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It’s written all over your face

by Dr. Claudia Aguirre

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Does our skin really reveal our innermost feelings, calling us out on our guilt, shame or panic? Yes, when coupled with the micro-expressions we make with our muscles. But another part is our actual skin acting as a tell-tale sign of emotional turmoil. 

Take a look at political figureheads pre-term and post-term. Notice the greying hair, the dark under-eye circles, the lines and wrinkles. These are not just effects of chronological aging; they are (sometimes) also the long-term effects of stress and anxiety on skin, hair and nails. And it’s this very brain-skin connection that’s been a focus of my studies over the past several years. But is this a new phenomenon? Or are we just beginning to understand the very real effects stress has on our minds and bodies?


Over two thousand years ago, the Greek physician Hippocrates described people who tore their hair out in response to emotional turmoil. Today, we call this condition trichotillomania. The ancient traditions from Greece to China to India highlighted the interdependence between the mind and the body. Somewhere along the lines in Western medicine, we lost this connection, focusing instead on philosophies that treated the body as a separate entity from the mind. Only in the past several decades have we seen the resurgence of mind-body awareness in medicine — and only in the past decade or so have we seen an emphasis on understanding the interaction between the nervous system and skin diseases. Psychodermatology is a new medical subspecialty emerging from the combination of psychiatry and dermatology. Psychiatry treats mental processes manifested internally, while dermatology treats skin diseases manifested externally. In essence, psychodermatology is a holistic view of skin disease within the medical world.

From acne breakouts, to rosacea flushes to eczema flare-ups, stress is the fuel to the fire of inflammation lurking in these conditions.

Stress is more than skin deep

Imagine any of these scenarios: back-to-back exams, a messy divorce, unexpected health issues, even being stuck in traffic when you’re already late. Does the mere thought of these send stress signals down your spine?  It doesn’t take scientific evidence for us to realize that the kind of stress driving us to the nearest pub — or reaching for the bowl of chocolate-covered nuts — isn’t good for our skin (and neither are those coping choices!). But the effects of psychological stress on our skin may be more serious than we realize. Scientific evidence has shown us that stress equates to inflammation, and this can cause havoc on the skin. From acne breakouts, to rosacea flushes to eczema flare-ups, stress is the fuel to the fire of inflammation lurking in these conditions. What’s more, stress not only triggers or exacerbates particular skin diseases, it can also lead to dehydration, lines, blotchiness, hair loss and brittle nails for those without an inherent condition.

O n the flip-side, the distress these stress-related skin conditions causes is also very real, feeding a vicious cycle. Getting that awful pimple before your date, or the significant hair loss after a traumatic event — these can in turn cause psychological distress, even to the point of creating a psychiatric condition such as depression and anxiety. The statistics are telling: people with the most visible skin conditions (vitiligo, psoriasis) have much higher risk factor for developing anxiety, depression and even suicidal thoughts.

A mind body approach

Sure, the creams, lotions and potions you spend your hard-earned money on can offer surface benefits. But if the problem stems in the mind, slather on as much retinol as you want but the tension lines will remain if your heart rate is reminiscent of the jackhammer pounding on the sidewalk. I’m not saying you can ohm your pimples away, but taking a look at the root cause, and certainly decreasing stress levels, could be the secret ingredient to your arsenal of skin-clearing techniques. In reducing cortisol, you’re putting and end to a molecular pathway (comprised of heavy hitters like prostaglandins, cytokines, neuropeptides, immune cells, and hormones) that could lead to devastation on skin tissue, to put it kindly. There is much to learn about this topic, but scientific evidence points to a very real neuroendocrine system in the skin that is particularly sensitive to psychological stress. Lucky for us, the solution is not an elaborate and labor-intensive one. In fact, it’s quite simple if we stick to it:

Take 10, stick to a whole-food diet, enjoy a walk in nature and your skin will thank you.

Dr. Claudia Aguirre

Dr. Claudia Aguirre is a neuroscientist and mind-body expert. She earned her doctorate degree in Neuroscience from the University of Southern California (USC), and she recently completed a year-long certificate course on Mindfulness, Yoga and Social Change from Loyola Marymount University. She is also a TED Ed educator, creating various neuroscience-related lessons, which have reached millions worldwide. She researches the latest science around mindfulness and meditation, and communicates these findings to the Headspace audience.

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