Bad skin can be caused by stress

When Sarah Kugelman was in her early thirties, she was severely stressed. Her highpowered job in the beauty industry in Colombus, Ohio, meant she was working long hours, travelling regularly — and neglecting her health.

She went on to suffer from various infections and illnesses, but not before she noticed an effect on her looks. “Everything was playing out on my skin,” she explains, now some 20 years later. “I had no glow — it was really dull. I was only 31 and had accelerated signs of ageing with wrinkles. I also had cystic acne, not just occasional small breakouts. The spots were itchy and red, too, almost like an allergic reaction.

“I moved back home to my parents in New York. The family doctor said if you don’t slow down, you won’t live till 40. That was a huge warning for me.”

When stressed, the adrenal glands produce cortisol, a hormone that can have an immunosuppressive effect, meaning bacteria which would normally be fought off can grow on the skin and lead to acne.

Stress can also cause DNA damage, leaving cells less able to repair themselves, leading to signs of accelerated ageing. As happened with Kugelman, it can also lead to skin irritation as the body creates more histamines.

Dr Claudia Louch, a Londonbased dermatologist internationally famed for her natural approach, says she has noticed a dramatic increase in middle-aged women experiencing a sudden bout of acne for the first time since their teenage years. Typically, they have perioral acne, which appears around the mouth and chin.

“I see it more, because as women we face much more challenging roles than ever before,” she explains. “We’re expected to be mothers, have a career, a family. Jobs are demanding and there is stress about how we look. Women hammer away in the gym on top of it, and that’s another physical stress.

“It’s also due to poor nutrition. If you’re underweight, immunosuppression can occur. Your skin is your body’s biggest organ and shows you what’s happening on the inside.”

She believes that while stress can have a negative impact on the skin, it is often also linked to underlying causes — be they hormonal imbalances, yeast infections or poor nutrition. Her clinic tackles skin problems by investigating what is going on inside the body, via a full hormonal check, blood screen and high-tech equipment looking at the skin. Clients are then often prescribed supplements, given full dietary plans and advised to use certain natural products to restore hydration to the skin.

This two-pronged approach to battle stress skin is something Kugelman also recognised when she was dealing with her own issues. “It’s a balance of dealing with what’s going on in the inside as well as the outside,” she explains. “It’s about getting seven to eight hours sleep at night, drinking 32 ounces (four cups) of water a day, doing some kind of fitness regularly, doing some kind of meditation and learning when you’re stressed.

“But dealing with what’s going on on the outside is important, too. If you get up and look into the mirror and your skin looks terrible, you won’t feel good about yourself. It can make you feel more stressed. You have to treat it from both ends.”

Though she returned to her job in the beauty industry after battling with her own stress in her thirties, she was later inspired to set up her own skincare brand Skyn, which aims to “treat stressed skin using pure and potent ingredients from Iceland” such as gooseberry extract and encapsulated oxygen.

“When you suddenly experience skin problems out of nowhere it can be tempting to rush out and buy a load of expensive products,” she says. “But they don’t always work, and can sometimes create more damage by drying out the skin instead of hydrating it. We try to keep it natural and help fortify the skin against stress.”

People suffering with sudden acne linked to stress are also advised to try and reduce their stress levels by improving their diet and exercise. Yet Dr Louch warns that often, without correct guidance and information, this can have an adverse effect — particularly with the rise of “clean eating” as people forego important nutrients in favour of a high-sugar diet, often believing that because they have cut out refined sugar, it “doesn’t count”.

“A lot of people think they’re eating healthily, but they’re not,” she says. “A lot of diets are high in fat and sugar, eating things like nuts and seeds. People substitute dairy with nut milk, which is just sugar. And 10 nuts have the same calories as chocolate bar. They eat more avocados and salmon, which is better than saturated fat, but fat is fat.

“A lot of people also go purposefully towards a vegan diet to be healthy. I understand doing it for religious or ethical reasons, but in terms of pure biological functions, we humans need meat. Our human body is different to a cow or rabbit. The most important part is red meat.”

Red meat contains high amounts of protein and iron. As Dr Louch says, it can play a role in a balanced diet, producing nutrients such as B vitamins and vitamin D, but the NHS advises it is possible to still obtain these nutrients on a vegetarian diet.

She also warns that too much exercise can lead to an increase in stressed skin, as the body becomes physically exhausted: “A lot of people completely overdo it, whether they’re overweight or underweight. It’s a stress to your body because it has to repair injuries and balance things out. I always say your body needs a break, so do it on alternate days. You should be moving but not overdoing it.”

The path to treating stress skin is, unfortunately, not as simple as popping a pill. But with a combined approach of improving health and nutrition, as well as treating the skin with the products it needs, it can eventually clear. For Kugelman, stress skin is firmly left in the past.

“People always tell me I have beautiful skin now,” she laughs. “I’m old enough that I shouldn’t be getting these comments. I’m 53 but people think I’m in my thirties. It shows it is possible.”

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As soya and almond-milk converts will tell you, dairy is not always your skin’s friend. According to dermatologists, cow’s milk — which is often thick with progesterone from the expectant cow — can knock your ordinary hormone levels off kilter resulting in bumpy, oily skin. Patients with inflammatory conditions such as acne, psoriasis and eczema are routinely put on low-dairy diets.

Acne breakouts? Take a break: Cortisol, the hormone released during periods of high physiological stress, is a key player when it comes to adult acne. As well as triggering the release of oil, high levels of cortisol have an immunosuppressive effect,

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Bumpy eyelids? Curb your cholesterol: Cheese-guzzlers and those fond of a thick steak may be familiar with xanthelasma, a lumpy eyelid condition that’s the result of a high-cholesterol diet. Opting for fibrous foods will quickly quash the yellowish lipids deposits, but it could be time for a cholesterol test, to find out whether your levels are healthy.

White patches? Double-check for diabetes: When your blood sugar levels max out, your body creates a series of surface-level warning signs. With vitiligo, smooth white patches appear on the skin because the cells that make pigment are destroyed — and could prefigure a diabetes diagnosis.