You may assume common skin conditions such as eczema, psoriasis and acneare the result of bad luck and bad genes alone. But you’d be wrong.
Stress can have a huge impact on skin conditions. A number of studies have shown that increased stress levels can greatly exacerbate common skin problems.
When I first see a patient, we discuss their lives in detail. Our skin is the first thing we see in the mirror every day – and if we have problems with our skin it may make us feel low and reluctant to face the world.
The mind and skin are closely inter-related and that’s why I work in clinic with a psychologist. I refer a number of patients to a psychologist each month in addition to offering medical treatment for their skin condition. Often the more emphasis given to the condition by the person suffering, the more likely it will remain an issue. That’s why it’s particularly important that patients understand the connection between skin disease and stress.
Stress = release of stress hormones
Stress hormones are incredibly important in dermatology, especially when looking at the role of stress in triggering or exacerbating common skin conditions such as eczema, psoriasis and acne.
Stress hormones such as Corticotropin-releasing factor (CRF) or CRH are a crucial part of our central stress response system. When we become emotional or stressed, CRF can be released from sensory nerves and immune cells, which in turn can lead to skin and systemic diseases.
It’s not just skin disease; as stress can make your skin age more rapidly. Chronic psychological stress stimulates the autonomic nervous system, renin-angiotensin system, and the hypothalamic-pituitary-adrenal axis as the body try to resolve the perceived threats.
Prolonged activation of these pathways can result in immune dysfunction, increased production of reactive oxygen species, and DNA damage, all of which can contribute to skin ageing.
Stress agitates us
How do we react to stress? If we become agitated, we may scratch our skin, which can lead to areas of thickened skin on the body. This is a particular issue in patients with eczema who often report feeling more itchy, and scratching more when stressed. In patients who have psoriasis, scratching can also be a problem as psoriasis often occurs in areas of skin that have been damaged, so scratching can make psoriasis worse.
One of the problems with scratching is that you can get stuck in a vicious cycle. You feel an itch, so you scratch it which causes the release of inflammatory chemicals, causing more and more itching.
SOLUTION: There is no one-size-fits-all solution, as each patient is very different. Often treatment requires a combination of topical remedies and emollients together with systemic treatment. I refer a number of patients for habit reversal sessions with a psychologist to help break the itch scratch cycle.
Stress causes us to eat less nutritious foods
If we experience prolonged stress then this may lead to depression and also have an impact on our diet. We may turn to sugary, comfort foods (starchy carbs) and more than the odd glass of wine, all of which can exacerbate skin conditions.
Recent studies have shown links between a high glycaemic index (GI) diet and worsening acne, suggesting that a low GI diet may help prevent flare ups of acne.
However, I know from patients that when life is getting a bit too much, whether at work or at home, the last thing they want to do is monitor their fruit and veg intake.
SOLUTION: Keep plenty of healthy snacks around the house and at work such as homemade popcorn, nuts, fresh vegetables and fruit.
You don’t get enough sleep
I see more and more patients presenting with various stress-induced skin diseases including hair loss, psoriasis, eczema and acne. Often when stressed, we don’t prioritise sleep but this is a mistake.
Did you know that the stress hormone cortisol naturally decreases while we sleep – allowing the skin to refresh?
SOLUTION: Strive for the recommended eight hours sleep a night to enable your body to rest and recover. Regular exercise can both help relieve anxiety and stress and also help you sleep.
Remember the best thing to do when stress levels kick in and show up on your skin is to take a step back and first ask yourself what is going on emotionally and internally.
That way you’ll be giving yourself the best chance to ease the problem before we treat it medically.