Stress is a well-documented trigger AND comorbidity of many skin conditions including psoriasis, eczema, rosacea and acne. But stress is very much a subjective term. Learning what it is that your mind and/or body finds stressful is the key to managing your flares and the answer might surprise you…
The skin is innervated by a network of cutaneous nerves and research has discovered that certain neurochemicals play a significant role in many skin conditions by modulating inflammation, cellular growth, immune response and wound repair. Certain characteristics of chronic skin conditions such as symmetrical distribution, sparing of de-nervated skin and initiation of a flare after stress indicates nerves may play a significant role in the pathogenesis of multiple chronic skin conditions, including psoriasis, eczema, rosacea, acne and more.
What types of stress can flare the skin?
There are 3 stages of stress to be aware of when it comes to skin flares, as different stages can have a different effect on the health of your skin.
- Alarm – This stage is also known as fight or flight. It is the acute stage of stress where your cortisol, heart rate and blood pressure increase as a protective mechanism. Due to the anti-inflammatory nature of cortisol, you may not experience any symptoms during this phase.
- Resistance – During this stage, the body attempts to adapt to the stressful situation. If the stressful event ceases, the body returns to normal. If not, the body continues to produce stress hormones, creating imbalances in the endocrine, immune and nervous systems. This is where symptoms may begin, often with new lesions appearing in new places.
- Exhaustion – After extended periods of stress, the body becomes exhausted from trying to maintain a balance in stress hormones. Your immune system can becomes vulnerable to infection, fatigue and lack of concentration set in and feelings of anxiety and depression are common. This is where a skin flare can become chronic.
Identifying your stress:
Many of us associate stress with a negative emotional experience, such as a relationship break up, argument, loss of job, financial difficulty and so on. These are certainly stressful events, but they have something more than negative emotions in common….CHANGE.
As a practitioner of many years, I have found that change is a major driver of skin flares, and what we consider a “Primary” or “Initiating” Trigger. The interesting part is that the change may even be a positive one, such as taking on a promotion, giving birth to your first child, buying your new home or getting married. Patients with chronic skin conditions are often very sensitive to changes in their environment. Even simple changes in weather or temperature can be enough to initiate a flare.
However, once the patient has adapted to the change, the skin should clear, right?
If it doesn’t clear, this indicates that “Secondary” or “Exacerbating” triggers are still present. This can include everyday stressors such as being busy, poor sleep, poor diet, nutrient deficiencies, obesity and so on. These place not only a mental but a physical stress on the body, again exhausting its defense mechanisms.
So how can you manage your stress, even if you don’t feel stressed?
The answer is ROUTINE! The nervous system loves routine. Creating a pattern around when you go to bed, when you wake up, when you eat, what you eat and when you exercise, takes a lot of pressure off your nervous system and the stress response, allowing it to adapt, rather than stay in a constant state of alarm. Of course, if your routine is not so unhealthy, you may need to make some initial dietary and lifestyle changes, such as less caffeine, less technology, more time outdoors, more vegetables, less processed foods, more water and less alcohol (Read more here). But once you have, keeping them consistent enough to create a new habit, will give your nervous system the rest it needs, in order to start healing.
If you are suffering from depression or anxiety and need support, please follow this link for more information.
Clinical Skin Nutritionist
Practitioner Integrative Dermatology