Научные данные подтверждают прямую связь между психологическим стрессом и обострением кожных заболеваний

Have you ever noticed that your acne tends to get worse just before an important presentation or while you're undergoing an examination, or that your eczema becomes worse during times of great stress? Although many people regard this as nothing more than a coincidence, there is ample scientific evidence showing a connection between psychological stress and chronic inflammatory skin diseases. The skin and the nervous system are closely linked, and emotional stress can have an effect on various biological pathways that influence skin health. Dr. Hina Kukreja Medical Director, Zurie Skin Clinic, shares how pyschology impacts the skin. Psychological stress causes the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system to become active, leading to the secretion of cortisol and other neuroendocrine mediators. This can result in a deterioration of the skin barrier function, modify immune responses and encourage inflammatory pathways, all of which have consequences for common dermatological conditions. Stress has been found to increase the activity of the sebaceous glands and to cause the release of pro-inflammatory mediators, which in turn leads to a worsening of the inflammatory lesions. It also has an effect on hormonal and metabolic pathways and thus can have an indirect impact on the skin. In women, acne tends to vary throughout the menstrual cycle and psychological stress can further exacerbate these outbreaks. Stress may also make breakouts worse in people who have underlying hormonal disorders such as polycystic ovary syndrome (PCOS). High levels of cortisol during chronic stress can boost sebum production and inflammation, and at the same time stress can lead to metabolic changes, including insulin resistance in those who are susceptible. Even though stress is not the main cause of acne, it is a well-recognised factor that can trigger flare-ups in people who are already prone to it. In people with atopic dermatitis (eczema) stress can cause a deterioration of the skin's barrier function, lead to an increase in transepidermal water loss and result in changes to immune regulation, thus making the skin more prone to itching and inflammation. This in turn often reinforces the well-known itch-scratch cycle, since scratching further damages the skin barrier and continues the disease process. The connection between stress and skin diseases is generally multifactorial since long-term stress can interfere with sleep, change eating habits, lead to poorer compliance with treatment, and promote actions like scratching or picking at the skin all of which can make existing skin problems worse. It can also aggravate any underlying endocrine or metabolic disorders that affect the skin. Because of this, when it is appropriate from a clinical point of view, dermatologists take into account the wider clinical situation, such as the patient's menstrual history, signs of hormonal imbalance, and other related medical conditions, rather than addressing the skin alone. The key point is that stress shouldn't be regarded as the only cause of acne or eczema - just as it shouldn't be ignored. Good management goes beyond the use of topical creams and oral medicines. By considering stress a factor that can modify the course of the disease and combining this with evidence-based dermatological treatment, sufficient sleep, stress management and healthy lifestyle choices, a significant improvement in long-term disease control can be achieved. In practice it is usually not sufficient to treat the skin alone; genuine improvement can only be obtained by considering the patient as a whole since the skin is affected not only by genetics and skincare but also by hormones, the immune function, lifestyle and psychological well-being.