Sign in

Combating Cultural Stress

Howard Murad, MD September 2006 issue of Skin Inc. magazine

It’s 1:20 pm, and Karen—a longtime client—is late, yet again, for her 1 pm treatment. She rushes in, drops her things and collapses in your chair, saying, “It’s been a crazy day; please help me relax.” You’re guiding her through a few deep breaths when her cell phone starts to ring. She turns it off. You begin again. Although Karen’s time has been cut short, you do your best to provide excellent service. When her mask is on, you reach for your BlackBerry to check in with your son’s teacher. His report card is being e-mailed to you. You open it, gasp and think, “How can he get into college with these grades?” Your heartbeat accelerates. You are distracted. All you can think about is finishing with your client so that you can call the school. In the meantime, the receptionist slides a note under your door, alerting you that the computer system has gone down and the remaining appointments for the week have been deleted.

If you can relate to this scene, you are experiencing a new type of anxiety called cultural stress. It is pervasive and thrives in today’s world. The word stress as it relates to emotions became part of the English vocabulary in the 1950s and originated with the onset of the Cold War. During this time, bomb shelters were built to protect citizens from atom bombs, but American society would not permit people to admit fear. Instead, the feeling was dubbed stress.

The domino effect

In the years since, stress has evolved. Cultural stress started infiltrating people’s lives 20 years ago as society became more technologically savvy and prosperous. And it doesn’t affect only adults—cultural stress starts young and is initiated by parents. New moms and dads often are anxious about getting their children into the best preschools. In fact, it’s common for unborn children to be placed on a preschool waiting list. The next focus is on ensuring that the child is enrolled in all the right extracurricular activities—from preschool through high school. This cycle puts pressure on children to excel at a very young age, while placing a burden on the parents to make more money to pay for the education and activities.

This scenario—coupled with Americans’ increasing affluence—has a far-reaching domino effect. In order to make more money to pay for all the activities in which you and your family are involved, you must work longer hours. According to a United States government report documented on The American Institute of Stress’ Web site in 1999, Americans now put in more time on the job—an average of 47 hours per week—than workers in any other industrialized nation.

The more money you make, the more things you buy. And this phenomenon extends well beyond possessions. As society has become more informed, people are more aware of the endless possibilities that are available in the form of clubs, lifestyles, diets and leisure activities, to name just a few. All of this has put a great strain on people’s health and well-being, especially because the vast majority is barely keeping up.

As a result of this pursuit to stay ahead, workers are experiencing extreme levels of on-the-job stress. According to a report from the federal government’s National Institute for Occupational Safety and Health in 2000, 40% of workers find their jobs to be stressful, and 75% believe that their jobs are more nerve-racking now than they were a generation ago.

Americans’ busy on-the-go lifestyles have created yet another problem: There is no time to cook at home, so people have grown accustomed to eating out. Those who do this are faced with the stress of choosing a restaurant and making a reservation, or sometimes waiting an hour or more for a table. Others become reliant on unhealthy fast-food meals. As a matter of fact, an article titled “Fast Food Consumption of U.S. Adults” in The Journal of the American College of Nutrition reported that 42% of the money used on food items was spent on unhealthy fast food in 2001. In either case, Americans are consuming more processed foods than ever before. Eating meals that are high in sugar and saturated fats can cause glycation, which can result in increased susceptibility to diabetes. Refined foods also contribute to poor brain function and depression, and this often is combated with caffeine to stay awake and prescription sleep aids to instigate rest. Americans’ national sleep deficit has translated into an astounding 43.1 million sleep aid prescriptions in 2005, according to Barnes-Jewish Hospital in St. Louis, and more than $9.2 billion in retail coffee sales in 1999, according to the Specialty Coffee Association of America.

In order to help maintain mental and physical health, it is important to consume complex carbohydrates from whole grains, fruits and vegetables, and good fats—especially omega-3 fatty acids. This substance not only encourages water attraction to the cells, but also is a component of the cell membrane. In fact, studies chronicled in the recent Nutraceuticals World article “The Stability of the Mood Health Market,” by Marian Zboraj, have shown that omega-3s in food may help to decrease depression—a leading mental health disorder that has been linked to constant, overwhelming stress in people’s lives.

Cultural stress and clients’ skin

How does cultural stress affect the skin? As skin care professionals know, all of these conditions are reflected in the way the skin looks and feels. First of all, any kind of anxiety leads to a tremendous amount of nervous system activity. It can cause an outpouring of adrenaline, cortisol and other stress-related hormones. In recent years, I have observed an increase in rosacea and adult acne, which I believe is directly related to a rise in cultural stress. When you are stressed, researchers believe that an increased number of certain hormones that are known to worsen acne are released.

Another skin condition that I believe may be attributed to cultural stress is an increase in facial hair among adult women. Hormonal shifts and the outpouring of androgens that come with anxiety can cause hair loss, as well as the sudden growth of hair in places where it didn’t previously exist.

