermatitis
• Dry skin, hair, and nails
• Fever blisters and cold sores
• Fine lines and wrinkles, especially frown and forehead lines
• Nails that stop growing become brittle or peel
• Under-eye bags and dark circles

Stress often kicks off a negative feedback loop. If you’re stressed, you’re more likely to neglect self-care or stay awake at night ruminating. Perhaps you get lax on your exercise and skincare routines. Even skipping out on washing your face at night or drinking alcohol can further aggravate skin issues.

It’s no surprise that people with psoriasis and eczema suffer from higher levels of depression, anxiety, and negative feelings associated with their skin condition. If you’re prone to these conditions, you may be preoccupied with how your skin looks or try to cover up rashes and plaques with clothing and makeup. This often leaves people feeling on high alert for any sign of an impending flare or outbreak, resulting in more stress and self-esteem issues.

If this sounds like you, don’t fret. Help is here.

Follow these self-care tips for stress-related skin conditions.

• Stick to your skincare routine, even when you’re stressed. Keep it simple. Wash your face with a gentle cleanser morning and night, wear non-comedogenic moisturizer with sunscreen and avoid skipping prescription and non-prescription topical treatments. Setting a reminder on your phone is a helpful way of staying on task.
• Schedule regular exercise. Find something you enjoy doing, whether that’s cycling, hiking, or online group fitness classes. Add in some gentle yoga or tai chi that will surely help combat stress. It’s good for your skin and your overall well-being. Bonus: Those feel-good workout hormones will elevate your energy, mood, and outlook.
• Practice regular stress management activities, including deep breathing, mindfulness, meditation, daily affirmations, and journaling.
• Be mindful of your diet. Avoid alcohol, nicotine, sweets and refined complex carbohydrates, highly processed foods, and known food allergens. Focus on eating a ‘rainbow’ of fruits and vegetables, lean protein, good fats, and antioxidant-rich foods such as avocado and berries.
• Take time for yourself to relax and unwind. Get your steps in by taking a nightly walk around the block or enjoy a calming oatmeal bath. Read a good book, listen to music or a compelling podcast, or splurge on a massage.
• Keep a regular sleep schedule. Stress can make you look tired and unwell, but so can lack of sleep. Proper sleep helps elevate mood, cognition and will help you cope with daily stressors all the better. Aim for 7-8 hours of uninterrupted sleep every night. Consider downloading a mediation or mindfulness app to help you unwind and unplug before bed. Turn off social media and your electronics an hour or two before bed.
• Stay hydrated. Drinking plenty of water helps flush toxins from the body and keeps your skin hydrated. Avoiding alcohol and excessive amounts of caffeine will help your state of hydration as well.
• Honor yourself and your commitments, but learn to say no and establish healthy boundaries. You don’t get extra points for checking e-mail 24/7 or volunteering for every carpool for the kids. Avoid overbooking or overextending yourself.  This only creates additional stress. Make sure you find time for at least one thing you enjoy.
• Engage a trusted friend or find a therapist to talk to, especially if your mental health is suffering. If you’re stressed about money, your marriage, or even your chronic skin condition, it never hurts to seek professional help. You may benefit from cognitive behavioral therapy and other stress-reduction techniques to help you cope during high-stress periods.

Medical treatment may be necessary

At-home remedies and self-care strategies can be a good first line of defense, but it may be time to consult your dermatologist if your skin problems persist. Stress-related skin conditions and outbreaks associated with psoriasis, rosacea, and eczema often require medical intervention.

If you’re struggling to pinpoint the cause of your skin issue, you can try tracking and recording symptoms in a diary. Contact your dermatologist if your skin doesn’t clear or worsens.

Your doctor may recommend:

• An individualized treatment plan including oral or topical medications.
• A gentle skincare routine with mild cleansers and noncomedogenic moisturizers free of fragrances and harsh additives
• Medicated creams or ointments, including topical corticosteroids and non-steroidal creams
• Prescription retinoids to help with breakouts.
• Strategies to help avoid scratching itchy skin, which may worsen your condition
• Advice on using cool compresses and ice packs to relieve swelling and itching.
• Particular combinations of over-the-counter medicines such as antihistamines help relieve symptoms.
• Journaling techniques that can help identify your triggers. Sources of stress are varied and can be environmental, emotional, financial, food-related, professional, physical, and psychological. Knowing your triggers will help avoid them.

The body’s stress response is systemic and can occur secondary to a number of insults.  And just like there isn’t one treatment for stressed skin, there likely isn’t one single factor causing your symptoms. Taking steps to be more mindful of what makes you feel stressed out and anxious can help you manage or minimize triggers by finding productive ways to release stress.

By keeping stress at bay, you can better manage chronic skin conditions or those exacerbated by stress. If you experience an unrelenting flare or rash, or your symptoms get worse, call your dermatologist. Skin rashes can often be diagnosed during a telehealth visit. You and your dermatologist can work together to improve the overall health of your skin.

APDerm offers a variety of medical, cosmetic, and surgical dermatology services. Contact APDerm today if you are concerned about stress-related skin conditions. Our team can diagnose your skin issues and help create an effective treatment plan. We also offer cosmetic procedures that can revive stressed-out skin.