If you've ever struggled with your skin, you know the level of stress that unpredictable flare-ups can cause. Now, an ever-growing body of research shows a complex link between the skin and the psyche—including the way stress itself affects skin conditions such as psoriasis, rosacea, and acne.
According the the American Academy of Dermatology, conditions like psoriasis may be more difficult to diagnose in darker skin and initial lesions can become darker as a result, leaving long-term scarring in some cases. Acne, on the other hand, is a growing problem for women in their 30s and beyond, though the ADA says it is unclear why that is.
“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," says dermatologist and clinical psychologist Richard G. Fried, MD of Yardley, Pa.
Dr. Fried explained the complex relationship between stress/distress and the skin at the American Academy of Dermatology’s Summer Academy Meeting 2011 in New York, according to Newswise. "It is important to consider the biological response that happens when a person experiences stress," they noted. "Neuropeptides, the chemicals released by skin’s nerve endings, are the skin’s first line of defense from infection and trauma. When responding to protect the skin, neuropeptides can create inflammation and an uncomfortable skin sensation, such as numbness, itching, sensitivity or tingling. However, stressful situations can cause neuropeptides to be inappropriately released, which can lead to a flare of skin conditions."
Those same neuropeptides can travel to the brain and disrupt the chemicals that regulate our emotions (including "happy hormones" serotonin and dopamine) causing further stress and setting a vicious cycle into motion.
“In my practice, I find that patients with chronic skin conditions tend to withdraw from normal, everyday activities...when you are withdrawn and have more time alone, it can make your symptoms seem more pronounced and you can end up feeling worse," Dr. Fried says.
Dermatologists now recommend incorporating stress management techniques into a dermatologic treatment regimen, including psychotherapy, cognitive behavioral therapy, meditation, hypnosis, tai chi, yoga, and antidepressants. They also believe that these techniques can help patients feel empowered and better comply with the treatment plans for their condition.