Stress is a large component of every day life and every single one of us encounters various levels of stress throughout their lives. But as discussed earlier in this book, different types of stress can have a drastically different impact on our health.
On one end, short term stress has been shown to stimulate the immune system and be beneficial to our health and development. On the other end of this spectrum, is chronic stress, which is debilitating and can cause a gradual degradation of our immune system and health.
Chronic stress was examined in detail in the immune system chapter of this book. This section, is a little more focused. It does go over the more relevant points from earlier, but mainly attempts to examine the potential connection between stress and seborrheic dermatitis progression in more detail.
The Role of Stress in Skin Disease
Since chronic stress can cause malfunctioning of the immune system (which the skin is a major component of), it is easy to assume it also plays a significant role in skin disease.
The first clue comes from the fact that chronic stress can cause changes in the inflammatory process and may impact wound healing. More specifically, the two most relevant points in this area (as noted in the immune system chapter) are:
- Wound healing occurs in a multi-step fashion were each step is important for the next
- Inflammation and reliable cytokine production are a crucial component of the very first step
- Stress can disrupt the production of inflammatory cytokines and delays wound healing
Now, if stress can disrupt healthy wound healing and a chronic skin condition is a major source of stress, could a vicious cycle be formed? And can chronic stress play a major role in fueling a chronic skin condition?
Unfortunately, specific research on this subject is quite sparse and many of the studies are fairly small in scale. Nevertheless, many of the studies have similar concluding remarks and a pattern does seem to emerge. Some research highlights include:
- Investigation of epidermal permeability barrier function showed that stress may decrease barrier recovery rates and alter it’s stability [1]
- A questionnaire based study concluded that seborrheic dermatitis can often be preceded by a stressful event and ongoing stress may results in poor prognosis [2]
- When seborrheic dermatitis effected individuals were compared to healthy subjects, psychiatric conditions were shown to be considerably more common in SD patients [3]
- In an experiment on mice, chronic stress resulted in immune system instability, increased tumor progression and increase susceptibility to skin cancer [4]
- A 1-year follow up study demonstrated that psychological based treatments led to significantly larger improvements (as compared to standard corticosteroid treatment) and reduced the dependence on topical steroids [5]
- An examination of 343 randomly selected individuals reveled major stressful events often pre-date the onset of Psoriasis [6]
- A study reviewing the effects of audio-tape mediation during UVB and PUVA treatment of Psoriasis, showed stress reduction practices can drastically improve treatment outcomes [7]
- In a volunteer sample of 22 university students effected by acne, levels of stress were shown to have a relationship to acne severity [8]
Though the studies are all fairly small, the results taken together do appear to show that a connection between levels of stress and the stability of the skin does exist.
Similarities Between Stress and AIDS
As noted several times throughout this book, some of the highest rates of seborrheic dermatitis are documented in individuals affected by AIDS. In this condition, incidence rates have been cited anywhere from 34 to 83%. Clearly, whatever happens to the immune system during this condition is in some way related to seborrheic dermatitis progression.
First, let’s briefly review the progression of AIDS. It (autoimmune disease) first starts with an initial infection of HIV. As the virus infects the system, it causes a major breakdown of the immune system and it’s various components. This leads to higher susceptibility to infection and a general decline in health.
Now, what happens in the case of stress? Well, chronic stress has been shown to also have a detrimental effect on the immune system. Resulting in a weakened ability for the body to defend against infection and a general decline in health status.
Clearly, there are some general similarities here. But, what happens if we compare the impact of stress to that of AIDS in more detail? Are there any specific similarities that exist? Well, let’s quickly review the literature:
| HIV/AIDS | Chronic Stress |
|---|---|
| – High rate of CD4 (helper) T cell loss and reduced function [9] | – Reduced numbers of available CD4 T cells & reduced function [10] |
| – Reduced ratio of CD4 (helper) and CD8 (killer) T cells [11] | – Mixed findings in terms of ratio of CD4/CD8 T cells [12, 10, 13] |
| – Impaired natural killer cell activity and function [14] | – Deceased cytotoxic T cell and natural killer cell activities [15] |
Though, it’s still hard to draw any conclusion from these points, some specific similarities are clearly evident.
Could it be the treatment and not the condition?
The most common treatment to AIDS is with the usage of protease inhibitors. This fact may be relevant as well. These drugs have been shown to impair glucose tolerance and cause lipid abnormalities [16]. So perhaps, it may not be the disease itself, but a side effect of the treatments that result in susceptibility to seborrheic dermatitis.
In any case, while AIDS is caused by HIV (an incurable virus), chronic stress is something that could potentially be controlled. As a result, reducing chronic stress may in fact be highly beneficial for potentially reversing seborrheic dermatitis progression.
The Power of Positive Thoughts and Emotions
Since stress and negative thoughts can detrimental effect, it only makes sense that positive thoughts may be beneficial. Luckily, this is far from just a theory and medical experiments have shown some exciting results. For example:
- 32 of 38 individuals who underwent hypnotic suggestion showed a significantly reduced inflammatory response to histamine. The study attributed this not to the hypnosis, but to the relaxed mental state brought about by the session [17].
- Individuals who underwent a imagery based relaxation session showed a reduced inflammatory response to stimulation by capsaicin (active component of chili peppers) compared to those without the session. Relaxations ability to lower blood pressure was speculated to be one of the main mechanisms responsible [18].
- Individuals shown a long funny video, demonstrated an increased presence of an antimicrobial peptide in their sweat. An extended study showed daily viewing helped reduce staphylococcus aureus colonization [19].
Though the results of these types of studies aren’t always positive [20], the majority does seem to indicate that positive emotions enhance immune function. Thus, stress reduction alone may not be enough and finding ways to further improve our moods on a daily basis may hold tremendous value as well.
Section Summary
This section described the possible connection between stress and the progression of skin disease. The key takeaways include:
- Stress is a part of every day life, but chronic stress can be debilitating and cause gradual degradation of the immune system
- The most relevant effects stress has on the immune system are the disruption of inflammatory cytokine production and a delay of wound healing
- A significant number of small scale studies conclude that there does appear to be a relationship between stress and severity of various skin disease
- Seborrheic dermatitis is extremely common in AIDS patients and similarities can be seen between the effects of AIDS and chronic stress
- Chronic stress is something that we can potentially control and stress reduction may be beneficial in reversing seborrheic dermatitis progression
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