Explained: How does stress worsen skin problems?

Are you exhausted from following strict skincare routines, eating well and yet experiencing worsened skin conditions? It is time for you to address the elephant in the room, and that is your mental health. Not many might be aware of this, but chronic stress might be gradually affecting your skin rendering expensive and regular skincare routines ineffective for many.

"Mental well-being is an extremely important factor to regulate hormonal equilibrium in the human body. Skin is the largest organ of the body and is an important target for stress responses, both acute and chronic," says Dr Nilam Jain Kothari, consultant dermatologist at Masina hospital, Mumbai.

As Dr Geetika Mittal Gupta, wellness aesthetician, explains stress is the body's response to external challenges and pressure, which can produce cortisol, also known as the body's stress hormone. Cortisol, in turn, causes an increase in oil production and triggers emotion-induced sweat.

"Emotion-induced sweat is secreted and excreted from the apocrine glands located in your scalp, groin and armpits. And this kind of sweat is denser and fattier than the sweat we normally produce due to exercising. This sweat is a breeding site for many bacteria, which collectively with increased oil production cause acne breakouts or many more skin conditions," says Gupta.

Moreover, stress also triggers production of histamine, chemicals which can cause allergies in the body. These can lead to reactions on the skin such as itching, redness, dryness and undesirable flares.

What kind of effects can one see on their skin when they experience stress?

Kothari: Stress causes increase in levels of stress mediators, increased release of steroids (glucocorticoids) and adrenaline which in turn can cause significant changes in immune responses and exaggerated inflammatory response. It is now known that the skin and hair follicular keratinocytes also have receptors for Corticotropin releasing hormone and Adrenocorticotropic hormones, which activate inflammatory responses causing increased melanogenesis (production of melanin pigments), increased sebum production, increased mast cell degranulation, angiogenesis and pro-inflammatory responses.

Thus, stress can act as a trigger for inflammatory skin conditions, premature ageing and delayed wound healing and premature termination of hair growth. Conditions like acne, eczema, psoriasis, rosacea and vitiligo can cause emotional stress - which, as we know, can end up making symptoms worse.

How can one identify that stress is affecting their skin? What are the common indicators?

Gupta: Anxiety can cause quite a few issues when it comes to your skin, such as stress rashes (hives) and excessive sweating. These conditions can be uncomfortable, sometimes itchy or painful, and may even impact how you feel about yourself.

Common indicators are:

1. Rashes

2. Itching

3. Sweating

4. Acne

5. Redness

6. Flaring up of chronic conditions like acne rosacea, psoriasis, eczema etc.

Is it just a one-way impact or a particular kind of skin condition, irritation that also triggers stress?

Kothari: Chronic skin and hair conditions can generally cause significant changes in the quality of life of patients due to excessive psychological stress. This is especially seen in patients with skin conditions affecting the appearance and cosmesis, like vitiligo, alopecia, psoriasis, lichen planus and atopic dermatitis.

In present times, stress is like an everyday affair for people. At what level can one start witnessing the impact?

Gupta: Yes, we all experience stress in our day-to-day life. Mild stress won't cause any serious skin conditions.

But when this stress starts interfering in the skin care routine, your diet, sleep pattern, aggravates any chronic illness and when it is not managed on a daily basis, then one can start witnessing the impact.

If daily skincare routine is interfered with, due to stress, what are the ways in which people can tackle the situation?

Gupta: Some methods to tackle the skin conditions due to stress:

1. One of the most proven methods to tackle the condition is to meditate and exercise regularly. One should include exercises in their daily routine, despite their busy routine.

2. One must have a well-balanced and nutritious diet in a timely manner daily.

3. Have proper sleep for six to eight hours.

4. Always wear sun protection formula when you go out to avoid any damage due to sun rays and signs of flaring up.

5. Avoid dryness. Moisturise three times a day. Look for barrier repairing ingredients like hyaluronic acid, ceramides, glycerine, petrolatum, squalene, vitamin E in your moisturiser.

6. Reduce dullness by using hyaluronic acid and ceramides in your skin care routine.

7. Restrict salt and alcohol intake.

8. Treat allergies, avoid constant eye rubbing, sleep adequately, avoid excessive sun exposure

9. Products with caffeine, vitamin K1, kojic acid, peptides, retinols and Vitamin C may help.

Kothari: Seeing a dermatologist, regularly, to keep the recurrences in check is essential. Barrier function of skin is extremely important to keep recurrences of autoimmune diseases especially atopic dermatitis and eczema in check. Moisturising daily is the key.

Also read: Do you feel burned out? Why it is urgent for Indian employers to act on employees' poor mental health