Skin + Stress

April 5, 2023

There is a well-established connection between skin health and stress. When in a
stressed state, our bodies release noradrenaline and cortisol. These hormones lead
to changes in our physiology that directly and indirectly impact our skins health.
Direct changes include increased sebum production and inflammation in the skin.
Indirectly, stress can impact immunological and digestive functioning which can
both impact the health and integrity of your skin.

Here is a brief breakdown of how stress can lead to worsening of several
dermatologic conditions:

  1. Acne – Stress directly increases sebocyte activity leading to increased sebum
    production.1 Additionally, stress increases cytokines (inflammatory
    mediators) in the skin.2 Both sebum production and inflammation play key
    roles in the pathogenesis of acne. This has been demonstrated in studies
    where students showed increased acne severity with stress from exams.3
  2. Eczema – Stress can negatively impact the skin’s barrier function leading to
    increased sensitization to environmental factors.4 Further, stress leads to
    immune and inflammation dysfunction which worsens the severity of
  3. Psoriasis – The relationship between psoriasis and stress is complex and not
    fully understood. It appears a two way relationship exists, with stress causing
    increased psoriasis exacerbations through immune and inflammatory
    changes. Additionally, psoriasis flares create stress in the body.6
  4. Premature Aging – Cortisol has been found to reduce collagen and lipid
    production in the skin. This manifests as atrophy of the skin, disruption to the
    skin’s barrier, and impaired wound healing, all of which can contribute to
    signs of premature aging.7

In addition to the physiologic changes, stress also typically leads to behaviour and
lifestyle changes. This includes poorer dietary choices, reduced exercise, increased
alcohol intake, and reduced sleeping. These can further impact our internal health
status and our skins health.

Managing stress is essential in maintaining healthy skin. There are many different
therapies that can be used to support your stress levels and keep your skin healthy
and clear! Lifestyle practices such as meditation, exercise, and proper sleep are
great foundations to stress management. There are also a wide array of botanicals
and nutraceuticals that can be implemented to support your skin and keep your
stress levels at bay. Another therapy that is effective in managing stress levels is
acupuncture – this utilizes the insertion of tiny needles into specific locations on
your face and body to promote relaxation and provide your skin with some extra
support. If you find your struggling with skin concerns and feel like stress may be
playing a role – come see me at Longev and I’ll provide you with the individualized
support you need to get your skin glowing for the summer!


  1. Zouboulis C C, Seltmann H, Hiroi N, Chen W, Young M, Oeff M, Scherbaum W
    A, Orfanos C E, McCann S M, Bornstein S R. Corticotropin-releasing hormone:
    an autocrine hormone that promotes lipogenesis in human sebocytes. Proc.
    Natl. Acad. Sci. U S A. 2002;99 (10):7148–7153.
  2. Zbytek B, Mysliwski A, Slominski A, Wortsman J, Wei E T, Mysliwska J.
    Corticotropin-releasing hormone affects cytokine production in human HaCaT
    keratinocytes. Life Sci. 2002;70 (9):1013–1021.
  3. Chiu A, Chon S Y, Kimball A B. The response of skin disease to stress:
    changes in the severity of acne vulgaris as affected by examination
    stress. Arch. Dermatol. 2003;139 (7):897–900.
  4. Levin J, Friedlander S F, Del Rosso J Q. Atopic dermatitis and the stratum
    corneum part 2 other structural and functional characteristics of the stratum
    corneum barrier in atopic skin. J. Clin. Aesthet Dermatol. 2013;6(11):49–54
  5. Okada H C, Alleyne B, Varghai K, Kinder K, Guyuron B. Facial changes caused
    by smoking: a comparison between smoking and nonsmoking identical
    twins. Plast. Reconstr. Surg. 2013;132 (5):1085–1092.
  6. Chen Y, Lyga J. Brain-Skin Connection: Stress, Inflammation, and Skin Aging.
    Inflamm Allergy Drug Targets. 2014;13(3):177-190.
  7. Dunn J, Koo J. Psychological Stress and skin aging: A review of possible
    mechanisms and potential therapies. Derm Online Journal. 2013;19(6).

Naturopathic Dermatology

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