You can’t always control what goes on outside, but you can always control what goes on inside- Wayne Dyer

Stress and anxiety, the plague of modern-day life has been escalated during these uncertain and tumultuous times of the COVID-19 pandemic. The skin is the mirror which reflects our body’s health and wellbeing is affected and all aspects of skincare and break in routine are visible. With nearly every aspect of our lives having been affected, the well-being of people has taken a severe beating with stress being both a cause and a consequence.

A common perception with stress is that it affects only the mental health of an individual – while this is true, as doctors we see the manifestation of stress in physical ways. One such major area that gets affected is the skin. When a person is stressed the level of the body’s stress hormone (cortisol) rises initially to combat this acute stress and cortisol other inflammatory mediators and histamine increase as well. Gradually the cortisol levels dip but inflammatory mediators remain high and thus we see the skin manifestations of stress.

Here are a few skin conditions typically aggravated by stress: 

1.Hives (urticaria) : 

It is a fairly common skin condition primarily triggered by allergy-inducing foods, medication, and stress. The most common symptoms of hives are itchiness and red or skin-colored wheals that appear on the skin’s surface. These skin lesions are typically evanescent and do not last more than 24 hours.

Urticaria also tends to get chronic and have flares on and off. Currently, we see a large number of well-controlled urticaria patients coming in with flares due to the increasing histamine levels and decrease in the endogenous steroid production in the body.

2. Dehydration and Dullness:

While working from home during the corona pandemic, many individuals are finding it difficult to maintain a balance between work and life. Long working hours and erratic sleep cycles have left many stressed and poorly groomed. Due to this several, people have started cutting corners in their sleep, hydration, and meals and have stopped prioritizing them. Such individuals are currently facing issues such as dehydration and dull skin.

It has been found in numerous researches that hydration, sleep and a healthy diet play a big part in skin health due to the natural release of anti-inflammatory mediators. Drinking more water and eating whole foods can certainly improve skin health. Adopting a balanced diet can help one overcome skin aging further thus changing the way the skin looks and feels.

Hence it recommended that individuals should aim to drink at least eight-ten glasses of water a day, load your plate with antioxidants, carotene-rich veggies, and proactively seek time to sleep for eight hours each night to avoid dehydration and dullness of skin.

3.Rosacea:

Rosacea is a chronic skin condition on the face, mistaken by many for acne vulgaris/ pimples. This can be easily triggered by environmental factors and emotional stress. This condition is worsened by inflammation, and we know all too well that stress can lead to inflammation.

People can avoid this condition by sun protection, avoiding caffeinated/spicy meals and drink. We dermatologists also prescribe topical creams, oral meds, or in-office treatments to help people overcome this condition.

4. Eczema

Eczema is a blanket term given for skin disease with involves inflammation, with or without oozing. The first step to overcome Eczema is to start moisturizing the skin hence improving the skin’s barrier function. Simply adding oatmeal to the bathing water and having quick and short lukewarm baths can help reduce dryness.

Cold-pressed coconut oil applied generously all over the body after bath further enhances the skin’s ability to lock in moisture and ward off allergens. Scratching an itch is one of the greatest pleasures in life- however, it triggers a cascade of events that further exacerbates the condition. A quick visit to your dermatologist should keep you symptom-free and help soothe the skin.

4.Psoriasis and Seborrheic dermatitis:

Psoriasis is a chronic autoimmune skin disorder that often leads to the formation of thick, red patches on the skin and appears to be covered in white silvery scales. Due to stress, this condition can become a whole lot worse. Just like the other skin conditions, there are a few treatments one can follow to relieve their symptoms.

Also, lot more patients are complaining of persistent dandruff non-responsive to OTC anti-dandruff medication. Institution of medicated tar, anti-fungal, and anti-inflammatory based shampoo helps relieve this condition.

In conclusion — though this pandemic has seen aggravation of many skin conditions- don’t let it stress you out further. Healthy habits and clean eating go a long way in keeping stress under control and thus improving your skin. Do seek your dermatologist’s help rather than self-medication.

Dr. Shireen Furtado
Consultant – Medical & Cosmetic Dermatology
Aster CMI Hospital, Bengaluru

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How to prevent and treat Psoriasis? First understand the root  causes for Psoriasis. Here are some of the recommendations , but do under guidance of a physician.

Psoriasis is an autoimmune disorder that accelerates the life cycle of skin cells. Although the symptoms of psoriasis present on skin, but the true cause is that the immune system is attacking it’s own tissues.

1. Eat whole food, anti-inflammatory diet-  Sources of omega-3 fats, berries, dark green leafy vegetables, sweet potatoes, nuts and seeds. Include turmeric, ginger and rosemary in daily diet.

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