Stress and Skin Disorders

Dec 05, 2008

In the emotional rollercoaster of life, sometimes the “down” periods have long-lasting effects on more than just our mood. In fact, numerous studies link factors that impact our emotional well-being, such as stress, depression and anxiety, to an increase in skin, hair or nail problems. Now, dermatologists are advising patients to recognize these secondary symptoms and to seek treatment early before they cause additional stress.

Speaking at the American Academy of Dermatology’s SKIN academy, dermatologist and clinical psychologist Richard G. Fried, MD, PhD, FAAD, of Yardley, Pennsylvania, discussed the reciprocal relationship between feelings and appearance, and how failing to address these concerns can affect how we look, feel and function.

“When patients are going through a rough period in their lives, negative emotions can wreak havoc on their appearance,” said Fried. “So, as a result, patients might start to notice that their hair is thinning, their skin is inflamed or their nails are brittle—which can be physical manifestations of their mental state. These unwanted physical changes can have a profoundly negative impact on how they feel. The negative emotions can trigger a vicious cycle of worsening skin, hair and nails leading to worsening of their emotional state and can lead to further worsening of the skin problem. Dermatologists can play a key role in helping patients not only alleviate these physical symptoms, but also help enhance their quality of life during a difficult time.”

Psychodermatology Interventions
Stress can manifest itself on one’s appearance in many ways, primarily by making the skin more sensitive and more reactive. For example, Dr. Fried noted that stress can make rosacea more red, result in acne lesions that are more inflamed and more persistent, cause brittle nails and ridging of the nails, cause hair loss, cause or worsen hives, and cause excessive perspiration. In addition, stress also is a known trigger or can be a worsening factor for fever blisters, psoriasis, seborrheic dermatitis and has even been shown to impair skin barrier function and dehydrate the skin—allowing more irritants, allergens, and infectious agents to penetrate the skin and cause problems. Stressed skin often appears stressed, distressed and older.

“When it comes to treating patients who we suspect may be experiencing skin, hair or nail problems as a result of stress or other emotional factors, it is helpful to ask them whether their skin seems to look or feel worse when they are stressed,” said Dr. Fried. “Beyond the direct physiological effects of stress, patients under stress also tend to neglect or abuse their skin, lacking the energy and motivation to adhere to their skin care regimens. There also might be signs of stress-related behaviors—such as scratching, pulling or rubbing—that can exacerbate problems.”

To successfully treat stress-related dermatologic conditions, Fried recommends that traditional dermatologic therapies should be used in conjunction with appropriate stress management strategies. For example, Fried discussed how stress reduction interventions and techniques can reduce the culmination of negative events that can worsen many of these problems. Wellness professionals are in a primary position to offer suitable stress management options to clients, such as breathing techniques and body awareness.

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