The Hidden Impact of Stress on Skin Health

You may have already experienced the connection between the skin and the nervous system. Perhaps you have experienced facial flushing or sweating when you have been in a stressful situation like an exam or before a performance. That is acute stress, which is actually beneficial to humans. However, when there is prolonged or chronic stress, the symptoms can go beyond flushing or sweating and may result in more complex skin conditions. 

Stress has become an integral part of our lives due to the fast-paced nature of today's world, which can impact our mental and physical well-being. While we often associate stress with its psychological effects, it is essential to understand how stress also impacts our skin.

The effects of mechanical, physical and chemical stress on the skin are well understood; however, the impact of psychological stress is often overlooked when considering skin conditions.

In this blog post, we delve into the scientific understanding of how stress impacts the functions of our skin, shedding light on the mechanisms that underlie these effects. Understanding this relationship is crucial for better skincare and overall health.

THE SKIN + STRESS 

The skin is a neuro-endocrine organ and its homeostasis is controlled locally by hormones, neuropeptides, neurotransmitters and cytokines that control and modify the skin's response to psychological and environmental stressors. Both local and systemic stress induce various inflammatory and immune responses that impact the skin. 

The skin is impacted by stress through the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. When the brain senses stress, corticotropin releasing hormone (CRH) is secreted, which stimulates the release of multiple stress mediators throughout the body.  

Amazingly, research has shown that CRH is also produced in the skin by keratinocytes (skin cells), melanocytes (pigment cells), sebocytes (oil cells) and mast cells (immune cells) upon stress. 

The various impacts of stress on skin health are discussed below.  

Stress reduces skin barrier function

The skin barrier becomes compromised by stress due to the reduced production of lipids and structural proteins. This leads to increased trans-epidermal water loss (TEWL) and impaired moisture retention. This disruption compromises the skin's natural defenses, making it more susceptible to irritants, allergens, and microbial infections. Impaired barrier function is associated with all skin conditions. 

Stress increases inflammation in the skin 

Stress-induced inflammation is a key player in the development and exacerbation of various skin conditions. The release of stress hormones activates pro-inflammatory pathways, leading to increased production of inflammatory molecules such as cytokines. Stress also causes mast cell degranulation resulting in increased histamine release, which causes flushing, swelling, pain and itchiness. As a result, conditions like acne, psoriasis, eczema, melasma and rosacea may worsen under chronic stress. Inflammation also contributes to accelerated skin aging, as it disrupts collagen synthesis and promotes the breakdown of existing collagen.

Stress impairs the skin’s healing capabilities

Stress can significantly impact the skin's ability to heal wounds and repair damaged tissues. Research suggests that stress hormones can delay wound healing by suppressing fibroblasts and the production of growth factors, in addition to impairing the function of immune cells involved in the healing process. Consequently, individuals under chronic stress may experience delayed wound closure, increased scar formation, and a higher risk of infection.

Stress increases sebum production and may increase acne

Stress hormones trigger the sebocytes to produce sebum in excess. This increase in sebum production, combined with hormonal imbalances caused by stress, creates an ideal environment for acne to thrive. Consequently, stress-induced acne breakouts are common, and individuals with pre-existing acne may experience worsening of their condition during stressful periods. Due to delayed wound healing caused by stress, individuals with acne may experience post-inflammatory pigmentation and scarring from their breakouts.

Stress increases oxidative stress and aging

Chronic stress can lead to an imbalance between the production of reactive oxygen species (ROS) and the body's antioxidant defense mechanisms. This condition, known as oxidative stress, can cause damage to skin cells and accelerate the aging process. Stress-induced oxidation contributes to the formation of wrinkles, fine lines, and age spots, making the skin appear older than it is.

Stress is a pervasive force that impacts not only our mental well-being but also our skin health. The skin's close connection to the brain means that stress can disrupt its functions, leading to inflammation, barrier dysfunction, accelerated aging, increased oil production, and exacerbation of existing skin conditions. By recognising the impact of stress on our skin and taking steps to manage stress levels, we can prioritize self-care and promote healthier, happier skin.

REFERENCES

Chen, Y., & Lyga, J. (2014). Brain-skin connection: stress, inflammation and skin aging. Inflammation & allergy drug targets, 13(3), 177–190. https://doi.org/10.2174/1871528113666140522104422 

M. Maarouf and others, The impact of stress on epidermal barrier function: an evidence‐based review, British Journal of Dermatology, Volume 181, Issue 6, 1 December 2019, Pages 1129–1137, https://doi.org/10.1111/bjd.17605 

Nives Pondeljak, Liborija Lugović-Mihić, Stress-induced Interaction of Skin Immune Cells, Hormones, and Neurotransmitters, Clinical Therapeutics, Volume 42, Issue 5,

2020, Pages 757-770, ISSN 0149-2918, https://doi.org/10.1016/j.clinthera.2020.03.008.

(https://www.sciencedirect.com/science/article/pii/S0149291820301715)