In life's pivotal moments, your skin can speak volumes. Whether it's a pimple that erupts the morning of your wedding or an outbreak of hives that appears just before a job interview, your skin has a way of letting the world know when you're feeling stressed.

When you think of skin protection, you probably think of sunscreen, moisturizers, balms, and protective clothing. But there's good evidence to show that skin requires protection from within as well, through a healthy mind-body connection and stress management techniques.

More than skin deep: How stress can lead to dermatological issues

Your brain and skin share a common language through the neuroendocrine and immune systems.1,2 The skin acts like a communication hub, receiving messages from nerves and the immune system and sending out responses to keep your body in balance. These responses include hormones, neurotransmitters, and other chemicals.2,3 

At the center of this drama is cortisol, the most well-known stress hormone and a main culprit in the interplay between psychological stress and skin health. Cortisol's primary purpose is to help your body respond to stress or danger. But when stress becomes chronic, cortisol turns into an agent of chaos. It can break down the skin's natural defenses, weaken the immune system, and trigger inflammation – all of which can activate or worsen skin conditions.2,4

Among cortisol's most notorious effects on the skin are:

  • Acne. Cortisol can trigger pimple outbreaks by increasing the production of sebum, the oily substance produced by the sebaceous glands.5
  • Rosacea. Cortisol-induced inflammation is a key factor in rosacea flare-ups.2,6 The stress hormone also constricts blood vessels, causing redness in the face.
  • Allergic reactions. For those of you who are susceptible to eczema or hives, stress can be a catalyst for more frequent flare-ups. But it doesn't stop there; stress cranks up the volume on itching, redness, and inflammation, intensifying the discomfort associated with these conditions.2,3
  • Delayed wound healing. You can thank cortisol for those lingering bruises and cuts that take their time scabbing over. An impaired immune response, increased inflammation, and a restriction of collagen are some of the body's stress responses that lead to slow recovery after an injury or surgery.2
  • Accelerated aging. Have you ever wondered why a president looks a decade older by the end of the first term? It’s stress. Cortisol-triggered inflammation breaks down collagen and elastin, resulting in fine lines, wrinkles, and uneven texture in the skin.3,7
  • Shingles. Some experts believe high levels of stress can reactivate the chicken pox virus and cause shingles in otherwise healthy adults.8,9

The interplay of lifestyle factors

Although physiological responses in the body play a significant role in how stress impacts skin, that's not the whole story. Chronic stress can change behavior – and usually not in a positive way. 

Nights spent tossing and turning can damage the skin's ability to repair and regenerate, leading to dullness and exacerbating existing skin issues.10 High-sugar, high-fat stress eating can compromise the skin's resilience, making it more susceptible to inflammation and breakouts – as well as making you look years older.11

Stress-induced behaviors like skin picking and cuticle chewing damage the skin and serve as visible manifestations of internal stress. When wound healing is impaired due to cortisol-triggered inflammation, those injuries can leave a lasting impression on the skin.

Stress and skin: A two-way street

It's clear that, through physiological processes and lifestyle choices, stress can have a negative impact on skin health. But the reverse is true as well: Skin issues can impact mental and emotional well-being.

Chronic acne, for example, goes beyond being a cosmetic issue. Many individuals with acne report low self-esteem, social anxiety, and depression. They might skip social events and become withdrawn.12 Skin-related symptoms like itching or pain can disrupt sleep and make it hard to focus at work or enjoy a hobby.

This creates a vicious cycle in which stress triggers skin conditions, which trigger more stress. The mind and body deliver signals of distress back and forth like a furious ping-pong game, making it harder to find a solution to either problem.

Healing from within: Strategies for managing stress-induced skin conditions

A holistic approach to skin health means protecting yourself inside and out. Here's what experts recommend:

  • Take the reins when you can. Not all stress is within your control – but some of it is. Reduce your stressors as much as possible by saying no to extra work, honing your time management skills, and asking for help when you need it.
  • Find inner peace. Turn off your chronic "fight or flight" response with intentional relaxation practices each day. Try stretching, listening to music, taking a warm bath – whatever helps you calm down and reconnect with a sense of ease.
  • Give mind-body practices a try. There's solid evidence that hypnosis, guided imagery, biofeedback, and meditation can help reverse the negative effects of stress, including skin-related issues like itching.13 Mindfulness meditation has been shown to significantly improve psoriasis.1
  • Talk to a professional. Cognitive behavioral therapy (CBT) is a widely recommended treatment for chronic stress. Some research shows that CBT sessions, in which a therapist helps you learn to reframe negative thoughts, can reduce cortisol levels and improve your body's immune response.1
  • Get moving. Regular exercise has long been touted as a reliable stress reliever. Studies show that hitting the gym (or yoga mat or basketball court) can help prevent psoriasis and bolster the skin's natural barrier, effectively slowing down aging.14
  • Go Mediterranean. The Mediterranean diet – which prioritizes vegetables, fruits, nuts, legumes, fish, whole grains, and olive oil – is well-known for reducing chronic inflammation, which can have a lasting positive effect on the skin.15 Some studies even show that a Mediterranean diet can reduce the severity of psoriasis.16
  • Commit to a skin-care routine. The American Academy of Dermatology recommends making skin-care simple with a gentle cleanser, sun protection, and a good moisturizer.17 Make it part of your daily relaxation practice by playing some gentle music, turning down the lights, and using warm water.

