Stress and Seborrheic Dermatitis: The Impact of Stress on Skin Health

Seborrheic dermatitis is a common chronic skin condition that causes red, flaky, greasy patches on the skin. It most often affects the scalp, face, chest, back, and areas where the skin folds together such as behind the ears and underneath the breasts [1]. While the exact cause is unknown, research suggests that stress may play a role in triggering flares and exacerbating symptoms of this troublesome skin condition [1][2].

What is Seborrheic Dermatitis?

Seborrheic dermatitis causes scaly, red patches and dandruff-like flaking on oily areas of the skin [3]. It can occur in infants within the first few months of life, where it is referred to as cradle cap. In adolescents and adults, seborrheic dermatitis often fluctuates, with flares followed by periods of remission [4].

The exact cause of seborrheic dermatitis is not fully understood. However, factors such as [5]:

• Overactive sebaceous glands in the skin
• Colonization of yeast on the skin (Malassezia)
• Inflammation
• An altered immune response

all appear to play a role in disease onset and progression. The condition itself is not contagious, but it can be annoying due to redness, scaling, and itchiness. Treatment focuses on controlling symptoms and preventing flares through [6] [7]:

• Antifungal creams and shampoos
• Anti-inflammatory creams and ointments
• Steroid creams and ointments

While seborrheic dermatitis is manageable for most people, flares can be triggered by external factors. Stress has emerged as one potential trigger that can worsen seborrheic dermatitis.

The Link Between Stress and Seborrheic Dermatitis

In a 2007 prospective study, stress was the most commonly self-reported trigger for seborrheic dermatitis flares [1]. 84% of patients reported a stressful event in the month prior to a flare-up of their condition. Patients who identified stress as a trigger also had higher anxiety levels based on psychological evaluations [1].

Additional studies have found that [2]:

• Chronic stress may play a role in flare-ups of several inflammatory skin diseases, including seborrheic dermatitis.
• Stress can disrupt the normal functioning of the nervous, endocrine, and immune systems. This can increase inflammation and skin sensitivity.
• Stress hormones may negatively impact the skin barrier function, leading to more irritation.

Furthermore, college students with seborrheic dermatitis tend to experience more frequent flares around exam times, suggesting a link to increased stress levels [5].

Overall, moderate evidence exists supporting a relationship between stress and seborrheic dermatitis flares. However, more research is still needed comparing seborrheic dermatitis patients to healthy controls.

How Stress Impacts Skin Health

To understand how stress may worsen seborrheic dermatitis, it is important to consider the various effects of stress on skin health. Both acute and chronic stress have been shown to [8]:

• Increase inflammation in the body
• Raise levels of stress hormones like cortisol
• Disrupt the skin barrier function

Specifically, chronic stress may:

• Increase skin sensitivity and reactivity [8]
• Reduce epidermal lipid production leading to dryness [9]
• Alter the skin microbiome, increasing susceptibility to pathogens [10]
• Worsen skin conditions like acne and psoriasis [11]

Furthermore, psychological stress has been linked to increased transepidermal water loss, which can worsen dryness and skin barrier damage [12].

These wide-ranging effects of stress on skin health provide biological mechanisms by which stress could trigger or worsen seborrheic dermatitis flares.

Managing Stress to Improve Skin Health

Given the associations between stress and skin conditions like seborrheic dermatitis, stress management emerges as an important part of treatment. Techniques to manage stress include [13] [14]:

• Mind-body therapies like meditation, yoga, and deep breathing
• Exercise and physical activity
• Social support and counseling
• Relaxation strategies like massage, music, and aromatherapy

These stress management approaches can help calm the body’s stress response and return the nervous, immune, and endocrine systems to a state of balance. This can help reduce overall inflammation.

Additionally, developing a positive [15]:

• Mindset about dealing with stressors may be beneficial. Reframing thoughts to view stress as a helpful challenge rather than a hindrance can improve resilience.

Taking active steps to address stress through lifestyle changes, mindset shifts, and relaxation techniques can improve skin health outcomes. This integrative approach may help reduce seborrheic dermatitis flares.

Conclusion

In summary, early research indicates that stress may serve as a trigger for seborrheic dermatitis flares. Stress can disrupt multiple physiological pathways involved in skin health, including the epidermal barrier, microbiome balance, inflammation, and moisture retention. Managing stress through mind-body interventions, exercise, social support, and positive mindsets may help mitigate some of the skin-related effects of stress. Further research is still needed, but an integrative approach addressing lifestyle, mindset, and skin care shows promise in reducing seborrheic dermatitis symptoms.