How stress triggers eczema and acne: The emotional causes of flare-ups and how to protect your skin

Red, angry and painful hives.

Dubai-based Meghan Clarke, a sales professional knows the unpleasant feeling of an itch coming along, whenever she is stressed. Perhaps, a looming presentation, or a hurdle in her personal life, and she starts to automatically scratch her hands and legs. Sometimes, her eczema strikes too, and she finds the skin peeling off her fingers. “There are days when my life is all about just ointments and band-aids,” she says.

Your skin reflects what you feel inside. This complicated relationship between the brain and the skin - known as psychodermatology and psychoneuroimmunology - is the interplay between mind, skin and the nervous system. Simply put, what you feel, tends to show up on your skin.

As issues with the skin are so visible to others, it culminates in much psychological distress and humiliation, with one’s self and finally a withdrawal from social activity and situations. People, like Clarke, often feel embarrassed or ashamed, which can lead to avoiding social situations altogether. Add the physical pain of conditions like eczema or acne, and it’s no surprise many start to withdraw. Left unaddressed, this isolation can spiral into low self-esteem, depression, and even a distorted self-image.

In his extensively researched book Handbook of Psychodermatology, American professor Mohammed Jafferny elucidates how psychological stress can cause disruption of the immune system, which results in a ‘weak’ skin defence. It causes inoculation of new pathogens and a reactivation of dormant pathogens.  He writes, “In recent decades, the connection between stress and dermatological disease has been researched. Skin plays a crucial role in maintaining homeostasis [a state of balance among all the body systems needed for the body to survive and function correctly] when dealing with internal and external stress.”

He goes on to define psychoneuroimmunology as the studies that focus on the interactions between the behavioural, neural, endocrine and immune systems and how they form a response to psychosocial stress. When the interactions between the systems are overwhelmed or disturbed by extreme stress, it results in a disease.

Maya Gera, a Dubai-based psychologist explains why this happens: Chronic skin disorders cause stress responses in the body that can act as triggering factors for inflammatory autoimmune and allergic diseases. When you’re anxious and stressed, the body produces more human cortisol, the stress hormone.  Cortisol causes a part of your brain, known as the hypothalamus to produce a hormone called corticotrophin-releasing hormone (CRH), which stimulates oil release from sebaceous glands around your hair follicles. Excessive oil productive by these glands can clog your pores and lead to acne.

Chronic stress floods the body with cortisol, triggering inflammation and weakening the immune system. Over time, this burn-out state not only slows acne healing but also worsens skin conditions. Cortisol can even reduce white blood cell function, leaving the body more vulnerable to infections and viruses.

‘My keratosis flares up’

 Autoimmune diseases like alopecia (hair loss) can also be triggered due to stress. Mukta Tewani, the founder of Miss Pallettable, a UAE-based skincare brand, explains the unusual phenomenon further by using her own example had earlier explained to Gulf News, “Stress and anxiety can have an effect on skin health, especially if you suffer from eczema, psoriasis or sensitive skin. I have sensitive skin and keratosis pillaris [dry, rough patched and bumps] on my arms. Many a times when I’m under a lot of mental pressure I have seen my keratosis flare up.”

Is there a way to protect your skin?

For starters, before dermatology, professional help is crucial for some, in the cases of those dealing with severe anxiety and depression. As Gera points out,  we could also slowly start paying attention to our food habits that get badly affected by stress. While junk food seems like a comfortable resort, it has a negative impact on your skin, as it has a high glycemic load that can elevate your blood sugar levels. This puts you at risk for certain diseases and increases inflammation in the body.

As you begin to focus more on your mental wellness, you can incorporate other practices like meditation and relaxation into your daily routines - and if you feel at a loss on how to craft a routine for yourself, don’t beat yourself down - consult your dermatologist and doctors and gradually, you’ll find your way to be at peace with yourself, and your skin will begin to reflect the state of your mind.

Here are some easy strategies to follow:

Manage stress effectively

Practise relaxation techniques: Regularly practice deep breathing, meditation, yoga, or mindfulness. These can lower cortisol levels, which are a major stress hormone linked to skin issues like acne or eczema.

Exercise regularly: Physical activity not only reduces stress but also promotes healthy circulation, which helps keep your skin glowing.

Get enough sleep: Stress and lack of sleep go hand in hand, and not getting enough rest can worsen skin problems. Aim for 7-9 hours of quality sleep each night.

Adopt a skincare routine

Hydrate: Stress can dehydrate the skin, making it look dull or flaky. Drink plenty of water throughout the day, and use a good moisturizer that suits your skin type.

Avoid harsh products: Stress can make your skin more sensitive. Use gentle, calming products with ingredients like aloe vera or chamomile that won’t irritate your skin.

Target stress-related skin issues: If you’re prone to breakouts or redness, look for products with salicylic acid or niacinamide, which are known to help calm inflammation.

 Watch your diet

Eat stress-busting Foods: Foods rich in antioxidants (like berries, leafy greens, and nuts) can help combat stress-induced skin damage. Omega-3 fatty acids, found in fatty fish like salmon, can reduce inflammation and promote a healthy complexion.

Avoid triggers: Some people find that caffeine, sugar, or dairy exacerbate skin issues. Pay attention to what might trigger flare-ups and cut back on these foods.

Don’t pick your skin: Stress can lead to the urge to pick or touch your face, which can cause scarring or even spread bacteria. Keep your hands away from your face as much as possible.