I don't think I'm wrong in saying that the holidays are over or coming to an end, much to the dismay of many of us. Unsurprisingly, the end of the holidays heralds the start of the new season, the return to the office and the stress that (often) comes with it.
Because, yes, we’ve had a great time at the beach or in the mountains, the sudden return to reality can sometimes, or even regularly, be anxiety-inducing. There’s a professional and personal rhythm to regain, ongoing projects to tackle, and new challenges to overcome: no doubt about it, it's back-to-work time.
You might say we're repeating ourselves, but SPOILER ALERT: whether it's occasional or chronic, stress affects our body, and today we're taking the time to (almost) explain you the consequences of stress on our skin.
Skin and stress: a close link
Out of curiosity, we decided to do a little roundtable discussion about the visible signs of stress on the skin within the Abyss Ingredients team [1], and here’s what we found:
Most of us experience skin issues when under stress, with the most common being redness and rashes. It is therefore crucial to get to know your skin better to understand how it might react when faced with stress or other external aggressors.
The skin, our shield
The skin is, in part, what biologically makes us who we are. It consists of several layers of tissue and forms a protective barrier against external aggressions [2] (ultraviolet rays, pollution...) while also performing other functions such as immune responses.
It is made up of 3 main layers:
The mechanics of stress on our skin
As we mentioned in our previous article on atopic dermatitis (check it out here if you missed it), various factors and triggers, both endogenous and environmental (allergens, pollution, irritants, climatic conditions...), play a key role in our skin health. Endogenous factors, such as genetic mutations, for example, can lead to dysfunction of the skin barrier, abnormalities in the skin microbiome, immune system dysregulation, or hormonal changes. The complex interaction of these alterations can make the skin particularly fragile and reactive.
But fortunately for us, not all these factors are inevitable; some, like stress—which triggers or exacerbates symptoms of many dermatological conditions—can be managed to some extent.
Stress represents a general response of the body to internal or external factors, involving both psychological and physiological resources. Stress activates the hypothalamic-pituitary (HPA) axis, which controls the immune response via neuroendocrine factors and the sympathetic nervous system. The skin, whose cells have a functional equivalent of the HPA axis, actively responds to stress, involving skin immune cells, hormones and neurotransmitters [3-4]. Stress-induced skin responses include the secretion of pro-inflammatory cytokines (IL-6, IL-1, IFN-γ), the release of peripheral neuroendocrine factors (CRH, ACTH) as well as the production of corticosteroids [5-6].
Which are the visible consequences for our skin?
Numbers of studies suggest that stress and neuroendocrine factors are involved in the onset, relapse or worsening of dermatological pathologies [7-9] such as:
References: France Psoriasis/Ameli/Les Laboratoires Pierre Fabre/Bioderma France/Inserm
This list of conditions is, of course (and unfortunately), not exhaustive and represents only a small portion of the impact that stress can have on our skin.
Other stress factors, such as feelings of helplessness or worry, can also play a role in exacerbating the sensation of itching in people with skin conditions. In many clinical studies, individuals report feeling stressed, or stress has been identified as a contributing factor to skin irritation or sensitive skin syndrome [11-14].
The body's response to stress can negatively impact the skin barrier function and influence the immune response [15]. Chronic stress can also lead to increased vulnerability to infections, thereby worsening skin lesions. Moreover, recent evidence suggests that the gut and skin microbiomes are modulating factors in the interactions between the skin and the brain [16].
As you've probably guessed, stress really takes a toll on your skin! While it's partly responsible for certain dermatological pathologies, that’s not all - it also plays a crucial role in premature skin aging, especially when stress is chronic.
Indeed, we can't talk about the skin/stress relationship without mentioning oxidative stress. As we mentioned in our previous article (still here for you latecomers), environmental factors such as pollution, UV and smoking create an overproduction of free radicals, leading to the well-known oxidative stress, which is one of the causes of premature skin aging. Oxidative stress leads to the alteration and degradation of collagen and elastin fibers, which are essential proteins for skin integrity [17-18].
In short, stress doesn’t bring much positivity (at least for your skin)! Just look at the illustration above to understand that stress can have daily repercussions on our skin, and consequently on our quality of life and well-being.
