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Pending job cuts at the office. Back-to-back final exams. A messy divorce. An unexpected surgery. What do they all have in common? In a word—stress. While everyone knows that stress can take a toll on a person physically and psychologically, it also can lead to dermatologic problems, such as acne, brittle nails or even hair loss.
In recognition of National Healthy Skin Month, dermatologist Flor A. Mayoral, MD, FAAD, clinical instructor in the departments of dermatology and cutaneous surgery at the University of Miamis Miller School of Medicine in Miami, Fla., spoke at the American Academy of Dermatology's SKIN Academy on the most common outward signs of stress on the skin, hair and nails, and offered stress management tips to control these symptoms.
“In treating hundreds of patients over the years with skin conditions such as eczema, rosacea, acne and psoriasis, I have seen first-hand how stress can aggravate the skin and trigger unexpected flare-ups that, in effect, create more stress for patients,” said Dr. Mayoral. “Learning how to manage the effects of stress on your skin can help alleviate some of the anxiety and symptoms.”
Stress and the skin
When a person becomes stressed, the level of the body's stress hormone (cortisol) rises. This in turn causes an increase in oil production, which can lead to oily skin, acne and other related skin problems. Dr. Mayoral noted that even patients with skin that is not affected by acne tend to develop temporary stress-related acne due to increased oil production.
In fact, a study in the January 2001 issue of the Archives of Dermatology entitled “Psychological Stress Perturbs Epidermal Permeability Barrier Homeostasis,” found that stress has a negative effect on the barrier function of the skin, resulting in water loss that inhibits the skin's ability to repair itself after an injury.
Specifically, the study involving 27 medical, dental and pharmacy students examined how periods of higher stress—in this case, during final examinations—impacted the skin's response to repeated stripping of cellophane tape on the subjects' forearms versus periods of lower stress, such as after returning from winter vacation. Researchers found that it took longer for the skin to recover from the minimally invasive tape stripping during periods of perceived higher stress than during less stressful periods.
“This study was the first of its kind to suggest what dermatologists anecdotally have known for years—that psychological stress adversely affects the normal functions of the skin," said Dr. Mayoral. “While the subjects in this study did not have any pre-existing skin conditions, I would suspect that people with skin conditions such as eczema or psoriasis would have been even more adversely affected by this experiment.”