Feeling Stressed? It Shows

By Allison Weber, APRN-C

You may know what stress feels like, but do you know what it looks like? It’s not new news that stress can take a toll on our physical and psychological health. But did you know that stress can also be seen visibly, as the effects wreak havoc on your skin, hair, and nails?

We live a world where stress has become our norm – ranging from from small inconveniences, like traffic jams, to COVID health scares, to the threat of a world war. Society is so stressed, we even have a Stress Awareness Month (yes, it’s April!).

Some stress can actually be a good thing. In fact, stress is an important part of human evolution’s response to danger. When stressed, our bodies create more stress hormones, like cortisol, which triggers our bodies physiological process to fight or flight.

Humans need cortisol to help us respond to danger, like say, a burglary. But, when your brain encounters chronic stress, your body reacts like there’s danger lurking in the shadows all day, every day. The resulting surplus of cortisol is where things start to go wrong.

Skin
Acne: Cortisol stimulates excess sebum, our skin’s natural oil, which clogs our pores. Increased oil production means more breakouts – whether you’re acne prone or not.

Psoriasis, Eczema, Rosacea: When too much cortisol is released due to chronic or severe stress, it can dysregulate the immune system. The result is an inflammatory skin flare up common in psoriasis, eczema, and rosacea. To make matters worse, the stress that caused your flare up also contributes to the slow down of your skin cell recycle, affecting how quickly you will be able to recover from the scaly, itchy, red patches.

Aging: Remember that when we are stressed, our body focuses on keeping us alive – not youthful. While the exact mechanisms are still unknown, recent research has shown that stress decreases the amount of lipids your skin secretes, causing dryness and sagging. Under stress, your skin also produces less of the proteins that hold your skin cells together, leading to lines and wrinkles. And since stress slows down the recycling of skin cells, expect to appear dull and tired.

Hair
Stress levels are high, and for some, that might mean a change in the hair on your head.

Telogen effluvium: Hair follicles have growth and resting stages. Recent research has determined that cortisol acts on cells underneath the hair follicle. A serious stress event (pregnancy, chronic illness, psychological trauma) can temporarily push the cells into a “resting” phase, when 70 percent of your hairs are shed all at once. The hair loss can occur up to three months following the stressful event, after which you can thankfully expect it to grow back.

Greying: The idea that stress causes gray hair was a myth – until science said otherwise. Hair color is determined by melanocyte cells, which live at the base of the hair follicle and produce the pigment melanin. As we age, these cells gradually disappear. The hair that regrows from hair follicles that have lost melanocyte cells has less pigment and appears gray. Science has shown that stress hormones are released in our hair follicles, causing the melanocyte cells to die. With no remaining cells, no new pigment can be made, and any new hair becomes gray, then white.

Nails
Nails are not immune to showing outward signs of stress.

Breakage and peeling: A healthy nail will appear pink in color and will be free of imperfections, like ridges. Healthy nails also need nutrients like biotin, zinc and iron and protein. Stress stops the absorption of nutrients to the nail, causing them to become dry, brittle and to sometimes peel.

Beau’s lines: Ever lose a nail? It seems to take a century to regrow. In fact, a fingernail takes approximately six months to fully grow out – a toenail may take a year.

Stress can further disrupt the regrowth of the nail plate, causing horizontal lines across the nail. Known as, “Beau’s lines,” they are literal markers of stress. If fingernails take 6 months to grow, that Beau’s lines in the middle of your nail means you were pretty stressed three months ago.

Nail biting/picking: Stress-induced behaviors can also affect your nails. Nail biting, in particular, is especially common. Science actually tells us that there’s a connection between nail biting and an emotional release. Translation: the more we bite, the more relaxed we feel. When we’re stressed, we’re also known to chronically rub or pick at the cuticle around the nails. Both behaviors damage the nail plate, can cause open sores, and a risk of infection.

Stress Cycle
It’s like the question of the chicken or the egg – what causes what? Stress causes a flare up of eczema. Visible patches of itchy dry skin cause us to – you guessed it – stress more. Stress causes us to lose hair. Sudden baldness causes us to – yet again – stress more. It’s a cycle that has to be broken, so it’s important to work with your healthcare provider and a dermatologist to break the cycle of stress that can make your dermatological health worse.

MidState Skin Institute Services:

www.midstateskin.com

Medical Dermatology
The science of treating the skin, hair, and nails to relieve or cure skin disorders.

Surgical Dermatology
The practice of dermatology that specializes in surgical procedures & minimally invasive techniques to treat skin cancer.

Cosmetic Dermatology
The practice of improving the look and health of one’s skin through medical or surgical procedures, to help patients look and feel their best.

Aesthetics
Treatment for the skin, hair or body that is meant to enhance the appearance of patients through minimally invasive techniques & personalized topical skin care recommendations.