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How Anxiety Affects Our Skin – and What You Can Do About It

Photographed by Francesco Scotti

There is a Roald Dahl quote often circulated on social media that reads: “If you have good thoughts, they will shine out of your face like sunbeams and you will always look lovely.” It’s a mantra that speaks to the power of the mind in impacting how we appear physically – positive, happy feelings always manifest as radiance. It follows, then, that when we are feeling low, our skin may well follow suit. With so many of us now suffering from anxiety, what are the dermatological consequences?

How does anxiety affect our skin?

As a psychodermatologist – a dermatologist who pays special attention to the psychology of our skin – Dr Alia Ahmed has a firm handle on the skin issues that can flare up as a result of stress and anxiety. Of course, there are the skin concerns you hear about daily – such as acne and eczema – and then there are those that are rooted in psychological distress and are less widely understood, such as skin picking and dysmorphia.

Put simply, tricky feelings go hand-in-hand with skin issues. “Anxiety is a well-known trigger of the stress response, which is linked to skin problems like acne, eczema, urticaria, psoriasis, rosacea and obsessive-compulsive spectrum disorders,” Dr Ahmed says. “Other established links include itching (dermatological conditions associated with itching have higher reported levels of anxiety and lower quality of life), disease flares (especially psoriasis and eczema), hives, flushing and sweating.” Anxiety, she adds, is often expressed in emotional facial expressions, such as forehead furrows and eleven lines.

What are the tell-tale signs that your skin is responding to anxiety?

If you’ve suddenly started to experience acne breakouts after an anxiety-filled period (hi there, Covid-19) or your eczema flares up every time a deadline looms, your body’s stress response is a likely culprit. “The brain has a stress-activated pathway that causes the release of various chemicals and hormones that drive inflammation both in the body and the skin,” explains Dr Ahmed. “Feelings of emotional distress lead to the release of a stress hormone (cortisol) which delays healing, disrupts the skin’s natural barrier and affects the immune system, making it less able to defend itself.” From red, dry and itchy skin to lines, wrinkles, pigmentation and dullness, difficult feelings can lead to skin that doesn’t function – or look – at its best.

What other factors impact the mind-skin connection?

Of course, it works the other way round, too: stress causes skin disease and, equally, skin disease causes stress. Every blemish, dry patch, and dark spot that appears on our skin has the potential to affect how we feel emotionally, with 17% of dermatology patients requiring psychological support to cope with their condition. It’s a catch-22 that has arguably worsened due to social media and its myriad filters, which breed unrealistic expectations of what skin should look like in the first place.

Increasingly common are patients whose inability to match their real skin to the filters (whether skin-smoothing or jaw-sculpting) due to “imperfections” causes them great distress. “An example of a patient in this category is someone that has mild acne but is so upset by it that they have stopped socializing with their friends, spend hours in front of the mirror examining their skin, and feel low and depressed about the way they look. In extreme cases, this can lead to suicidal thoughts. My job in this scenario is to treat the acne appropriately but also explore why it is such a problem for the individual concerned,” says Dr Ahmed.

Even in ostensibly less extreme cases, skin that won’t play ball can affect mental wellbeing with feelings of embarrassment, low mood, anxiousness, and isolation proving common. “These feelings can then impact the skin and it turns into a vicious cycle,” says Dr Ahmed. This is just one reason why social media campaigns, such as the acne-positive movement, are so important in breaking the stigma around having spots – the less we can stress, the better our skin will be.

How can we break the cycle? 

Read on for Dr Ahmed’s seven tips on how to treat anxiety-prone skin.

1. Manage your environment. Create a positive environment, keeping favorite candles, scents, music or colors close by. People feel more satisfied and experience improved mental health if the surrounding conditions are well managed.

2. Self-dialogue. Keep a positive mantra to recite to yourself, especially at the times when you are feeling low. Try affirmative phrases such as: “I respect myself, I am worthy, I am unique, I will not give up.” Think about what you’re thankful for daily, and remind yourself of them periodically.

3. Get more sleep. Sleep at least eight hours a night to allow skin the time to repair itself.

4. Banish negative influences. If you are noticing that something in your life is emotionally draining or making you feel low about yourself, begin the process of removing it if you can.

5. Stay hydrated. Drink at least two-and-a-half liters of fluid a day to reduce the effects of dehydration on the skin.

6. Invest in a facial tool. Consider gentle facial massage to improve circulation, lymphatic drainage and boost collagen production – it’s also a great method of relaxation. Try a gua sha tool, such as Mount Lai’s Jade Gua Sha (£25, available at, to aid your massage movements.

7. Don’t forget your diet. The interaction between the gut, brain and skin should not be forgotten when assessing skin health. The natural balance of the gut can be skewed by lifestyle factors and stress, which can in turn promote inflammation, which is implicated in skin conditions. Take some time to consider if your diet is working well for your body, incorporate some healthy choices and consider a probiotic supplement. We love Symprove’s liquid probiotic offering.

Read Next: Selena Gomez Opens Up About Feeling Depressed During Covid-19 Quarantine

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