The Visible Effects of Stress

Get a Grip on Anxiety and Ease a Troubled Face — and Mind

By Barbara Hey

Originally published in Skin Deep, October/November 2004.

Eons ago, back when evading predators and foraging for food were humankind’s main activities, stress was essential to survival. The body’s fight-or-flight response to stress in the face of danger set off a chain reaction of physiological changes, priming the body for action and increasing the likelihood of escaping physical harm.

These days stress is more often induced by threats of the psychological or emotional kind, but the response is the same. While stability-shattering events such as divorce, illness, or job loss take their toll, it’s the low-grade, chronic stress — commuter traffic, rebellious computers, overbooked schedules — that does the greatest damage to body, mind, and even appearance. In addition to the well-documented stress-related illnesses such as heart disease, insomnia, and backaches, chronic stress increases oil production, exacerbating acne, eczema, atopic dermatitis, and psoriasis.

It’s Written All Over Your Face

“Stress is a major deterrent to having good skin,” according to Howard Murad, a dermatologist and CEO of skin care company Murad, Inc. “Even if you eat a perfect diet, if you’re under stress you’re not going to like the way it looks on you.”

The link between stress and skin is becoming clearer all the time. “There are many studies that show the direct connection between the brain, endocrine system, and your skin,” Murad says. In a study published in 2001, researchers found that stress causes deterioration in the skin’s permeability barrier, which is the body’s front line of protection against the outside world and essential to our survival. According to Peter Elias, a professor of dermatology at the University of California, San Francisco who led the study, when that barrier breaks down, there is havoc: Molecules are released whose job it is to shore up the barrier, but they also initiate inflammation on deeper skin layers.

“When you’re stressed the barrier function of your skin gets damaged, and there’s transdermal water loss,” Murad says. This means fluid is lacking in all layers of the skin, which causes a dull complexion and exacerbates wrinkles.

Furthermore, stress throws the body’s biochemical balance out of whack. The fight-or-flight response in the brain sends a message to the body to get ready for action. Then the adrenal glands produce adrenaline and noradrenaline, as well as the stress hormone cortisol, activating the metabolism and keying the body to respond to the threat, whether truly life-threatening or just being late for an appointment.

In regular, peaceful circumstances, the stressor goes away and
hormones return to normal levels. But chronic stress — the scourge of modern life — can have long-lasting, chaotic effects on the body’s biochemistry. Instead of dissipating, cortisol lingers in the body, which depresses the immune system and brings on hormonal imbalances, causing increased sebum production. Skin gets oilier and breakouts occur.

Erasing the Effects of Stress

The good news is plenty can be done to ease stress, minimize its effects, and benefit skin and all-around health. In addition to stress-reducing practices (see “7 Tips,” right), nutrition supplements play an important role. “There are several important nutrients for skin that few get in sufficient quantities, particularly when under stress,” according to Ann Louise Gittleman, clinical nutritionist and author of more than 20 books, including The Fat Flush Plan (McGraw Hill/-Contemporary Books, 2002) and The Living Beauty Detox Program (Harper San Francisco, 2000).

No. 1, she says, are essential fatty acids. The most important for skin is gamma linolenic acid (GLA), found in borage oil, black currant seed oil, and evening primrose. “Roughly 33 percent of all adults are deficient in GLA, which supports the skin cell membranes,” she says. “It’s been shown to be an effective treatment for inflammation and moisture loss associated with dry skin and aging, and a potent anti-inflammatory. Studies have shown that borage oil applied topically has a very dramatic healing effect on eczema, psoriasis, and contact dermatitis.”

So, apply it topically or take it internally? “I love the concept of beauty inside and out,” Gittleman says. That is, apply and consume it. As for internal consumption, Gittleman recommends the GLA supplement manufactured by Health from the Sun, a brand she finds to be of consistent quality. The dose: 500 mg a day.

Internal organs also need support in times of stress, particularly the adrenal system. “Pantothenic acid, a B vitamin, is the best support for the adrenals,” she says. “It balances out the cortisol.” Her recommendation is 500 mg, three times a day.

For those under maximum stress loads, Gittleman suggests an adrenal support supplement that includes zinc, tyrosine, and vitamin B6, three tablets in the morning and three more before 4 p.m. (But always check specific dosage directions, and confer with a healthcare practitioner for the most appropriate remedy and dosage.)

She also notes that when stressed, the body secrets magnesium, and recommends 400 mg in the morning and 400 mg right before bed. “That can help with sleep,” she says. For more information, visit Gittleman’s website,

Stress can be the obstacle standing in the way of clear skin. Addressing this root cause can be pivotal in achieving clarity — from the inside out.