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Can Stress Make Your Skin Problem Worse?

Can Stress Make Your Skin Problem Worse?

Skin Care Tips from the Dermatologist

The answer is yes. Experts agree that stress does not cause the skin problem, but it can make symptoms worse.

Authors of a detailed scientific review paper out of Germany conclude that there is “mounting evidence that stress in the sense of psychosocial stress alters the ability of the skin – through neuroendocrine and immune changes – to respond to environmental challenges. Especially in case of skin damage, due for example to a chronic disease such as atopic dermatitis, there is a more rapid and severe exacerbation of the skin disease under psychosocial stress. It therefore seems obvious: Anything that reduces stress must also reduce inflammation. This possibly also plays a role in the development of skin tumors.” (1)

As a dermatologist, I know that skin problems cause stress. I’ve also observed over the years, that when my patients are under stress, their skin problems are much worse. In my 30 years of practice, I’ve even seen patients whose skin formed a flurry of basal cell skin cancers over several years when they were under severe life stress. Once the stress dissipated, their skin stopped forming basal cell cancers.

Stress reduction can help improve skin problems.

Now that researchers are working out the neuroendocrine immunologic pathways for skin problems, we know that stress reduction is an important component for improving them. Whether the problem is classic eczema (atopic dermatitis), rosacea, psoriasis, acne, hives and even skin cancer, the neuroendocrine immune state of your overall physiology will be impacted by stress - and so will your skin. Stress, whether acute or chronic, shifts the state of your body’s immune balance, and that will impact your skin problems.

Any patient with a skin problem will tell you that the problem also causes them stress. It can be a ‘which came first, the chicken or the egg’ question with stress and skin problems. We are now able to say that no matter which came first, stress reduction will help. This is important.

How can you lower your stress to help your skin problem?

Mindfulness has been shown to help.
According to Susan Abbey, MD, “Dermatology was actually the first area to show an impact of mindfulness… because the skin has been regarded as an organ that responds to emotional stimuli and psychological influences.”

Dr. Abbey gave what I think is a really important example, one that may help you creates a fundamental shift in a perspective regarding a skin problem, “Instead of a treatment being applied to get rid of a skin condition that is bothersome and aesthetically unpleasing, mindfulness would bring a perspective of being compassionate to one's self by applying the treatment.”

There are mindfulness-based forms of therapy and also stress reduction. There are mindfulness tapes and books. Dr. Abbey recommends Jon Kabat-Zinn PhD, Executive Director of the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School.

I’ve read a number of his books. They helped me through breast cancer treatment. In my experience, mindfulness helps you manage stress with less reactivity. I’m a huge fan. I always have a mindfulness book by my bedside to read before falling asleep. Ten years ago, I also studied mindfulness in daily living for several years with a local mindfulness center, and I see a therapist who helps me with my own personal approach to reacting to my life stresses in a more mindful way. I ramped up all of these mindfulness tools during the year that I was treated for breast cancer. It helped.

Mindfulness does not take the place of medical care, it supports it.

I used mindfulness tools during breast cancer treatment along with chemotherapy and surgeries. I know that modulating the stress helped support my physiology to heal well.

Combining care with lifestyle recommendation is now more common in dermatology.

As a dermatologist, I know the value of treating skin conditions comprehensively, with both traditional medical care and, what is now called Integrative Care. That includes mindfulness, diet and exercise advice and stress reduction among other things. Patients get their dermatologic care and we talk about their life, stress and diet and how we can use these to help their healing. For example, my Integrative Dermatology Care for a skin problem may include:

Step 1: I start with the building blocks of skin care to heal the skin problem and support a remission

  • For eczema or psoriasis, we would use hypoallergenic and hydrating skin care with VaniCream Soap and my Natural Lotion.
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Natural hand and face body lotion.

Get redness relief and enjoy healthier skin!
  • For seborrhea or rosacea we would use my Redness Relief Kit, Daily Face Cream and Citrix Sunscreen or Sheer Strength Pure Physical Spray
Sunscreen from the dermatologist
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  • For acne we would use my Ultimate Acne Solutions Kit and Daily Face Cream for Normal to Oily Skin or my Pityrosporum Folliculitis Kit.
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Fight acne fast with the pityrosporum folliculitis sunsavvy kit

Step 2: I add appropriate prescription medicines as needed.

Step 3: I then give supporting lifestyle advice to help lower body inflammatory physiology. These include recommending a low inflammatory diet (described in my ebook), regular sleep, regular exercise appropriate for their fitness level, and stress reduction such as a mindfulness practice.

I’m also a big fan of being outside in nature as often as possible, so that’s usually a recommendation - along with sun protection advice, of course.

I’m glad to see rigorous scientific study supporting stress reduction as an important therapeutic aspect of medical care in dermatology.

Good self care, including mindfulness, is now mainstream instead of alternative and that’s a real step forward!

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Reference:

  1. Peters Eva M.J., Stressed skin? A molecular psychosomatic update on stress-causes and effects in dermatologic diseases, Journal of German Dermatologic Society, Volume 14, Issue 3, March 2016 https://doi.org/10.1111/ddg.12957
  2. Fordham B, Griffiths CE, Bundy C. A pilot study examining mindfulness-based cognitive therapy in psoriasis. Psychol Health Med. 2015;20(1):121-7.
  3. Montgomery K, Norman P, Messenger AG, Thompson AR. The importance of mindfulness in psychosocial distress and quality of life in dermatology patients. Br J Dermatol. 2016 May 12.