Emerging research highlights the multifaceted link between our emotions and skin conditions. Experts say a cycle may develop in which stress triggers skin conditions, and then the condition leads to more stress.
The findings are welcomed by anyone with a chronic, inflammatory skin condition, such as psoriasis, rosacea or acne – conditions that often flare when an individual is under stress.
The skin-psyche connection was the topic of a presentation at the American Academy of Dermatology’s Summer Academy. Dermatologist and clinical psychologist Richard G. Fried, M.D., Ph.D., FAAD, discussed the value of incorporating various stress management techniques into a dermatologic treatment regimen.
He believes the combined approach can help patients with skin conditions feel better physically and emotionally.
“Stress is personal, so what might be stressful for one person may be a non-stressor or even exhilarating for someone else,” Fried said.
“In terms of how stress can exacerbate or even initiate a skin condition, we are talking about distress, such as feelings of anger, anxiety, depression or tension, and how these emotional states translate to physiological problems.”
Stress causes distinct biological changes to the body causing the skin to release chemicals called neuropeptides. The neuropeptides can create inflammation and an uncomfortable skin sensation, such as numbness, itching, sensitivity or tingling.
“Until recently, it was thought that neuropeptides only stayed in the skin when they were released,” Fried said. “But we now know that they travel to the brain and ultimately increase the reuptake of neurotransmitters – meaning that stress depletes the chemicals that regulate our emotions, such as serotonin, norepinephrine, and dopamine.”
For example, he said, when psoriasis patients feel stressed about their condition, it can aggravate their symptoms and lead to a further decline in their emotional state, which becomes a vicious cycle.
To help patients combat stress-aggravated skin conditions, Fried recommends that appropriate stress management strategies be used in conjunction with traditional dermatologic therapies.
These strategies include psychotherapy, cognitive behavioral therapy, meditation, hypnosis, tai chi, yoga, antidepressants and beta blockers.
Fried noted that stress management makes patients feel more empowered and in control, which can make them more likely to comply with a treatment plan for their skin condition and see improvement.
“In my practice, I find that patients with chronic skin conditions tend to withdraw from normal, everyday activities and sometimes ‘shut down’ emotionally, which can really impact their personal lives,” said Fried.
“In addition, when you are withdrawn and have more time alone, it can make your symptoms seem more pronounced and you can end up feeling worse. That’s why it is so important for patients to seek a treatment plan from their dermatologist to help reduce their stress level and break the cycle of stress-related flares.”
Stress can also impair the ability of the skin to act as a protective outer layer. Stress can make the skin more permeable, more sensitive and more reactive, which is why dermatologists recommend the use of over-the-counter moisturizers to enhance the skin barrier function.
If stress compromises the skin’s barrier function, more irritants, allergens, and bacteria can penetrate the skin and cause problems. Specifically, stress can make a person’s rosacea more red or acne lesions more inflamed and more persistent. It can worsen hives, fever blisters, psoriasis and seborrheic dermatitis.
Source: American Academy of Dermatology