The water principle

The good news is that cultural stress can be counteracted, and health can be improved both physically and emotionally by understanding what I have dubbed “the water principle.” Cultural stress contributes to damaged cell walls, allowing the precious water that keeps them functioning to escape. This water loss has a myriad of effects. It causes the cells and connective tissues to break down, preventing your heart, lungs, brain and other organs from functioning at optimal levels—all of which become apparent when you look at the skin. You can encourage more water in the cells and reduce cultural stress by teaching these three simple steps to your clients.

  1. Topical care. As the largest organ of the body, the skin is extremely responsive to topically applied products. By using the appropriate skin care regimen, along with professional spa treatments, you can address skin care concerns that range from acne to wrinkles, while also preventing future damage.


  2. Internal care. With topical skin care, you can treat approximately 20% of the skin—the epidermis. The remaining 80%—the dermis—responds by feeding the skin from the inside. Encourage your clients to adopt a diet that is rich in raw fruits and vegetables, as well as healthy fats—such as those found in raw nuts and olive oil—to promote healthy, hydrated cells. Recommend a dietary supplement to provide the body with a constant supply of essential nutrients.


  3. Emotional care. Maintain connections with others. Discover a passion, such as painting or dancing. Reducing isolation promotes a healthy sense of self. In your treatment room, you are providing one of the most powerful tools for emotional care—that of the healing power of touch. Research from the renowned Touch Research Institute shows that it is as beneficial to touch as it is to be touched. Massage is shown to increase weight gain in premature infants, alleviate depression and positively alter the immune system.


Whether caused by fear, overwork or too many options that result in conflicted decision making, cultural stress ultimately leads to isolation, which is one of the most prevalent diseases in today’s world. Reports, such as those documented in the article “Social Isolation Growing in the U.S.,” by Washington Post staff writer Shankar Vedantam, have shown that, in order to reduce isolation, people need to have regular physical and social contact. This decreases cultural stress, leading to happier, healthier lives.

The esthetician’s role

Estheticians are health care providers. You are in a unique position to help your clients reduce the symptoms derived from cultural stress and achieve an improved state of well-being. According to the 2006 International SPA Association (ISPA) Industry Trend Survey, the spa lifestyle has become the fourth-largest leisure industry in the United States. This is evidence that more people are turning to spas to relieve stress and promote overall health.

It’s important to understand cultural stress and its pervasiveness. Keeping this concept in mind is a necessary step in creating spa surroundings that are completely free of the factors that can contribute to this type of anxiety, including cell phones, PDAs, television and loud music. The atmosphere should be focused on creating the optimum healing environment.

Also, simplify the remedies that you prescribe to clients. Often, you get so caught up in the solutions to clients’ problems that you actually can overwhelm them and make the situation worse. If you keep the message simple and focus on the client’s main concern—whether it be sun damage, acne, muscle tension or anything else—the treatment will become much more palatable, and the client will be more likely to embrace it and benefit from it.

Another simple way to help ease the weight of cultural stress is to make clients aware of it. Most people are feeling this tension without even knowing its cause. Once clients become aware of its existence, they can begin to take steps to combat the problem, and become more healthy, balanced and relaxed.

Develop coping tools

Cultural stress is a part of life. It’s something that affects everyone, but it doesn’t have to overtake your life. Although clients initially may come to you with a skin condition, they ultimately return because you do more than just care for their skin. By helping them to develop tools to cope with the cultural stress in their lives, you will be giving them a benefit that they will see on their skin, as well as feel physically, internally and emotionally.

Related Content



Tips for Reducing Cultural Stress

Practitioner, heal thyself. The first step in reducing cultural stress is trying to determine what gets you worked up. Identify its biggest causes for you, and then develop a plan of action to reduce its impact on your daily life.

Be mindful. Take some time each day to meditate or be quiet, and enjoy the simple rhythms of life.

Use psychology on yourself. Most of us have cell phones. If you are stuck in traffic and late for an appointment, make a call and then accept the fact that you can’t control the situation. One thing you can control is how you react to it. Try to make the best of the situation—why have a bad day when you can have a good one?

Exercise regularly. Go for a walk, do yoga or take an exercise class. Being physically active, even for just a few minutes, can make a difference in the way you feel.

Nourish your body for optimum health. Make it a habit to avoid the standard American diet. Consume foods that encourage and increase the water content in your body—a diet that is rich in whole grains, fresh fruits and vegetables, and good fats and proteins. Take a nutritional supplement to fill the gaps in your diet. And remember the water principle.

Get a good night’s sleep. Americans sleep less than people in any other industrialized country in the world, according to David Schardt, author of “How Sleep Affects Your Weight,” from the Nutrition Action Healthletter. You need seven to nine hours of sleep every night in order to fully restore the body. Don’t lose sleep. Find the time to recharge your body at night so that you have the energy to face the challenges that arise every day.

Find a hobby. It forces you to take time out for yourself and do something enjoyable. It also provides time for you to reflect.

Next image >