Skin care often remains a mystery to many. Throughout their lives, women are constantly searching for that “Holy Grail” moisturizer or serum. As we age, we battle with problems as basic as acne and even turn to dermatologists for answers to big questions. I asked some of those questions to Chelsea File, a Physician’s Assistant at Bexley Dermatology, and received plenty of interesting answers.
Effects of cortisol
When it comes to stress and even mild anxiety, File says that there is a definite link. The two can contribute to many skin conditions by way of increased inflammation and increased oil production in the case of acne. When it comes to our tresses, stress and anxiety can cause the hair to prematurely enter what is known as the resting phase, which then causes hair to shed, sometimes even significantly. Even cold sores can be brought about by stress. There are also dermatological conditions that can be made worse by stress, such as eczema, psoriasis, acne, hair loss, perioral dermatitis and seborrheic dermatitis.
Cortisol, or the “stress hormone”, doesn’t only wreak havoc on our bodies. File says it does serve a purpose.
“Cortisol, in general, gets a bad wrap, but it is long-term cortisol imbalance that has negative consequences. When levels are balanced, cortisol helps to maintain blood pressure, blood glucose, immune function and anti-inflammatory mechanisms. Cortisol also dictates our fight-or-flight response, which can be literally life-saving.”
Cortisol, though, can often be one of the causes of acne outbreaks. I had heard the myth that you could identify a stress outbreak by spotting blemishes on a person’s jawline, so I asked File if this was based in fact. She put that myth to rest.
“Not necessarily. It really depends on the person. Stress-related acne can manifest in different ways for different people.” Â
treating breakouts
Treatment is often on many individuals’ minds the moment they begin to break out. File explained her choices for treating her patients to me. She often starts with topical treatments for mild to moderate acne because they are more tolerable and cost-effective. When it comes to severe acne, though, sometimes oral medication is used in tandem with topical treatments.
Severe hormonal acne can really prove to be a pain in treating, but there are preventative measures a person can take before a breakout occurs. They can benefit from oral contraception or androgen blockers like topical or oral spironolactone or clascoterone. Even a solution as delicious as spearmint tea can assist in preventing hormonal acne!
However, there are certain things a person can do to make hormonal acne worse. Progesterone-only birth control is known for causing breakouts. Straying from a healthy lifestyle in excess is a definite way to cause your skin stress.
stress and hair loss
Acne is far from the only problem caused by stress that relates to our skin, though. I brought up a friend of mine in my interview with File who had undergone a stressful brain surgery and experienced hair loss afterwards. File explained this phenomenon to me.
“It is very common to lose hair after administration of anesthesia, surgery, a serious illness or periods of significant stress.”
File says there are effective treatments for even significant hair loss, however.
“Addressing any nutritional deficiencies or thyroid abnormalities is generally step one if there is not a known inciting event like illness, surgery or major stressor. If no lab abnormalities are present, we often use a combination of oral medications like spironolactone or minoxidil with OTC supplements like Viviscal or Nutrafol. OTC topical minoxidil is a commonly used treatment as well.”
exploring impacts on eczema
As far as cortisol goes, there is also one other major affliction people deal with every day that can be made worse by anxiety or stress -– eczema. File explained it to me in terms anyone can understand.
“Eczema is an inflammatory disorder of the skin that causes rash, itching and sometimes pain in the areas affected. This rash and the symptoms that follow are essentially caused by barrier dysfunction of the skin. Our skin cells are kind of like bricks and mortar. When we’re missing some of the “mortar,” our skin is more likely to develop a rash or become itchy.”
Luckily for those suffering from eczema, though, new treatments, including nonsteroidal topical creams, are very effective and safe for long-term use! Other medications can be injected or taken orally. These newer medications are much more effective than past treatments.
care for your skin and wellness
In a world where stressors lurk in every corner, taking a proactive approach to skin health can make all the difference. Skincare is a journey, not a quick fix, and even the most minor adjustments—be it a cup of spearmint tea or a quick chat with a dermatologist—can have a meaningful impact. As Chelsea File reminds us, it’s not just about chasing perfection but understanding and treating our skin with care, especially during times of high stress. Each condition has unique triggers, from acne to eczema, and our best defense is a combination of knowledge, balance and a little patience. So, let’s give our skin the attention it deserves—it’s our body’s first line of defense and, with the proper care, a lasting reflection of our health and well-being.