The reciprocal relationship between stress and skin health can be a challenging cycle to interrupt. But the solution is transformative self-care through stress management. Prioritizing holistic well-being not only fosters healthier skin, but it also cultivates inner resilience, ultimately paving the way for a radiant complexion and a harmonious mind-body connection. 

A word from Thorne

With all the talk about cortisol, perhaps you would like to investigate your own adrenal hormone levels. Thorne’s at-home Stress Test measures your cortisol level at four time points during your day, in addition to another adrenal hormone – DHEA. Test results are accompanied by diet, lifestyle, and nutritional supplement recommendations. 

Along with exploring your stress hormones, support your skin health from the inside with Thorne’s Collagen Plus, a great-tasting powdered supplement that supports skin hydration, elasticity, and even skin tones and helps reduce fine lines and wrinkles.*

References

  1. Mar K, Rivers JK. The mind body connection in dermatologic conditions: A literature review. J Cutan Med Surg 2023;27(6):628-640.
  2. Zhang H, Wang M, Zhao X, et al. Role of stress in skin diseases: A neuroendocrine-immune interaction view. Brain Behav Immun 2024;116:286-302.
  3. Pondeljak N, Lugović-Mihić L. Stress-induced interaction of skin immune cells, hormones, and neurotransmitters. Clin Ther 2020;42(5):757-770.
  4. Agrawal R, Hu A, Bollag WB. The skin and inflamm-aging. Biology (Basel) 2023;12(11):1396.
  5. Popa GL, Mitran CI, Mitran MI, et al. Markers of oxidative stress in patients with acne: A literature review. Life (Basel) 2023;13(7):1433.
  6. Chen C, Wang P, Zhang L, et al. Exploring the pathogenesis and mechanism-targeted treatments of rosacea: Previous understanding and updates. Biomedicines 2023;11(8):2153.
  7. Khalid KA, Nawi AFM, Zulkifli N, et al. Aging and wound healing of the skin: A review of clinical and pathophysiological hallmarks. Life (Basel) 2022;12(12):2142.
  8. Schmidt SAJ, Sørensen HT, Langan SM, et al. Perceived psychological stress and risk of herpes zoster: A nationwide population-based cohort study. Br J Dermatol 2021;185(1):130-138.
  9. Marra F, Parhar K, Huang B, et al. Risk factors for herpes zoster infection: A meta-analysis. Open Forum Infect Dis 2020;7(1):ofaa005.
  10. Shao L, Jiang S, Li Y, et al. Regular late bedtime significantly affects the skin physiological characteristics and skin bacterial microbiome. Clin Cosmet Investig Dermatol 2022;15:1051-1063.
  11. Cao C, Xiao Z, Wu Y, et al. Diet and skin aging-from the perspective of food nutrition. Nutrients 2020;12(3):870.
  12. Nandy P, Shrivastava T. Exploring the multifaceted impact of acne on quality of life and well-being. Cureus 2024;16(1):e52727. 
  13. Graubard R, Perez-Sanchez A, Katta R. Stress and skin: An overview of mind body therapies as a treatment strategy in dermatology. Dermatol Pract Concept 2021;11(4):e2021091.
  14. Yeh C, Flatley E, Elkattawy O, et al. Exercise in dermatology: Exercise's influence on skin aging, skin cancer, psoriasis, venous ulcers, and androgenetic alopecia. J Am Acad Dermatol 2022;87(1):183-184.
  15. Mansilla-Polo M, Piquero-Casals J, Morgado-Carrasco D. Popular diets and skin effects: A narrative review. Actas Dermosifiliogr 2023;S0001-7310(23)00846-3.
  16. Garbicz J, Całyniuk B, Górski M, et al. Nutritional therapy in persons suffering from psoriasis. Nutrients 2021;14(1):119.
  17. Skincare tips dermatologists use. American Academy of Dermatology Association. https://www.aad.org/public/everyday-care/skin-care-basics/care/skin-care-tips-dermatologists-use. [Accessed March 13, 2024]