Moving onto more of a generalized connection, it makes sense to examine stress, which can be considered as a product of the nervous system. In this area, there are no single clear case studies which can demonstrate the cause and effect relation, but instead, we need to examine the corresponding evidence from large groups of individuals and look for a possible link.
Without a doubt, stress is one of the most common self-reported triggers for seborrheic dermatitis flare-ups. And while this associate is widely accepted and mentioned through the literature discussing seborrheic dermatitis, little actual research in the area has been performed to date (likely due to the complexity of controlling such a study).
Nonetheless, there are two questionnaire-based studies which have confirmed the connection with some empirical data:
- A large scale study from Barcelona, Spain carried out in 2007 documented that 76% of 2,159 study participants reported periods of stress and anxiety typically preceded symptom flare-ups .
- A French study also carried out in 2007 evaluated the anxiety and depression scores for a total of 82 participants. Analysis of the results showed a higher anxiety score showed a significant relationship to the condition and the researchers concluded stressful events often precede symptom onset .
On the flip-side, others have argued that the nature of a skin condition which impacts such visible areas of the skin (such as the face) can itself create stress/anxiety for those affected. And determining the direction of the relationship is notably difficult .
Despite the complexity, if we review the impact stress can have on barrier function:
- A study of 27 healthy individuals (without any skin conditions) examined the impact stressful conditions have on skin barrier permeability and recovery. The result was that stress had a clear and significant impact on skin barrier stability .
- A study of 25 healthy women analyzed the impact of three different stressors: interview stress, sleep deprivation, and physical exercise; on skin barrier function. The result was that both interview stress and sleep deprivation negatively impacted skin barrier function, while physical exercise did not induce any negative changes .
Combing this evidence together with the frequently reported connection between seborrheic dermatitis and stress, it becomes easier to lean on the side that argues that stress is likely to precede skin issues and then serves to reinforce/magnify the extent of future flare-ups.
Stress as a feature of nervous system instability
When reviewing stress, it’s common that it is categorized as a general aspect of mental health. However, in a more fundamental sense, all varieties and sub-types of stress (acute stress, chronic stress, depression, and anxiety) can be thought of as mental states directly under the control of the nervous system.
This section briefly touched upon the allusive, yet often reported, connection between stress and seborrheic dermatitis.
Key points include:
- Stress appears to be one of the most commonly reported triggers for both ongoing seborrheic dermatitis symptoms and their initial onset
- The two studies which set out to examine this connection both showed that stress and anxiety may in-fact play a significant role for many of us
- Some have argued that its nearly impossible to determine the direction of such relationship and higher levels of stress can itself be triggered by such skin issues
- The nature of such a relationship may not be relevant, as it’s clear that stress can have a negative impact on skin barrier function (via the relationship between the nervous and immune systems)