The Skin Deep Impact of Stress and Anxiety
How Your Mental Health Affects Your Skin
For as long as I can remember, I have always been incredibly ticklish. This was a curse when I was younger; as soon as people found out where my weak spots were, they would relentlessly tickle me. If you’re like me, you know that being tickled isn’t a pleasant experience, despite the uncontrollable eruption of laughter and perceived enjoyment from the perspective of the tickler. In fact, being tickled can be excruciatingly uncomfortable, almost painful for some.
In the last few years following my grandfather’s passing in early 2020, coupled with the unfolding of the pandemic, I noticed a drastic increase in my sensitivity to being touched. Any form of touch has become ticklish to me. This is especially the case when the touch is unexpected. At first, I didn’t acknowledge or process this change and nonchalantly shrugged it off, but recently it started to negatively impact and actually prevent physical intimacy with family, friends and worst of all, my husband. I realised this wasn’t something I could comfortably ignore.
I'm Maryam Matter, a Neuroscience and Mental Health Specialist and the Founder of Neurominded, offering speaking, coaching and writing services. Mental health is my why and neuroscience is my how. I care deeply about improving mental health literacy for all - with the science to back it up.
After looking into this a bit further and digging into the research behind my experience, it became clear that this extreme sensitivity, or hypersensitivity, to touch can be a symptom of heightened anxiety. This was reassuring as I could attribute this sudden change to the immense stress and anxiety I have been harbouring. It also spurred an interest in the different ways in which anxiety and stress can actually impact our skin. If you have had similar experiences to mine or seen changes to your skin which you’re finding difficult to explain, the culprits may well be stress or anxiety.
In this article, we’ll be exploring some of the various ways in which poor mental wellbeing can manifest when it comes to our skin. If your experience is affecting your daily life or your quality of life, make sure to speak to your GP or a health professional, such as a dermatologist, before making any conclusions.
Why does our skin react to anxiety and stress?
Anxiety and stressful stimuli can trigger our fight-or-flight response. When we perceive a threat, our bodies gear up to face it through the release of various hormones, including cortisol, the ‘stress hormone’, and adrenaline. A number of physiological changes happen such as raised heart and breathing rates, increasing the circulation of oxygen around our body, and preparing us to bolt out of the situation or stay and fight. This is also why we sometimes experience hot flushes, sudden and intense heat rushing through our upper bodies, when we receive a shock to the system, like hearing bad news, for example. The stress response can cause an inflammatory response in our skin, contributing to and leading to the psychosomatic, uncomfortable and sometimes debilitating conditions and symptoms we might experience as a result of our anxiety.
What might these reactions look like?
Hypersensitive skin unfortunately isn’t my first experience of high levels of stress and anxiety evincing themselves physically, specifically through my skin. In the past, I have developed mild eczema, a skin condition that causes inflamed and itchy skin, on my eyelid during exam season. Prior to this, I had never had eczema, so I was surprised to hear from a pharmacist that my dry, itchy eyelid was in fact an eczema flare-up triggered by elevated stress. Luckily, I was able to easily treat my eczema, using a sensitive skin moisturiser recommended by the pharmacist. I take solace in the fact that it is usually much easier to reach a pharmacist for advice, especially when it can sometimes take several weeks to see a general practitioner.
A slightly more distressing symptom of anxiety for me and one which reoccurs, particularly when I’m lying in bed, is formication. Formication is a tactile hallucination where it feels as if small insects are crawling on or underneath your skin, an unsettling prickling (creepy, I know!).
Formication originates from the Latin word, "formicare": crawl like an ant. It is an unusual skin sensation, to say the least, and anxiety is amongst its potential causes. As somebody with moderately severe arachnophobia, the first time I experienced formication on my arms, I was absolutely terrified and furiously smacked my arms in the dark, just to realise nothing was actually there. My anxiety tends to peak when I'm in bed, as I am forced to reckon with my most unsettling thoughts and worries. My brain likes to replay a stale slideshow of my most embarrassing memories.
Another nighttime offender is restlessness and restless legs syndrome. When trying to fall asleep, I sometimes find myself frantically kicking my legs in bed, trying to shake the overwhelming feeling of needing to move them and the build-up of energy. At times, the only way to release the energy and dispel the discomfort is to get out of bed and wait until the feeling subsides, making it much more difficult to fall asleep later. Another symptom of restless legs syndrome is the sensation of crawling or tingling. It can be super uncomfortable and unpleasant, feeling so restless, on edge, and unable to relax. Restlessness is a widely recognised and common symptom of anxiety, more prevalent amongst young people.
Anxiety itch, or psychogenic itch, is an itch caused by psychological factors like anxiety, stress, and depression, rather than an existing skin or physical condition. Itches arise from an interaction between our skin cells and skin-associated nerve cells. Sometimes having irritable skin can be a result of heightened stress or anxiety, and feeling itchy or the urge to scratch can elicit great discomfort. My anxiety itch tends to emerge during important presentations, interviews, and other situations which evoke nervousness, specifically along my forearms. Some anxiety itches are irresistible and I can unfortunately end up with very long and red scratch lines ahead of stress-inducing situations.
One obvious way in which anxiety can manifest itself is dreaded breakouts and sometimes acne flare-ups, which, annoyingly, is not exclusive to our teenage years. The most common association between anxiety and breakouts is the release of stress hormones during the fight-or-flight response. These hormones potentially increase the production of skin oils and in turn clog our pores, allowing bacteria to build up inside the pore leading to unwelcome red, angry swelling spots. During the more stressful periods of my life, such as exam seasons or big life changes, my face lights up like a Christmas tree and out comes my arsenal of Sudocrem and spot patches. Research has shown that mental distress can also exacerbate pre-existing skin conditions, like acne.
The skin symptoms of anxiety discussed in this article are by no means exhaustive. There are many other ways that anxiety and stress can show themselves through our skin. In fact, research has demonstrated that the relationship between our mood and skin goes both ways. Those with existing skin conditions, such as eczema, acne, and psoriasis, may be at a higher risk of experiencing or developing higher stress, anxiety and depression disorders. This is due to consistent discomfort, itch and perceived stigma surrounding visible skin conditions, leading to issues with self-esteem. The elevated stress and anxiety consequently exacerbate the existing condition, feeding into a vicious cycle.
Our emotions and mental wellbeing are clearly very much connected to our skin, giving us tangible stress signals, indicating we need to address our levels of anxiety. It is crucial to both the health of our skin and wellbeing that we find different ways to manage our anxiety and stress, and this looks different for everybody. As aforementioned, if your mental wellbeing or skin conditions are negatively impacting your quality of life, please reach out to relevant health services and seek support and treatment where necessary, whether that be in the form of medication, therapy or something totally different.