Breaking the cycle: Inflammatory skin disease and stress

What is an inflammatory skin disease?

Inflammatory skin diseases are characterised by the activation of the innate and adaptive immune system via the production of pro-inflammatory cytokines (small proteins that regulate immune responses.)* They are classified as autoimmune diseases and autoinflammatory syndromes or diseases:

Autoimmune inflammatory skin diseases: Autoimmune skin diseases occur because the body’s immune system attacks its own healthy tissues and includes Vitiligo. The immune system would normally produce antibodies—proteins that react against toxins, bacteria and viruses. When these antibodies attack healthy tissues, they are called autoantibodies. When it comes to autoimmune skin conditions, autoantibodies attack skin cells or collagen tissues.

Autoinflammatory skin diseases are characterised by numerous inflammatory episodes caused by an exaggerated innate immune response such as periodic fever syndromes.

Skin diseases such as psoriasis can have both autoimmune and autoinflammatory components.

What Is Inflammation?

Inflammation is the body’s response to a threat (which can include a virus or emotional stressor). In response, the immune system sends out chemicals, called pro-inflammatory cytokines, to attack the threat. Pro-inflammatory cytokines usually do this and then disappear, but when stress is chronic, they are “upregulated” - continuing the cycle of stress and inflammatory response within the body and over time this can cause harmful effects.

Inflammation can negatively affect your skin in many ways including:

Accelerated ageing: As inflammation slows cellular regeneration, causes DNA damage, and can lead to dryness and dehydration, this can make your skin appear wrinkled sooner than it naturally would.

Dark spots: Inflammation also turns on cells called melanocytes, which are responsible for creating melanin, or pigment. This is why emotional stress, sun exposure, air pollution, and other stressors often cause dark spots on the skin.

Dryness and dehydration: Inflammation can deplete your skin of the lipids that make up its natural protective barrier, allowing excess water to escape into the atmosphere. This is known as trans epidermal water loss and leaves your skin dry and dehydrated.

Stress and skin disease

Research has found a bidirectional "brain-skin" connection between chronic stress and chronic inflammatory skin disease including urticaria, psoriasis and atopic dermatitis.**

The relationship between stress and psoriasis was first investigated in 1945, with stress now regularly reported to play an important role in the onset or exacerbation of psoriasis. Later, other inflammatory skin diseases were investigated as to their association to stress. During the last two decades, multiple studies have shown that patients with skin disease have a higher risk for depression, anxiety, stress and issues with body image.***

What can you do?

Stress reduction techniques and psychological support have been recommended as treatments for those with skin disease following these findings. Whilst it is impossible to completely remove stress from our lives, you can work on reducing stress and improving your wellbeing in the process. The first step is to see your GP, who can carry out the assessments needed to give you a professional diagnosis before recommending treatment. If stress is becoming unmanageable, consider speaking to your GP or a supportive friend and prioritising healthy habits such as exercise, getting enough sleep and eating a balanced diet.