Stress Related Skin Disorders - Your Health By Dr. C. Farquharson-Deveaux,MD

Do you have a chronic skin condition that always seem to flare-up at the wrong time?  Like before a big event such as an exam, wedding, reunion, important business meeting or seminar.  How about when things are hectic around the home and there is just a lot going on in your life related to your family, relationship, finance or employment.  Well it’s because they all have one underlying theme.  These are all stressful events in your life that cause not only mental strain, but also physical response as well.  Unfortunately for people who have certain skin disorders, they may also manifest the stress visually.  The more familiar ones are atopic dermatitis (i.e. eczema), psoriasis, acne and hidradentis suppurativa.  These disorders undergo periods of remission when there is no activity and periods of flare-ups or break-outs when the skin will be affected.  None of these conditions is contagious, and occur only in people who are predisposed to them.

Atopic dermatitis (AD) is an inherited tendency to develop red, itchy skin rashes.  It may start out dry and extremely itchy, which causes you to scratch.  This then worsens the rash which becomes more itchy, red, swollen and sore.  It can eventually become infected or crust over, forming thick, scaly crusts.  Common areas are the elbow creases, behind the knees, on the cheeks and on the buttocks.  AD typically starts in infancy, continues into childhood, and occasionally persists into adulthood.  In addition to stress, other things that can cause a flare-up include skin irritants like household cleansers, detergents, fragranced lotions and soaps, synthetic fibers, getting too hot and sweaty and over drying the skin.

Psoriasis is an abnormal response by the white blood cells of the body’s immune system that mistakenly attack normal skin cells.  This causes thick, red marks that look like scales or plaques to form due to an increase in the number of skin cells in that area.  It is an inherited disorder which usually develops between ages 10 to 45 years and the patches can appear anywhere on the body, but more likely appear on the knees and elbows.  Flare-ups can be caused by infections (like coughs or colds), diseases that weaken the immune system, certain medications (like beta-blockers for high blood pressure), cold weather, smoking or any skin irritant.  

Acne is a condition that typically starts in the early teen years (puberty), when the oil glands in the body increase the production of oil (sebum).  This excess oil mixes with the dead skin cells on the face and plugs up hair follicles in the skin.  If excess bacteria grow in this plugged up mixture it causes more skin irritation.  These can then continue on to be whiteheads, blackheads, pimples, nodules or cysts, depending on the amount of blockage, degree of infection or the body’s response to the irritation.  Acne typically affects the face, but can also be found on the chest, back and shoulders.  It usually fades by age 25 for most, but it can continue well into adult years.  Both girls and boys get acne, but boys tend to have it worse because they produce more oil.  It can be worsened by oil-based make-up and hair products, hormonal changes, especially during menstruation, squeezing or picking at blemishes or by scrubbing the skin. Things that are not shown to cause acne are dirt, chocolate, french fries, sexual activity or masturbation.
Hidradenitis suppurativa is considered to be a severe form of acne.  Affected persons develop painful red bumps or sores in the armpits and groin that leak pus.  It can also occur under the breasts in women and in areas where your skin rubs together, like between your thighs.  It is not caused by poor hygiene.  Flare-ups for some people also occur with shaving, using deodorants, wearing tight synthetic clothing and excessive heat and sweating.

There are many available treatments for all of these conditions ranging from home remedies (e.g. aloe), over-the-counter creams, skin therapy products (aesthetic/spa products) and prescription medications.  Mild skin changes can usually be easily managed with simple home regimens using OTC treatments; however, moderate to severe forms of these disorders require more intensive treatments with prescription medications rubbed into the skin or taken by mouth under the care of a medical doctor.  Additionally, taking other precautions like avoiding irritating factors, wearing cool, natural fibers, like cotton, keeping healthy, losing weight and managing stress will allow for quicker healing with longer periods of remission.  Specifically for AD and psoriasis, keeping the skin moisturized, avoiding over drying, rubbing and scratching the skin significantly helps the symptoms.

Remember that because the skin takes an average of 4 weeks to renew, it may take about 4-8 weeks for noticeable improvement to occur with any treatment regimen.  Therefore try to stick with one regimen for at least 8 weeks before deciding it is not working.  Work with your doctor to determine the best therapy for you and make sure you are doing your part to get the best results. 

Dr. Farquharson is a Family Medicine Specialist at Holistic Family Medicine Center, Tonique Williams-Darling Hwy (West) , Nassau, N.P. Bahamas.  P.O. Box S.P. 60568,  Tel: 242-326-1665/6. Office Hours 9a.m. to 5p.m. -  Call For more Information