Does stress cause skin problems?

Stress and your skin

When you’re stressed, your body’s defence mechanism kicks in, releasing ‘stress hormones’. These affect different functions, like the flow of blood to your skin. A common sign of stress is skin irritation or a rash.

And you can get severe (but temporary) hair loss and a sore scalp following a stressful event like bereavement or a major operation. But stress also builds up through little things. Ongoing stress has a direct impact on your immune system, making your overall resistance to illness lower.

This makes you vulnerable to skin diseases like vitiligo (loss of skin colour) and urticaria. These are autoimmune diseases, meaning your body thinks it’s fighting an infection and produces chemicals that attack normal cells. Extreme or sudden stress may lead to vitiligo if you’re already liable to get this. There’s one form of hives called ‘adrenergic urticaria’ that’s caused by stress because it’s linked to your nervous system. Stress can also lead to inflammatory conditions like rosacea.

If you’ve already got a skin condition like acne, stress can make it worse. And stress may also trigger flare-ups of problems originally caused by something else, such as infection. One example is the herpes simplex virus, which causes cold sores. It lies dormant in your body but can be activated when you’re stressed or run down.

Coping with stress

Unlike some common triggers, stress is hard to avoid. And how you respond to it can affect your skin too. Stress can both keep you awake and increase the urge to scratch itchy eczema and urticaria so it’s even harder to get a good night’s sleep.

Turning to sugary and fatty comfort foods, alcohol, caffeine or smoking to cope with stress isn’t good for either your overall health or your skin. Alcohol and caffeine trigger the flushing typical of rosacea and the itchiness of urticaria and eczema. Smoking and drinking too much both make psoriasis worse.

Stress can also trigger habits called ‘body-focused repetitive behaviours’, like pulling at your hair and lashes, or picking at your skin. These addictive habits release dopamine, a ‘feel-good’ hormone, so can seem a form of short-term stress relief, but are obviously damaging in the long term.

Breaking the cycle

Skin conditions may actually cause stress because of how they make you feel about yourself and their impact on everyday life, social activities and professional and personal relationships. You can end up in a ‘vicious cycle’. A flare-up is something else to worry about so you find it even more difficult to cope with whatever’s making you stressed.

It’s important to break this cycle. Talk to your doctor about tackling both problems together, not in isolation. For instance, relaxation techniques can reduce stress and the ‘habit scratching’ that makes eczema worse.

Cognitive behavioural therapy (CBT) can help you react differently to potentially stressful situations. At the same time it can teach you to cope with the psychological effects of a condition like vitiligo and to address body-focused repetitive behaviours.

Mindfulness makes you more aware of your own thoughts, emotions and how you feel physically. It can help you be kinder to yourself and others. This should reduce stress symptoms that affect your skin, such as anger, which produces flushing in rosacea.

Studies suggest a combination of CBT and mindfulness can reduce the severity of psoriasis.

Your doctor can suggest local support groups and healthy lifestyle advice to help you feel better able to cope with both stress and skin problems. For instance, physical activity reduces stress hormones and produces natural chemicals that create a sense of wellbeing and help you sleep better. Your doctor can advise on ‘good sleep hygiene’ so you get the rest needed to deal with stress.

So although you may not be able to avoid stress altogether, there are ways to both reduce stress and its impact on your skin.