I can’t begin to tell you how often the subject of stress arises when I’m discussing skin conditions. Not only can stress be a trigger for skin flares, the stress of the flare itself can further exacerbate the condition. Skin cells are activated by stress, and in turn they produce stress hormones and inflammatory factors. All this can lead to a vicious cycle of stress-induced inflammatory events – aka stressed skin. It’s an unhealthy sequence that becomes increasingly frustrating, and feels difficult to break free from.

If you’re wondering whether stress might in some way play a part in your eczema, acne, rosacea or psoriasis, the short answer is yes probably. If you still have doubts over a possible connection between what goes on in our mind and what we see on the skin’s surface, think about the times you’ve blushed with embarrassment – our skin can most definitely reflect what we’re feeling inside. 

What is Stress?

Stress is our body’s way of responding to a perceived danger or threat. In our caveman days this might have been something really serious, like coming face to face with a wild animal. In this situation acute stress would be essential to keep us alive. Our senses become heightened as the body’s defence mechanisms kick into high gear, resulting in a rapid, automatic process known as the “fight-or-flight” response. This reaction is the body’s way of protecting us. We’re on full alert, ready to battle or flee. 

 The problem these days is that the danger no longer comes from a life threatening encounter with a fierce creature. More likely it arises thanks to an irritating driver who cut in front of us on the way to work, financial struggles at home, or that mountain of paperwork stacking up at the office. This sort of stress is not short-lived, it doesn’t go away and so we find ourselves chronically frazzled and overwhelmed. Our nervous system is not very good at distinguishing between emotional and life-threatening danger, so the physical response is just as strong in either case. 

The Impact of Chronic Stress 

Chronic stress has the ability to disrupt almost every system in the body. It can suppress our immune system, increase the risk of heart attacks or strokes, and seriously impact the bacteria in our gut, leaving the digestive system off balance. If you’re still doubting the very real connection between brain and gut, think about the feelings you experience when you’re anxious. Where is that sensation? We talk about ‘butterflies in our tummy’, a nauseous feeling ‘in the pit of our stomach’, suddenly those worrisome emotions in our mind have travelled all the way down to our abdomen. It’s the reason we can’t eat before a job interview or feel ‘sick to the stomach’ with financial worry. 

Stress is sneaky. It can hit us as the result of one major event, but often its a build up, a series of life-situations that, when combined, begin to feel overwhelming. This gradual accumulation is stealth-like. It might even begin to feel familiar or normal. In this situation, we don’t realise the impact stress is having, even as it’s taking a heavy toll on our health.

Stress, gut health and skin 

I have spoken before about the strong correlation between gut health and skin. Our skin is essentially a map of the gut – whatever is going on in our digestive tract can be reflected on the skin’s surface. Since stress has been shown to significantly impact our gut bacteria, it makes sense that this in turn can manifest as skin disease.   

Not everybody is affected by stress in the same way. For some it exhibits as stomach cramps or IBS, for others it’s a headache or unbearable migraine. For those of us prone to skin flare-ups, stress can play a very real role in triggering or worsening them – and stressed skin can be tricky to deal with.

External Stressors

Our skin is the body’s largest organ. It’s an important protective barrier that defends against injury and infection. It helps us to maintain a healthy balance between our external environment and internal tissues. It’s our primary sensing organ for external stressors, including heat, cold and pain. As well as having a significant internal impact, psychological stress can have many negative consequences on our skin’s ability to protect us. Including a disturbance of our permeability barrier and compromised immunity. 

Wound healing and PH balance might also be adversely affected. Research suggests that chronic, negative stress can disrupt the function of the epidermal barrier, which protects the body from excessive water loss and normally keeps out harmful substances. A key cause of stressed skin, this disruption can lead to flaky or dry skin, and in eczema patients, has been shown to increase sensitivity to allergens and microbial organisms. It can also significantly lower our itch threshold creating a frustrating cycle of scratching and irritation.

Treatment for Stressed Skin

There is no proven medical treatment that can specifically remedy for stressed skin conditions. This further highlights the importance of working on the cause. If we can reduce the levels of stress we experience in the first instance, the symptoms are much less likely to arise. 

Focused breathing and mindfulness meditation are well-established antidotes to the harmful effects of the body’s response to stress. The mechanisms by which these practices fight disease and promote healing are the focus of a discipline called ‘psychoneuroimmunology’, which studies the axis between the brain, our immune system and behaviour. Relaxation techniques have been successfully used alongside conventional medicine in treating acne, eczema, hives and psoriasis. One study of psoriasis patients found that those who listened to mindfulness meditation tapes while undergoing light therapy healed faster than those who had the light treatment alone.

Sleep Stress Away

Normally cortisol levels are strictly regulated by our internal circadian clock. We should see a peak early in the morning and a dip at around midnight. Stress can significantly disrupt these hormone levels, throwing a delicate balance into chaos. In this situation, a good nights sleep can be especially important. If itching is keeping you awake, try a soothing oatmeal bath before bed to minimise sleep disruption through the night.  

Stressed Skin and Psychology 

The psychological impact of dealing with skin disease should not be underestimated. Coping with a very visible condition can take a massive toll on our mental health. Many psychotherapeutic approaches can assist in treating difficult skin disorders. Cognitive behavioural therapy (CBT) for example, can focus on changing the thought patterns that cause distress or hinder healing. Supportive counselling can offer reassurance and help us to better understand our skin ailments, giving us a sense of clarity in working towards solutions. 

It’s important to remember that stressed skin is usually the result of a series of lifestyle factors over time. Unless your condition was triggered by a single, traumatic event, chances are it’s resulted due to a build up of stressors. Whilst I understand the desperation to heal, give your body time. Take small steps each day to work on those underlying triggers. This in turn will help to build a cycle of calm, relieving the pressure of stressed skin. 

Hanna Sillitoe began sharing her personal battle with skin health through an online food blog, which eventually led to her best-selling book Radiant – Recipes to Heal Skin from Within. Hanna’s book has sold over 25,000 copies around the world and it’s the 28-day plan within this book that many of her online followers credit as having cured their skin complaints.