Stress and skin: the impact on self-image
As we explained, stress obviously has many physical consequences on our skin. But in reality, its impact is far more powerful and extends beyond physical barriers, affecting what we might call the psychology of appearance.
What’s worse is that it creates a vicious circle! Seeing your skin physically and visibly deteriorate because of stress leads to psychological consequences, such as a poor self-image, lack of self-confidence and anxiety… which in turn, continuously fuels stress and its repercussions.
The psychology of appearance, especially in the context of dermatological conditions, is a highly relevant and interesting topic. In 2024, a French infodemiological study was carried out on the freedom of expression of patients regarding skin diseases on social media [19]. This study includes testimonies, feelings, complaints and emotional experiences of people suffering from the 5 diseases presented above: eczema, acne, psoriasis, vitiligo and rosacea.
After analysis, over 20,000 messages related to one of these 5 conditions were extracted. The main topics of discussion were: « Impact on self-image and self-confidence » (23.66%), « General discussion on treatments » (23.32%), and the « Burden of others' opinions » (12.81%).
The 3 main difficulties mentioned across the 5 targeted skin diseases were similar and focused on « fear and symptom management », « the psychological impact » and « damage to self-image ». Also noted were the challenge of therapeutic wandering, therapeutic deadlock, and the ineffectiveness of pharmaceutical/dermatological products.
This illustration, inspired by this French study [19], clearly shows the crucial impact that stress-related dermatological conditions can have on psychology and self-image. These testimonies highlight the undeniable suffering of patients with skin problems, who struggle daily with psychological difficulties such as anxiety, fear of judgement, loneliness and self-image issues.
How to support your skin against stress?
It's time for the “tips” section of this article! We don't claim to have all the answers, but there are several strategies to promote the well-being of stressed skin. Here are two alternatives:
Solutions that will prevent or relieve the symptoms of stress on your skin.
Tackling the source of the problem by using stress-reduction techniques.
👀 So, keep your eyes open to discover some recommended tips for improving your skin's well-being during stressful times.
The famous skincare routine 🧼: As you know, it is important to take care of your skin daily. During stressful periods, it's best to simplify your routine (no need for 36 products), focusing on gentle and soothing ingredients that won't irritate the skin barrier [20]. The only “perfect” routine is the one that suits your skin! For instance, if stress causes your skin to dry out, moisturising products will be essential. Conversely, if your skin becomes more acne-prone during stress, it would be more appropriate to use deep-cleansing products.
Relaxation 🧘 : As mentioned earlier; to relieve your skin, you sometimes need to tackle the root cause, in this case stress. Relaxation can be a good alternative, ranging from a simple walk to a yoga class, or engaging in calm and soothing activities like reading, painting, or breathing.
Nutrition 🥗: Of course, we couldn't skip this one! Numerous studies have shown that nutrition is associated with skin health and can play a crucial role (both positive and negative) in its biological processes, from aging to dermatological diseases. Indeed, research has shown a causal link between dietary habits and premature aging, as well as skin health [21]. Practically speaking, you should drink plenty of water and maintain a diet rich in fibres and fatty acids, which, according to some studies, may help balance stress hormones.
There are many other solutions to better manage stress and thus spare your skin from its effects: getting good sleep or engaging in physical activity. To learn more, we invite you to read our blog article on stress and sleep.
Each coping strategy is different and may or may not work for everyone. The key is to find your own balance by also learning to listen to yourself! 👂
References
[1] Internal survey lead by Abyss Ingredients - 2024
[2] Diet and skin health: The good and the bad – 2024 Idris Adewale Ahmed, Maryam Abimbola Mikail
[3] Slominski, A.T.; Zmijewski, M.A.; Zbytek, B.; Tobin, D.J.; Theoharides, T.C.; Rivier, J. Key Role of CRF in the Skin Stress Response System. Endocr. Rev. 2013, 34, 827–884.
[4] Slominski, A.;Wortsman, J. Neuroendocrinology of the Skin. Endocr. Rev. 2000, 21, 457–487.
