Skin's reaction to stress

Psychological stress and your skin

The COVID-19 pandemic is sweeping across the globe. Unfortunately, this causes many people to experience psychological stress on an unprecedented scale. We have been forced into a lockdown situation where we may not leave our houses  not only for our own health and safety, but more importantly to prevent passing on the virus to those with compromised immune systems or the elderlyUnemployment, a great cause of stress, is a real possibility for many on the other side of the lockdown.  

Many of our usual endorphininducing rituals such as outdoor exercise, in-person socialisation with friends, the celebration of important milestones and attending events have all been forbidden. It is the first time in our lifetime that we have been forced into a new normal. The unknown on the other side has the very real possibility to induce even more anxiety.  

Whether you have been affected directly by COVID-19 by being infected with the virus, having a loved one infected or pass away due to the virus, or indirectly by being forced into the lockdown to help flatten the curve, the psychological stress that millions of members of society are facing is very palpable.  

Effects of stress on the skin 

often get asked a whether psychological stress has an effect on the skin. And yes, your body’s largest organ is highly vulnerable to the effects of stress.  

Stress activates the Hypothalamus-Pituitary-Adrenal axis (HPA-axis), which in turn raises your blood cortisol levels. This is what triggers the human body to go into flight or fright responses. This is great when you are running away from a lion, but not great when you are sitting at home on your couch bingewatching a Netflix series. An activated HPAaxis leads to a pro-inflammatory state that aggravates flare-ups of pre-existing skin conditions such as psoriasis, atopic and seborrheic dermatitis, acne, contact dermatitis, vitiligo, alopecia areata and pruritis (itch). 

Stress also disrupts the normal hair growth cycle. It can lead to a type of hair loss called telogen effluvium where a large amount of hair follicles send the hair cycle into a resting phase and leads to a large amount of hair shedding. This type of hair loss is usually not permanent, and fortunately hair may grow back about six months after the stressful event.  

Chronic stress has also been suggested to lead to skin aging. Stress leads to immune dysfunction and the formation of free radicals. As a result DNA in the skin is damaged, which leads to aging of the skin. 

Reducing stress levels   

For now, you can do simple things such as building a daily routine for your household. This involves eating healthy, nutrientrich meals and where possible get good night’s rest of between seven to eight hours at least. Try to follow an online exercise plan, even if it is just for ten minutes a day 

I also suggest reducing endless scrolling through the internet to read more about COVID-19. Stay informed, but pick only reliable sources of information to get your information from, such as the World Health Organisationthe Centre for Disease Control and Prevention and the South African Department of Health. Fake news can cause unnecessary stress and anxiety.  

Taking care of the skin  

There are a few things you can do from an external perspective to ensure your skin stays in a good condition during lockdown:  

  • Continue to wash your skin twice daily with a gentle product. 
  • Stress impairs the skin barrier, therefore moisturize your skin with a good, gentle moisturizer. two to three times a day or as needed. I recommend Cetamacrogol. 
  • Serums containing antioxidants such as Vitamin C or Vitamin E may be helpful to reduce oxidative stress to the skin. 
  • To reduce additional stress to the skin from external sources such as UV radiation, ensure you avoid exposure to the sun between 10am and 4pm. When you are exposed to the sun, wear protective clothing such as long sleeves and a wide-brimmed hat. Always wear a good sunscreen (I recommend a SPF 50 with UVA and UVB filters).  


Chen Y, Lyga J. Brain-Skin Connection: Stress, Inflammation and Skin Aging. Inflamm Allergy Drug Targets. 2014 Jun; 13(3): 177–190. 

Alexopoulos A, Chrousos GP. Stress-related skin disorders. Reviews in Endocrine and Metabolic Disorders. 2016; 17: 295–304.