If you’re stressed out, your skin will show it. Not only does chronic stress exacerbate skin conditions such as acne, eczema, and psoriasis, but it also has a significant impact on aging of the skin. 

When you're stressed, your body releases the hormones cortisol and adrenaline and when they are elevated over long periods, they cause important and detrimental changes in the skin. 

Chronic stress weakens the skin's barrier function, through decreasing skin lipids, such as fatty acids, ceramides and cholesterol which form a protective layer on the skin that reduces transepidermal water loss and helps to protect the skin from environmental stressors and external irritants. A compromised skin barrier can result in increased water loss, dryness, and heightened sensitivity. For more on how to maintain a healthy skin barrier, read this. 

High levels of cortisol triggers excess sebum production and leads to breakouts and clogged pores. Stress can also make the skin more sensitive, irritated, and reactive. It can trigger or exacerbate existing skin conditions and lead to further redness, itching, and inflammation.

Finally, stress can affect blood circulation, leading to reduced oxygen and nutrient supply to the skin. This can result in a lackluster complexion, dullness, and uneven skin tone.

The impact of stress on collagen 

Stress has a major impact on premature aging. Chronic stress can accelerate the aging process of the skin because high levels of cortisol can increase the breakdown of collagen and elastin, both of which are responsible for maintaining the skin's elasticity and firmness. 

So how exactly does stress impact collagen production? Normally, cortisol levels naturally rise in the morning and are highest between 7-8am. After this time, cortisol levels start to taper off and reach their daily lows in the evening, as we get ready to sleep. However, for those who experience chronic, low-level stress, whether from money worries, carer duties, relationship problems, or work issues, cortisol levels stay elevated throughout the day.

It’s the ongoing, low-grade chronic stress that has a major impact on our sleep, diet, skin, and overall resilience. In the skin, elevated cortisol leads to inflammation, which damages collagen and causes the release of enzymes (MMPs, cathepsins, peptidases) that cause collagen to rapidly break down. The disrupted sleep and chronic sleep deprivation associated with chronic stress also causes the body to produce less collagen.

Why the brain-skin axis matters

The brain-skin axis is a two-way communication pathway between the brain and the skin. It’s a complex system made up of the nervous system which is responsible for sending signals between the brain and the skin, the endocrine system which produces hormones that can affect the skin's appearance and function, the immune system (which includes the skin’s microbiome) that protects the skin from infection and disease. It is the interconnection of all three of these systems that play an important role in many skin conditions and in general skin health. 

Although not well understood, the skin actively participates in the stress response through peripheral nerve endings and local skin cells. In addition to signaling for the accelerated breakdown of collagen, cortisol also participates in oxidation, inflammation, and glycation. 

Understanding the biological connection between the brain and the skin is a key step to understanding how stress can affect skin conditions and the aging process. 

How to cope with stress

According to the Mental Health Foundation, 74% of people in the UK have felt stress last year. Understanding how to manage stress is so important if we want to age well. There is no one way to manage stress, everyone must develop strategies of their own, but some tips include:

• Exercise lowers levels of stress hormones,it produces endorphins and can help take your mind off the cause of stress. Research shows that exercise can increase mental resilience, which can lower your perceived stress and improve the way you handle it. 
• Good lifestyle habits such as eating a healthy diet and sleeping enough will help manage stress better throughout the day. 
• Taking time to talk. Loneliness can exacerbate stress, so talking to a friend, family member or a mental health professional can be helpful.
• Meditation. Studies show that regular meditation helps to improve the way you respond to stress, which reduces cortisol levels. 
• Herbal remedies such as adaptogen, nervines, and relaxing herbs can help manage stress.