[5] Slominski, A.; Zbytek, B.; Nikolakis, G.; Manna, P.R.; Skobowiat, C.; Zmijewski, M.; Li, W.; Janjetovic, Z.; Postlethwaite, A.; Zouboulis, C.C.; et al. Steroidogenesis in the Skin: Implications for Local Immune Functions. J. Steroid Biochem. Mol. Biol. 2013, 137, 107–123.
[6] Slominski, R.M.; Tuckey, R.C.; Manna, P.R.; Jetten, A.M.; Postlethwaite, A.; Raman, C.; Slominski, A.T. Extra-Adrenal Glucocorticoid Biosynthesis: Implications for Autoimmune and Inflammatory Disorders. Genes Immun. 2020, 21, 150–168.
[7] Huynh, T.T. Burden of Disease: The Psychosocial Impact of Rosacea on a Patient’s Quality of Life. Am. Health Drug Benefits 2013, 6, 348–354.
[8] Reich, A., Wójcik-Maciejewicz, A., Slominski, A.T. Stress and the skin. G. Ital. Dermatol. Venereol. 2010, 145, 213–219.
[9] Blount, B.W.; Pelletier, A.L. Rosacea: A common, yet commonly overlooked, condition. Am. Fam. Physician 2002, 66, 435–440.
[10] Verhoeven, E.W.; de Klerk, S.; Kraaimaat, F.W.; van de Kerkhof, P.C.; de Jong, E.M.; Evers, A.W. Biopsychosocial mechanisms of chronic itch in patients with skin diseases: A review. Acta Derm. Venereol. 2008, 88, 211–218.
[11] Dalgard, F.J.; Gieler, U.; Tomas-Aragones, L.; Lien, L.; Poot, F.; Jemec, G.B.E.; Misery, L.; Szabo, C.; Linder, D.; Sampogna, F.; et al. The psychological burden of skin diseases: A cross-sectional multicenter study among dermatological out-patients in 13 European countries. J. Investig. Dermatol. 2015, 135, 984–991.
[12] Farage, M.A. Perceptions of sensitive skin: Changes in perceived severity and associations with environmental causes. Contact Dermat. 2008, 59, 226–232.
[13] Misery, L.; Morisset, S.; Séité, S.; Brenaut, E.; Ficheux, A.S.; Fluhr, J.W.; Delvigne, V.; Taieb, C. Relationship between sensitive skin and sleep disorders, fatigue, dust, sweating, food, tobacco consumption or female hormonal changes: Results from a worldwide survey of 10 743 individuals. J. Eur. Acad. Dermatol. Venereol. 2021, 35, 1371–1376.
[14] Saint-Martory, C.; Roguedas-Contios, A.M.; Sibaud, V.; Degouy, A.; Schmitt, A.M.; Misery, L. Sensitive skin is not limited to the face. Br. J. Dermatol. 2008, 158, 130–133.
[15] Silverberg JI, Lei D, Yousaf M, Janmohamed SR, Vakharia PP, Chopra R, et al. Association of itch triggers with atopic dermatitis severity and course in adults. Ann Allergy Asthma Immunol. 2020;125(5):552-9.e2.
[16] Wang, X., Li, Y., Wu, L., Xiao, S., Ji, Y., Tan, Y., Jiang, C., Zhang, G. Dysregulation of the gut-brain-skin axis and key overlapping inflammatory and immune mechanisms of psoriasis and depression. Biomedicine & Pharmacotherapy. 2021. 111065.
[17] Emerging evidence for stress effects on skin aging and the value of mindfulness (Journal of Clinical and Aesthetic Dermatology, 2020)
[18] Skin aging and the role of oxidative stress: a comparative study on chronologically and photo-induced aging (Oxidative Medicine and Cellular Longevity, 2019)
[19] Patients' testimonies, feelings, complaints and emotional experiences with dermatoses on open social media: The French infodemiologic patient's free speech study – Marty et al., 2024
[20] L’impact du stress sur votre peau : stratégies efficaces pour gérer le stress – dermatologieconferences.com
21 Diet and skin aging – From the perspective of Food Nutrition – 2020 March
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