The Brain-Gut-Skin Connection Series: Happiness leads to a beautiful skin

I traveled extensively in the past few weeks.  Usually, when traveling, I try to take time to relax through yoga and meditation and control my stress level.  However, in this round of trips, I became negligent in keeping up with my exercise routine.  And, this morning, two pimples popped up on my chin.  This is not the first time that I observed the direct link between my stress level and skin condition.  I’ve also seen the same phenomena with my teenage son—whenever he is under stress (believe me, it’s pretty often for a 14-year old), his eczema would flare up.  So, is there a link between our mind and our skin condition?  A quick google scholar seems to suggest yes.

The skin has long been recognized as an organ system that responds to emotional stress and to psychological influences with both short- and long-lasting effects. See, for example, Dunbar F: Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships 1910-1953. 4th edition. New York, Columbia, 1954, 594-631; and Selye H: The Physiology and Pathology of Exposure to Stress. Montreal, Acta Inc., 1950, 726-741.   Studies have shown that the skin is a prominent target of key stress hormones, such as corticotropin-releasing hormone, ACTH, cortisol, catecholamines, prolactin, substance P, and nerve growth factor.  Several of these stress hormones are known to activate sebum secretion, expand pore size and cause inflammation in skin.

In a British studied published in 1994, the role of stressful life events in the progress of various skin conditions was studied retrospectively in patients who presented with either psoriasis, urticaria, acne, alopecia and non-atopic eczema, malignant melanoma, fungal infection, basal cell carcinoma and melanocytic naevi. When patients in the three groups were matched for age, those with psoriasis were more likely to report that the experience of stress pre-dated the onset and exacerbations of their condition than patients with other skin diseases. For the psoriasis patients the most common types of life events were family upsets (such as bereavements), and work or school demands, but chronic difficulties were also common. The results support the notion that stress is likely to be associated with skin problems. See AL’ABADIE, M.S., KENT, G.G. and GAWKRODGER, D.J. (1994), The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions. British Journal of Dermatology, 130: 199–203.

The stress induced skin condition can be modulated by relaxation treatments.  Case reports have described positive responses with hypnosis, thermal biofeedback, meditation coupled with imagery, and psychotherapy, and some investigators.  See, for example, Frankel FH, Misch RC: Hypnosis in a case of long-standing psoriasis in a person with character problems. Int J Clin Exp Hypn 21:121-129, 1973; Goodman M: An hypothesis explaining the successful treatment of psoriasis with thermal biofeedback: A case report. Biofeed Self Regul 19(4):347-352, 1994; Tsushima WT: Current psychological treatments for stress-related skin disorders. Cutis 42(5): 402-404, 1988; Kantor SD: Stress and psoriasis. Cutis 46:321-322, 1990; Winchell SA, Watts RA: Relaxation therapies in the treatment of psoriasis and possible pathophysiologic mechanisms. J Am Acad Dermatol 18:101-104, 1988; Zachariae R, Oster H, Bjerring P, Kragballe, K: Effects of psychologic intervention on psoriasis: A preliminary report. J Am Acad Dermatol 34:1008-1015, 1996; and Keinan G, Segl A, Gal U, Brenner S: Stress management for psoriasis patients: The effectiveness of biofeedback and relaxation techniques. Stress Med 11:235-241, 1995.

In one such report, a group of researchers from UMass Medical School studied the influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis.   In the study, thirty-seven patients with psoriasis were randomly assigned to one of two conditions: a mindfulness meditation-based stress reduction intervention guided by audiotaped instructions during light treatments, or a control condition consisting of the light treatments alone with no taped instructions. Four sequential indicators of skin status were monitored during the study: a First Response Point, a Turning Point, a Halfway Point, and a Clearing Point.  The results suggest that the rate of skin clearing in patients with moderate to severe psoriasis can be accelerated when subjects engage in an audiotape-guided, meditative stress reduction exercise.  The psychological outcome data, taken as a whole, suggest that the tape intervention resulted in reduced distress and increased well-being. See, Kabat-Zinn, Jon et al. Psychosomatic Medicine, 60 (5), 625-632, 1998.

Therefore, psychological wellbeing is essential for keeping a healthy and beautiful skin.  Stress shows not only through deepened wrinkles around your eyes and forehead but also through pimples and acne.   Your mind does affect your skin condition—be happy and be beautiful.

Thanks for reading.

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