REDUCING STRESS MAY HELP LEAD TO CLEAR SKIN
Anyone who's had a
pimple form right before an important event may wonder if stress caused the
break out. While commonly linked anecdotally, proving the relationship between
stress and inflammatory skin conditions, such as acne, psoriasis and rosacea,
is another matter.
Nearly everyone has
some form of stress in their life, so it's difficult to determine whether
stress can actually make the skin's appearance worse," said
board-certified dermatologist Richard D. Granstein, MD, FAAD, the George W.
Hambrick Jr., professor and chairman of the department of dermatology, Weill
Cornell Medical College, New York. "However, it's been known for a long
time that the nervous system, which processes our stress, has an impact on
conditions such as psoriasis."
Dr. Granstein
discusses the latest research on the impact stress has on inflammatory skin
conditions and his thoughts on how this research could change treatment
options.
How does stress play a
role in inflammatory skin conditions? Dr. Granstein said research linking the
nervous system and the skin has long been understood. "If you interrupt
the nerves' path to an area of a patient's skin affected by psoriasis, the
psoriasis improves," said Dr. Granstein. "In addition, the condition
improves if you inject local anesthetic into psoriasis patches. This
information strongly suggests that nerves play a role in how psoriasis
operates."
Dr. Granstein notes
that animal studies have demonstrated that stress can make inflammatory skin
conditions worse. In a Japanese study , mice genetically prone to develop a
rash similar to the inflammatory skin condition atopic dermatitis did so when
stressed, while mice that were not exposed to stress did not develop the rash.
Dr. Granstein said
experimental data support the idea that the nervous system and stress affect
inflammatory skin conditions in humans. Many types of cells in the skin,
including immune cells and endothelial cells (cells that line blood vessels),
can be regulated by neuropeptides and neurotransmitters, which are chemicals
released by the skin's nerve endings. Stress can result in the skin's nerve
endings releasing an increased level of these chemicals. When this occurs, it
can affect how and at what level our body responds to many important functions,
such as sensation and control of blood flow, and can contribute to the symptoms
of stress that we feel. In addition, the release of these chemicals can lead to
inflammation of the skin.
"If we could
block specific steps in certain pathways between the nervous system and the
skin -- without impacting the whole body -- we would likely have new ways to
prevent or treat some skin disorders," said Dr. Granstein. "We're
gaining a greater understanding of the mechanisms underlying many skin
conditions, which will help us develop new therapies."
Has stress been shown
to impact the skin in other ways? While commonly believed, Dr. Granstein said
research has not proven that stress causes skin aging.
When combined with
exposure to ultraviolet rays, Dr. Granstein noted that animal studies have
shown that stress could have an impact on the development of skin cancer.
"When exposed to ultraviolet radiation, stressed mice developed skin
cancers more quickly than mice that were not exposed to stress," he said.
How does current
research impact how people with inflammatory skin conditions are treated? Dr.
Granstein said more research needs to be done to further understand the role of
the nervous system and stress on inflammatory skin conditions, especially since
other factors play a role, including genetics. He encourages people with
inflammatory skin conditions to tell their dermatologist if they believe stress
is impacting their condition. They can experiment with stress reduction
techniques such as meditation, yoga, or tai chi, but they should continue their
treatment plan as prescribed by their dermatologist.
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