Isolation due to the coronavirus created a secondary crisis. Reported symptoms of anxiety, stress, depression and other disorders have more than tripled since 2019, according to a September study by the American Medical Association. This column addresses how stress affects the health of skin.

According to the American Psychological Association’s 2020 annual stress survey conducted by The Harris Poll, 78% of adults said the pandemic is a significant source of stress in their lives, while three in five said the number of issues America faces is overwhelming to them.

Stress is a physiological response that causes a disturbance in the equilibrium of the body, according to Evan Rieder, MD, a dermatologist and psychiatrist in New York. Under stress, typical body changes include blood pressure and pulse rate rise, breathing speeds up, digestion slows, immune activity decreases, sleeplessness increases and muscles tense. Beauty consumers should consider holistic wellness as integral to their daily routines, particularly as stress and mental health have taken over the conversation amidst COVID-19.

The consumer wellness boom presents strong opportunities for beauty companies to target mood and wellbeing, via functional products, routine enhancements or powerful brand messaging, according to Mintel. The beauty and personal care industry has long advocated wellbeing and positivity, this messaging is more relevant than ever with ongoing COVID-19 pandemic, says Mintel. Grand View Market Research goes a step further. It estimates the global “anti-fatigue cosmetics market” will grow 4.5% a year to reach $267 million by 2025.

Emotional and environmental stress stimulate various inflammatory pathways, causing a number of adverse effects on skin. A study published in the Journal of the European Academy of Dermatology and Venerology explores how internalizing psychological stress can age skin. Emerging research highlights the multi-faceted link between emotions and skin conditions. A recent Euromonitor International survey found consumers associate their overall health with mental wellbeing. People are exposed to stress and anxiety on a daily basis, from work, social media or news, and seek ways to find work-life balance, manage stress and improve sleep habits. Several skin conditions have emerged mainly as a result of prolonged contact with personal protective equipment and excessive personal hygiene. Some people’s hands just don’t stand up to multiple washings every day. Stress levels have grown and the effect shows on the face.

New York City Dermatologist Amy Wechsler MD, who is also board-certified in psychiatry, has spent decades exploring the link between mental health and complexion.¹ Emotional stress during a global pandemic unleashes a toxic cocktail of stress hormones which cause skin dryness and sensitivity. If you sleep four hours a night, your skin is not going to see the benefits of stress-relieving skin care products. The importance of managing and reducing stress cannot be underestimated. Taking steps to reduce chronic stress can have positive effects on overall health, wellness and skin condition.

According to results of a May 2020 University of Chicago survey, roughly two-thirds of Americans had strong negative emotions at least once during the seven days prior to the survey, and it is showing up on our skin according to Wechsler. The mind-complexion connection seems obvious, but recent research suggests that the link between skin and stress is perhaps stronger than we realized. Stress causes distinct biological changes to the body causing the skin to release chemicals called neuropeptides. Neuropeptides can create inflammation and an uncomfortable skin sensation, such as numbness, itching, sensitivity and tingling. Neuropeptides also travel to the brain and ultimately increase the re-uptake of neurotransmitters meaning that stress depletes the chemicals such as serotonin, norepinephrine and dopamine.

There is a profound connection between how we feel emotionally and how our skin behaves, according to Dr. Laurel Naversen Geraghty, a dermatologist in Medford, OR. The rush of stress hormones, like cortisol, causes inflammation, which can trigger bumps, rashes and breakouts. It can worsen psoriasis, and poke holes in collagen, impairing the ability of the skin to act as a protective outer layer.

Researchers have linked certain illnesses to mental stress, because our physical resistance to diseases decreases. We become more susceptible to contracting a disease because our ability to keep our immune system in top working order decreases. Removing anxiety from our lives is nearly impossible, so experts are researching ways to de-stress skin. Medical experts have long suggested that feelings of continued and intense stress can result in premature signs of skin aging, inflammation and an increase in acne. Stress can make skin more permeable, more sensitive, and more reactive, which is why dermatologists recommend the use of over-the counter moisturizers to enhance the skin barrier function.

Depression and mental health had a moderate or severe impact on 73% of consumers’ lives last year, according to Euromonitor. No surprise, then, that mood-targeted beauty has blossomed with numerous brands aligning toward wellness, happiness, acceptance and mental health. Some of the prominent players in the anti-fatigue cosmetics segment include L’Oréal, Unilever, Shiseido, Estée Lauder, Biotique, Christian Dior and Nuxe Inc.

