A year ago, Priyanka S., a 20-something with healthy, glowing skin, started on a high-stress job and found it was leagues ahead of her experience. As her hours in the office doubled, so – it seemed – did her age. Her face took on a sallow hue, her skin began to break out, dark circles outlined puffy eyes. When she looked into the mirror, she felt she was beginning to look a year older with each passing day.
And if stress can make 20-something skin look weary and worn, you know you’re in for trouble if it tackles you a decade or two later. Indeed, as damaging as external stresses – like sun and pollution – can be, one of skin’s worst enemies is the enemy within. Emotional stress, researchers have found, can add years to your appearance, as well as trigger flare-ups of skin disorders.
Whatever its source, stress sets off a number of responses as it prepares the body for action. There is a rush of hormones, a sharp rise in breathing and heart rate, and a diversion of blood to large muscles, while energy sources are put on standby. Skin gets the short end of the stick. A body under stress sends blood to its most vital organs – the brain, heart and lungs – rather than to skin.
The result is an anemic look that makes under-eye circles stand out like smudged thumbprints. Chronic stress slows the rate at which dead skin cells are sloughed of the surface, which gives skin a dull, dry look. And, due to a decrease in the production of the proteins that provide elasticity to the skin, skin under stress can become lax. Also, it is speculated that the rise in respiration that accompanies anxiety might increase production of toxic, skin-damaging by-products known as free radicals.
Also read: Heal Thy Self | Hearing Voices?
The chief stress hormone is cortisol. Chronic stress causes a rise in levels of this hormone, which damages the skin’s ability to hold on to water. The resulting moisture loss also diminishes luminosity, aggravating the dullness of skin under stress.
Stress can also upset the care and feeding of the body. When you’re under stress, you may eat poorly and pay less attention to proper skin care. The perfect set-up for puffy eyes and the dry skin that can that can accentuate fine lines and wrinkles. And just as you were warned by your mother that if you kept making a certain face it would stay that way, the frowns and furrows of a tense face will eventually be etched in place.
What about skin diseases like acne, eczema, psoriasis and allergies? Stress is a component in all of them. Here’s a look at what we know to date:
Acne. Stress does not cause acne, but studies indicate that, for those who have acne, stress can worsen the severity of an attack.
Rosacea. Also known as adult acne, it is the reddened skin condition that occurs on middle-aged faces. Rosacea, too, is aggravated by stress due to the tendency of blood vessels to dilate when you are under duress.
Skin Allergies. While stress does not cause allergies, a pile of studies has shown that stress and anxiety, even at mild or moderate levels, can worsen allergy symptoms, including hives, the itchy spots most often linked to allergies. Scientists suspect it has something to do with the way stress affects the immune system, causing a rise in the levels of compounds that heighten the allergic response. In the case of severe stress, the allergy symptoms can continue for some time even after the stress has subsided, suggesting a lingering response.
Atopic Dermatitis. This is the most common type of eczema. It shows up as a red, itchy rash, most commonly on the cheeks, arms and legs. A combination of genetic and environmental triggers are known to be involved. Emotional stress is one of the triggers that can cause a person’s atopic dermatitis to flare up and get worse.
Psoriasis. In this chronic skin disorder, there are periodic flare-ups of sharply-defined red patches, covered by a silvery flaky surface. Psoriasis occurs when the immune system mistakenly attacks normal body tissues. This results in a faster turnover of skin cells. As they rise to the surface of the skin, the body cannot slough them off fast enough. They pile up, forming the red, scale-covered plaques that are characteristic of psoriasis. In India, research indicates that the most commonly affected sites are the palms and soles, followed by the scalp.
Scientists don’t know what causes the immune system to malfunction in the first place. However, stress, unexpressed anger, and emotional disorders, including depression and anxiety, are strongly associated with psoriasis flare-ups.
Stress management is the long-term answer to preventing high-pressure living from literally getting under your skin. In India, psycho-dermatology is a relatively limited but emerging field. Psycho-dermatologists work on the premise of an underlying connection between the psyche and the skin, and therefore use a holistic approach in treatment. If you cannot access a psycho-dermatologist, then you need to combine medical treatment for a skin disorder with stress control techniques. You can learn these on your own, or if you feel you aren’t making much headway, take the help of a psychiatrist or therapist.
Medical therapies can be combined with targeted home treatments to counter those not-so-lovely effects of stress on your skin. Here are specific self-care measures for some of the most common skin ailments:
Dryness. Avoid using hot water to wash your skin: it can strip skin of its natural oils. Pat – don’t rub – skin dry. Using a moisturizer on the skin while it is still slightly damp seals in moisture. Choose an intensive moisturizer that includes emollients (oils), plus humectants (such as hyaluronic acid) that lock in moisture.
Acne. Mild acne can be treated by a general physician; moderate-to-severe cases are best treated by a dermatologist.
On the self-care front, avoid excessive washing and scrubbing, which can irritate the skin and worsen acne. Ditto for products such as facial scrubs, astringents and masks. Use a mild soap or a gentle cleanser when washing affected areas.
In choosing cosmetics, look for products labeled “non-comedogenic”, which means they are formulated so as not to cause blocked pores. Avoid oily or greasy cosmetics.
And, of course, don’t pick or squeeze those zits – that can cause infection or scarring.
Atopic Dermatitis. Daily skincare may help you cut down on the amount of medication you need to use. Keep your skin moist with regular moisturizing. Choose skin products that do not contain alcohol, perfumes, dyes and other chemicals. Use gentle body washes instead of regular soap. Short, cooler baths are better than long, hot baths. Do not scrub or dry your skin too hard or for too long.
To avoid scratching the rash and worsening it, keep your finger-nails short; if night-time scratching is a problem, use light cotton gloves when you sleep.
Psoriasis. Psoriasis is a treatable, but not a curable, condition. A wide range of therapies is used today to tame the symptoms. In some sufferers, symptoms may go into remission even without treatment, but then recur. In a few cases, however, large areas of plaque persist for years.
Exposure to sunlight has been found to help cases of mild-to-moderate psoriasis. UVA (Ultra Violet– A) radiation is a popular treatment for psoriasis, which is why the natural UVA rays of the sun can be therapeutic.
Do not overdo it, however. Sunburn can worsen psoriasis or cause new plaques to develop because of the direct damage to skin cells. Additionally, some psoriasis drugs increase sun sensitivity, and if you are using any of these, you need to be even more careful about limiting exposure to sunlight.
For those who suffer from one type of psoriasis called seborrhoea, which affects the face and scalp, the warmer temperature of summer can actually exacerbate the condition. The reason is thought to be the increased perspiration which can irritate the skin and sometimes increase psoriasis symptoms.
Can dietary changes help? A number of studies have shown that fish oils containing Omega-3 fatty acids may control symptoms of psoriasis, the improvement ranging from moderate to excellent. The benefit comes from the anti-inflammatory properties of these acids.
Because of the association between negative emotions and psoriatic flare-ups, relaxation and anti-stress techniques may be helpful. Some patients have had a traumatic or stressful event coincide with the appearance of psoriasis. Talking to a psychiatrist or a counselor about the issue may significantly improve symptoms.
In a world grown so fiercely competitive today that it’s ready to dismiss, snub, marginalize or even exclude those whose countenance fails to radiate vitality, energy and good health, you cannot allow stress to get under your skin.
(The author, a former editor of 'Health & Nutrition' magazine, now works as a counseling therapist)