Discover my current regimen (since August 2015) more info

The Connection Between Stress and Seborrheic Dermatitis

Book Extract

This article is an extract from: Seborrheic Dermatitis - The Owner's Manual; a book dedicated to understanding seborrheic dermatitis. See the book overview page for more information.

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:

  1. Stress is a part of every day life, but chronic stress can be debilitating and cause gradual degradation of the immune system
  2. The most relevant effects stress has on the immune system are the disruption of inflammatory cytokine production and a delay of wound healing
  3. A significant number of small scale studies conclude that there does appear to be a relationship between stress and severity of various skin disease
  4. Seborrheic dermatitis is extremely common in AIDS patients and similarities can be seen between the effects of AIDS and chronic stress
  5. Chronic stress is something that we can potentially control and stress reduction may be beneficial in reversing seborrheic dermatitis progression

Book Extract

This article is an extract from: Seborrheic Dermatitis - The Owner's Manual; a book dedicated to understanding seborrheic dermatitis. See the book overview page for more information.


  1. A Garg, M M Chren, L P Sands, M S Matsui, K D Marenus, K R Feingold, P M Elias "Psychological stress perturbs epidermal permeability barrier homeostasis: implications for the pathogenesis of stress-associated skin disorders." Archives of dermatology 137.1 (2001): 53-9. PubMed
  2. L Misery, S Touboul, C Vinueot, S Dutray, G Rolland-Jacob, S-G Consoli, Y Farcet, N Feton-Danou, F Cardinaud, V Callot, C De La Chapelle, D Pomey-Rey, S-M Consoli "[Stress and seborrheic dermatitis]." Annales de dermatologie et de venereologie 134.11 (2007): 833-7. PubMed
  3. Ali urfan Gufcl, Emine ucuflgeueen "Personality traits and common psychiatric conditions in adult patients with acne vulgaris." Annals of dermatology 27.1 (2015): 48-52. PubMed
  4. Alison N Saul, Tatiana M Oberyszyn, Christine Daugherty, Donna Kusewitt, Susie Jones, Scott Jewell, William B Malarkey, Amy Lehman, Stanley Lemeshow, Firdaus S Dhabhar "Chronic stress and susceptibility to skin cancer." Journal of the National Cancer Institute 97.23 (2005): 1760-7. PubMed
  5. A Ehlers, U Stangier, U Gieler "Treatment of atopic dermatitis: a comparison of psychological and dermatological approaches to relapse prevention." Journal of consulting and clinical psychology 63.4 (1995): 624-35. PubMed
  6. M S Al'Abadie, G G Kent, D J Gawkrodger "The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions." The British journal of dermatology 130.2 (1994): 199-203. PubMed
  7. J Kabat-Zinn, E Wheeler, T Light, A Skillings, M J Scharf, T G Cropley, D Hosmer, J D Bernhard "Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA)." Psychosomatic medicine 60.5 (1998): 625-32. PubMed
  8. Annie Chiu, Susan Y Chon, Alexa B Kimball "The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress." Archives of dermatology 139.7 (2003): 897-900. PubMed
  9. D D Ho, A U Neumann, A S Perelson, W Chen, J M Leonard, M Markowitz "Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection." Nature 373.6510 (1995): 123-6. PubMed
  10. L R Frick, M L Barreiro Arcos, M Rapanelli, M P Zappia, M Brocco, C Mongini, A M Genaro, G A Cremaschi "Chronic restraint stress impairs T-cell immunity and promotes tumor progression in mice." Stress (Amsterdam, Netherlands) 12.2 (2009): 134-43. PubMed
  11. Z Liu, W G Cumberland, L E Hultin, H E Prince, R Detels, J V Giorgi "Elevated CD38 antigen expression on CD8+ T cells is a stronger marker for the risk of chronic HIV disease progression to AIDS and death in the Multicenter AIDS Cohort Study than CD4+ cell count, soluble immune activation markers, or combinations of HLA-DR and CD38 expression." Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association 16.2 (1997): 83-92. PubMed
  12. J M Scanlan, P P Vitaliano, H Ochs, M V Savage, S Borson "CD4 and CD8 counts are associated with interactions of gender and psychosocial stress." Psychosomatic medicine 60.5 (1998): 644-53. PubMed
  13. V Stefanski, H Engler "Effects of acute and chronic social stress on blood cellular immunity in rats." Physiology & behavior 64.5 (1999): 733-41. PubMed
  14. D Scott-Algara, F Vuillier, A Cayota, G Dighiero "Natural killer (NK) cell activity during HIV infection: a decrease in NK activity is observed at the clonal level and is not restored after in vitro long-term culture of NK cells." Clinical and experimental immunology 90.2 (1992): 181-7. PubMed
  15. Edna Maria Vissoci Reiche, Sandra Odebrecht Vargas Nunes, Helena Kaminami Morimoto "Stress, depression, the immune system, and cancer." The Lancet. Oncology 5.10 (2004): 617-25. PubMed
  16. G Behrens, A Dejam, H Schmidt, H J Balks, G Brabant, T Kufrner, M Stoll, R E Schmidt "Impaired glucose tolerance, beta cell function and lipid metabolism in HIV patients under treatment with protease inhibitors." AIDS (London, England) 13.10 (1999): F63-70. PubMed
  17. T M Laidlaw, R J Booth, R G Large "Reduction in skin reactions to histamine after a hypnotic procedure." Psychosomatic medicine 58.3 (1996): 242-8. PubMed
  18. S Lutgendorf, H Logan, H L Kirchner, N Rothrock, S Svengalis, K Iverson, D Lubaroff "Effects of relaxation and stress on the capsaicin-induced local inflammatory response." Psychosomatic medicine 62.4 (2000): 524-34. PubMed
  19. Hajime Kimata "Increase in dermcidin-derived peptides in sweat of patients with atopic eczema caused by a humorous video." Journal of psychosomatic research 62.1 (2006): 57-9. PubMed
  20. J O Beahrs, D R Harris, E R Hilgard "Failure to alter skin inflammation by hypnotic suggestion in five subjects with normal skin reactivity." Psychosomatic medicine 32.6 (1971): 627-31. PubMed
Last Updated:
in Seborrheic Dermatitis   0

About Michael Anders

After being affected by seborrheic dermatitis, I have made it my goal to gather and organize all the information that has helped me in my journey.

Share Your Thoughts

(will not be published)

No Comments

Be the first to start a conversation