Stressed out? It shows on your skin

Contributed by Dr Kok Wai Leong, Senior Consultant Dermatologist, StarMed Specialist Centre

Is stress wreaking havoc on your skin? If you’re noticing rashes, acne breakouts, or other skin issues, it may be more than just a coincidence. 

I often get asked by patients whether there is a link between stress and skin health – the short answer is a resounding yes. Many of us have experienced outbreaks of rashes, acne, or sensitive skin during stressful periods. This is your body’s response to stressors from environmental changes or personal challenges.

Stress stems from various sources, from preparing for an important presentation to coping with loss or a devastating life event. When feeling stressed, your body triggers a chain reaction of increased levels of hormones and chemical signals. These changes can manifest in various skin, hair, and nail issues, including:

• Sensitive skin
• Inflammation in the skin
• Hair loss
• More oil and sebum production
• Skin infection and delayed wound healing

Sensitive skin
During periods of stress, your body’s immune response undergoes changes that can lead to more sensitive and reactive skin. As a result, you may notice redness and itching, or stress-induced hives characterised by raised, itchy bumps or patches.

Inflammation in the skin
Stress is a catalyst for various inflammatory skin conditions, notably atopic dermatitis and rosacea. Atopic dermatitis, a form of eczema, flares up due to heightened inflammation levels during stressful periods. Similarly, rosacea, characterised by facial redness, worsens as stress triggers increased blood flow to the skin, intensifying the symptoms.

Immune-related conditions, also known as autoimmune diseases, occur when the body’s immune system mistakenly attacks its own healthy cells, including those of the skin. Individuals with vitiligo, a condition characterised by white patches on the skin, may experience exacerbations triggered by extreme or sudden stress.

Hair loss
Hair loss, known as telogen effluvium, is another common consequence of stress. This condition often occurs after significant physical or emotional stressors, resulting in temporary hair loss and nail abnormalities.

More oil and sebum production
Individuals with acne may notice flare-ups during times of stress. This occurs due to heightened cortisol levels, which stimulate increased activity in the oil glands. Similarly, skin infections like cold sores may flare up, and wounds may take longer to heal when stress levels are high.

Skin Infection and delayed wound healing
Skin infections such as cold sores are typically more active during periods of stress. Also, you might find that your skin does not heal as well when you are stressed.

Behavioural and lifestyle effects
Stress can indirectly affect your skin in many ways through behavioural and lifestyle changes. It can disrupt sleep patterns, leading to insomnia or difficulty falling asleep, and exacerbate tendencies to scratch or touch the skin, which can further aggravate existing rashes or acne.

Furthermore, individuals under stress may resort to unhealthy coping mechanisms, such as excessive consumption of sugary and dairy-laden comfort foods or increased alcohol and tobacco use. These actions may aggravate skin inflammation and worsen conditions like psoriasis, eczema, or urticaria.

Caring for your skin during times of stress

Stress is an inevitable part of life, affecting everyone to varying degrees. While it’s impossible to completely eradicate stress from our daily routines, there are effective strategies for mitigating its impact on both our minds and skin.

Begin by prioritising relaxation techniques such as mindfulness exercises. These practices can significantly reduce stress levels, benefiting you’re your mind and your skin. Additionally, adopting healthy habits like staying hydrated, eating a balanced diet, and ensuring you get enough sleep can work wonders for your skin health.

Here are some additional tips to keep in mind:

• Stick to a consistent healthy lifestyle routine, as your skin requires good habits for repair and restoration.
• Adhere to any additional skincare routines recommended by your dermatologist to address specific concerns.
• Be mindful of your urge to scratch or touch your face. Instead, try distraction techniques like tapping and keep your hands clean.
• If you find yourself struggling to cope with stress, don’t hesitate to seek professional help. Behavioural therapy and other therapeutic options can provide valuable support.

By being mindful of the impact of stress on our skin and taking proactive steps to manage it, you can safeguard your skin’s health and appearance. Remember to continue implementing these lifestyle and skincare practices, and if your skin concerns persist, consult with a dermatologist for personalised guidance.

References

1. Hunter HJA, Momen SE, Kleyn CE, et al. The impact of psychosocial stress on healthy skin. Clin Exp Dermatol. 2015;40(5):540–546.
2. Patel A, Jafferany M, et al. Multidisciplinary and Holistic Models of Care for Patients With Dermatologic Disease and Psychosocial Comorbidity: A Systematic Review. JAMA Dermatol. 2020;156(6):686–694.