In one of our first ASK A DERMA features, we talked about how stress is linked to pimples. Other people, however, may not be experiencing spots, but manifest the effects of stress via dry skin.

If you’re reaching for lotion more than usual, it’s not just the lack of moisture or the weather. The stress about these days could be affecting your skin health. How? And what can one do to avoid it?

These are a few questions we brought to Dr. Antonio C. Sison, Psychiatry, Dermatology, and EMDR (Eye Movement Desensitization and Reprocessing).

How do medical experts define stress?

It was Hans Selye who, in 1936, coined the word “stress.” It’s defined as “the non-specific responses of the body to any demand for change.” He later used the term stressor to describe the stimulus to distinguish the stress response. One misconception is that stress is negative and is a threat to one’s well being.

There is also eustress, which helps the person perform better. In contrast, when the person feels a level of stress is overwhelming, the person would experience distress resulting in lowered performance.

Stress was of particular interest in the medical field, which propelled the description of Psychosomatic symptoms. These are bodily symptoms and sensations triggered by stress or other psychological symptoms.

In 2010, the International Classification of Diseases included Acute Stress Reaction as a diagnosis.

From 1936 up to the present, we see the development and recognition of the impact of stress on medical and mental health.

What are the different skin conditions that stress causes?

The field of Psychodermatology studies the interplay of the brain and the skin. One focus of interest is the impact of stress and skin. When one is under extreme stress, the body responds by increasing levels of cortisol and other hormones, which may lead to increased oil production resulting in skin breakouts. Further stress can also be a cause of hair loss.

Moreover, stress can cause chronic skin conditions like acne, psoriasis, rosacea, and eczema to flare or worsen. And when this happens, this may become another stressor for the patient.

Parents are advised to be watchful on the impact of stress on young children. At that age, they would not be able to communicate their feelings. Stress may cause a flare of the child’s atopic dermatitis, causing itchiness, which may disturb the child’s sleeping patterns. These symptoms, in turn, further aggravate the stress level of the child.

This highlights the importance of addressing both stress and the skin condition of the person.

Why is dry skin linked to stress?

The stress response increases levels of cortisol and related hormones, which could lead to a decrease in the synthesis of hyaluronic acid. Moreover, persons under stress may forget their usual skincare routine, another possible reason for dry skin. Additionally, the person may forget to drink adequate amounts of water, which may lead to dehydration.

Since I mentioned earlier that children are also vulnerable to adverse effects of stress, such as skin problems, it’s important to note that a child’s skin is much thinner than that of adult skin. This makes a child’s skin more permeable and more prone to dryness than adult skin.

Dry skin increases the risk of developing skin conditions.

What are habits people often do that exacerbate dry skin?

This is a very interesting topic since I observe that Filipinos have concepts of cleanliness that lead to habits that contribute to dryness of the skin. Typical examples are the excessive use ofhilod, stone, face towel, or loofah during bathing, use of strong soaps, hot water, and taking long baths.

Excessive use of alcohol-based skin products, excessive face and hand washing, along with using exfoliating products can contribute to dry skin.

Other habits that make dry skin worse are alcohol drinking as it induces loss of water, smoking as it depletes Vitamin C, inadequate intake of water, and having an inconsistent skincare regiment.

What are things one must look or avoid in soaps, lotions, and other skincare products to alleviate dry skin?

Avoid sodium lauryl sulfate (SLS). This is a surfactant — a compound in many cleansing detergents that degreases and washes dirt away. This ingredient is also in certain body washes, shampoos, and facial cleansers. It’s an effective cleanser, and some people can use it on their body and face with no adverse side effects. But since surfactants can have a drying effect on the skin, soaps containing SLS can cause further drying in people with already dry skin.

Look for glycerin. If you can’t find a natural soap, look for products that have glycerin, which will provide the skin with enough moisture.

Avoid added fragrances and alcohol. Fragrances, ethyl, and alcohol can dry the skin and irritate. When shopping for soap, it also helps to smell it before buying it. It’s not uncommon for soaps and body washes to have added fragrances. This appeals to the senses, but it can mess with the skin. If you are looking for a soap with scent, it is best to ensure that the soap’s perfume content is held to a minimum.

Avoid synthetic dyes. Not only should you look for ingredients that hydrate the skin, but it’s also important to avoid artificial colors. Synthetic colors are chemically achieved and typically harmful to the skin, the likes of which may exacerbate dry skin problems rather than relieve them.

It is best to use a soap that is designed for dry and sensitive skin that is suitable for everyday use. One example is Oilatum. This soap is an emollient cleanser that is suitable for daily cleansing. Oilatum has protective anti-oxidants, is non-GMO, contains no animal derivatives, and is paraben-free – which makes it safe for both parent and child.