Written by: Prim. Dr. Sc. Ivana Manola, MD.
For most people, stress is an integral part of daily life and is considered a lifestyle. And it is not always bad. In small amounts, it can help us perform tasks and motivate us to give our best. But when we constantly feel a lack of time, our mind and body pay a high price. Prolonged exposure to stress can cause serious health issues. Chronic stress damages almost every organ in our body: it raises blood pressure, weakens the immune system, increases the risk of heart attack or stroke, accelerates aging, and contributes to infertility… It can affect mood and trigger anxiety, depression, and many other issues, including skin reactions.
How it Works
The skin is the largest organ of the human body and the first line of defense against external influences. In addition to having a protective and immune function, it is strongly connected to the neuroendocrine and immune systems. This is why stress—whether acute or chronic—can significantly affect its health and appearance. Psychoneuroimmunology and new research confirm that the skin and brain communicate through the so-called skin-brain-immune system axis, so emotional and physical stress often visibly manifests on the skin. There are several ways in which stress affects the skin.
One of them is the activation of the HPA axis (hypothalamus-pituitary-adrenal gland), which occurs when cortisol, the main ‘stress hormone’, is activated in stressful situations, altering the immune system’s function, increasing the level of inflammatory cytokines, and affecting the skin barrier. Prolonged elevated cortisol weakens the skin barrier, slows wound healing, and increases sensitivity. Additionally, stress increases the secretion of adrenaline and noradrenaline, causing changes in skin microcirculation (redness, paleness, cold hands or feet). The activation of peripheral nerve endings in the skin stimulates the secretion of neuropeptides (substance P, CGRP), which enhance inflammation and itching.
Stress also affects the immune response, which can cause an imbalance of Th1/Th2 lymphocytes, favoring autoimmune skin diseases (e.g., vitiligo, alopecia areata, psoriasis). Chronic stress increases oxidative stress, further damaging melanocytes, keratinocytes, and fibroblasts. It also reduces the synthesis of ceramides and lipids in the epidermis, resulting in dry, irritated skin that is more prone to infections and allergic reactions. It is also linked to the microbiome, so exposure to stress can change the composition of the gut and skin microbiome. Dysbiosis favors inflammatory reactions and the occurrence of acne, rosacea, and atopic dermatitis. Along with the usual treatment of specific skin diseases prescribed by a specialist doctor, it is extremely important to try to reduce stress levels.