As the mind-skin connection gains credence, beauty companies have seized on this opportunity, launching serums and balms that they say cater specifically to the effects of stress on the skin. Without any independent clinical trials to back up these product claims, dermatologists remain skeptical about their effectiveness. According to Dr. Joshua Zeichner, Mount Sinai Hospital, anti-stress skin care formulas promise to hydrate, repair the skin barrier and reduce inflammation. While they can be effective in addressing stress-related skin issues, there are many products not specifically labelled as treating stressed skin, that can be effective as well. According to Dr. Dennis Gross, a New York dermatologist, during stress, skin gets less oxygen and fewer nutrients and antioxidants—all things it needs to look and function at its best. Based on his research, Gross created B3 Adaptive Super Foods Stress Rescue Super Serum. It consists of high concentrations of antibacterial herb ashwagandha, enzyme-rich kiwi and four varieties of mushrooms, which are said to boost elasticity. These are potent enough to provide relief in times of extreme stress.

According to Dermatologist Marnie Nussbaum, stress causes inflammation, which compromises the immune system, which is why skin conditions like eczema, psoriasis and rosacea flare up. Excess water loss leads to dry, dehydrated skin. If stress disrupts your sleep, you may also have dark circles, puffiness and a dull complexion.

Lipotec introduced Thermostressine, a peptide said to increase cellular tolerance to stress caused by daily aggressions which weaken the skin. It makes skin look less brittle, less tired and as a result, the complexion recovers, according to Lipotec.

Givaudan launched Tephrosia purpurea extract, which has beneficial effects on skin homeostasis through control of the wellbeing state leading to an improvement of dark circles, a clinical feature particularly impacted by emotional and environmental stress.

Provital Group’s Agascalm is a natural active that reduces stress-induced skin inflammation and redness. It decreases the amount of NF-KB, that moves toward the nucleus and, therefore, reduces the effects of the stress on the skin.

If all else fails, cry. According to Dermatologist Purvashi Patel, crying can result in fewer breakouts.²

The skin-psyche connection was the topic of a presentation at the American Academy of Dermatology’s summer session. Dermatologist Richard Fried discussed the value of incorporating various stress management techniques such as psychotherapy, cognitive behavioral therapy, meditation, hypnosis, tai chi, yoga, antidepressants and beta blockers into a dermatologic treatment regimen.

Francisco Tausk, a professor of dermatology at the University of Rochester, studied the effects of stress on the skin for three decades with a focus on psychosomatic medicine. He says that the brain-skin connection is so strong, some patients clear their psoriasis with a placebo. Consumers should calm their nerves as best as possible, whether it is with meditation, a stepped-up running schedule or, by using a calming serum and hope for serenity and better skin.

The mind plays a role in a clearer complexion. Calming moves like meditation and hypnosis have been proven to help the skin and mental state. Exercise releases endorphins in the brain, which elevate mood and can even act as a natural painkiller. Exercise also help to regulate sleep patterns which, in turn, help to manage stress and anxiety. Listening to soothing music, spending time in nature, performing breathing exercises and meditation have all been shown to help reduce high stress levels. Meditation is a way to eliminate the lack of balance caused by life’s stressors. Researchers have recorded that the brain activity in people who meditate reflects a state of deep relaxation. Their mind becomes calmer. Meditation also calms the body.

Tausk encourages stressed patients to practice mindfulness by taking outdoor walks, meditating or exercising. Small steps can improve wellbeing and reduce stress. She prescribes using a creamy cleanser, a soothing moisturizer with hyaluronic acid, ceramides and a zinc-based mineral sunscreen. For skin that breaks out with stress consider spot-treating with adapalene gel.

If the barrier function is compromised, then more irritants, allergens and bacteria can penetrate the skin disrupting the skin barrier and cause problems such as rosacea, making skin redder or acne lesions more inflamed and more persistent. It can worsen hives, fever blisters, psoriasis and seborrheic dermatitis.

Stress is even more damaging to skin than previously thought. It would be helpful to get serious about managing the daily stressors in our lives. There is proof that mind-body treatments like hypnosis and biofeedback, are effective. A variety of topical therapies, detailed in this column, show potential for stress relief. This is further supported by the consumer behavior observations made by the leading market research company Mintel, that the beauty routines that combat stress, anxiety, and bring normality during these uncertain times, create long-term value for consumers. 

References

1. 
   J. Dunn. Keep Calm, Vogue.com, August, 2020.
2. 
   J. DeFino, Skin and Stress, The New York Times, December 10, 2020.

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Navin Geria
Chief Scientific Officer

Ayurderm Technologies, LLC
navin@ayurderm.com

Navin Geria, former Pfizer Research Fellow is a cosmetic and pharmaceutical product development chemist and the chief scientific officer of AyurDerm Technologies LLC, which provides Ayurvedic, natural and cosmeceutical custom formulation development and consulting services to the spa-wellness-dermatology industries. He has launched dozens of cosmeceutical and ayurvedic anti-aging products. Geria has more than 30 years of experience in the personal care industry and was previously with Clairol, Warner-Lambert, Schick-Energizer, Bristol-Myers and Spa Dermaceuticals. He has nearly 20 US patents and has been published extensively. Geria edited the Handbook of Skin-Aging Theories for Cosmetic Formulation Development focus book published in April 2016 by Harry’s Cosmeticology. He is a speaker, moderator and chairman at cosmetic industry events.