Understanding the Impact of Stress on Skin: A Dermatologist's Perspective

We tend to know generally how stress impacts us physically. We may know that in order to counteract its effects on our mental and physical health, self-care, mental and physical wellbeing need to take priority in winter. But do you know how stress impacts your skin and how you can protect it? 

In this blog post, we check in with our very own board-certified dermatologist and Skincare Junkie founder, Dr Blair Murphy-Rose, to learn about the effects of stress on skin and understand how to manage stress and keep our skin happy and healthy. 

How Can Stress Affect Our Skin? 

Skin is the largest organ in our body — it protects us from the external environment and expresses what’s going on inside. Our skin closely interacts with our nervous system and responds to physical and emotional stimuli. It is particularly sensitive to the effects of stress. 

Stress affects skin function and can trigger or exacerbate some skin conditions. Stress can lead to skin inflammation, itching, acne, skin barrier impairment, aging, dermal thinning, and poor wound healing. Skin conditions that are caused or worsened by stress include acne, eczema, psoriasis, rosacea, some forms of alopecia, urticaria, and many others. 

Dr Murphy-Rose says that she sees the impact of stress on skin in her practice every day. Let’s look at each of the key ways that stress can affect skin and the science behind it. 

Stress, Skin Barrier, and Aging  

One of the principal functions of the skin is to protect us from harmful external environmental factors and organisms, such as microbes, and to provide a barrier to water loss. A healthy skin barrier is essential for healthy skin. When disrupted, it can lead to skin irritation, dryness, and chronic skin conditions such as eczema, psoriasis, etc. 

Stress can disrupt the skin barrier. In one study, students were followed throughout the academic year. As their sleep quality decreased and stress increased, their skin barrier function was impaired, which led to increased amount of oil (sebum) production, skin issues, and dark circles. 

Stress can also have a large impact on skin aging. When we are stressed, our body releases cortisol, a hormone that can accelerate the aging process. High cortisol levels lead to breakdown of collagen and elastin, the proteins responsible for keeping our skin firm and elastic. This breakdown leads to the development of fine lines and wrinkles, making the skin appear older.

By impairing the skin’s barrier function, stress makes skin more prone to dehydration. Dehydrated skin loses its plumpness, leading to dullness and lackluster appearance, further accentuating signs of aging. And by affecting sleep patterns, stress-induced poor sleep quality can also lead to skin aging, as sleep is a time when the body undergoes repair and regeneration processes. Lack of adequate sleep can lead to increased signs of aging and slower recovery from environmental stressors like UV exposure, temperature changes, etc. 

Stress, Inflammation, and Acne

Stress is a common trigger of inflammation in the body, including in the skin. Stress can exacerbate inflammatory skin disorders, including eczema, psoriasis, acne, and others. 

Stress induces the biochemical reactions that lead to activation of the so-called HPA axis (hypothalamic-pituitary-adrenal) and production of pro-inflammatory cytokines (substances). This leads to inflammation, which slows down wound healing and can cause a variety of health issues, including skin conditions. 

When we are under stress, our body releases hormones like cortisol. These hormones stimulate the oil glands in the skin, leading to increased oil production. Excess oil can clog pores, creating the perfect environment for acne-causing bacteria to thrive. Because stress slows down the healing process, acne may last longer, and the risk of scarring is higher. 

Stress, Hair Loss, and Depigmentation   

Interestingly, Dr Murphy-Rose says that she frequently gets questions about the link between stress and hair loss. Stress is known to inhibit hair growth and cause hair thinning and hair loss. 

Fortunately, most stress-induced hair loss is temporary, but it’s important to address the causes promptly to prevent long-term damage. 

A more well-known effect of stress is that it can lead to hair graying — it stimulates the release of a hormone called norepinephrine, which depletes pigment-producing stem cells within the hair follicle and leads to graying. 

Can Managing Stress Improve Skin Conditions?

Yes. Even though stress can be difficult to manage and to treat, many stress-induced skin conditions and dermatological concerns respond well to available treatments, says Dr Murphy-Rose. 

“I do like to educate my patients about how stress impacts the skin so that they can work on making stress reduction a priority. Finding time for stress relieving activities — whatever those may be for any individual — is important. We often get so caught up in the hustle and bustle that we neglect our mental health unintentionally. It is critical to take a step back and check in with ourselves to make sure we are OK and that we are making time for self-care.” 

Here are some of the steps that Dr Murphy-Rose recommends to take to reduce the impact of stress on your skin and health:  

• Manage stress through relaxation techniques like meditation and mindfulness. 
• Maintain a healthy diet, as poor nutrition increases stress and exacerbates skin problems. 
• Ensure adequate sleep, as it's crucial for skin repair and health. 
• Stay hydrated to maintain skin moisture and health. 
• Avoid smoking and excessive alcohol consumption, as they can aggravate skin issues. 
• Protect your skin from the sun, as UV exposure can worsen skin problems.
• Follow a consistent skincare routine tailored to your skin type. 
• Use skincare products that suit your skin type and address specific concerns. 

In order to mitigate the effects of stress on your skin, you should develop a stress management routine. This might include mindfulness practices, exercise, making time for stress-relieving activities and/or seeking professional help for chronic stress. Maintaining a healthy skincare regimen is vital. This includes gentle cleansing, moisturizing, and using products designed to strengthen the skin barrier. 

What Do Dermatologists Do to Manage Stress? 

We asked Dr Murphy-Rose to share what she does to manage stress in her busy life as a board-certified dermatologist, clinical instructor, business founder, mother, and wife.  

• Find time to exercise and meditate regularly. 
• Put down electronics and be present with family and friends.
• Maintain a healthy diet, get adequate sleep and get outside for fresh air each day (even during cold NYC winters!).
• Get organized: “When I have a ton on my plate, the best thing for me is to write down all of the things I need to get done, even the small ones — this makes it feel more manageable.” 

The next time you sit down to meditate or treat yourself to some self-care, remember this will benefit not only your mental health, but also the health of your skin. 

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