The way we talk about skin is taking a cue from mental health—here’s why

January 28, 2020 at 03:00AM by CWC

Once upon a time not so long ago, the words we used to talk about our complexions revolved around physical markers. It was dry, oily, red, scaly, congested, or some combination of all of these things. In a fairly recent phenomenon, however, there’s been a shift. The way that we talk about skin has largely come to mimic the way that we talk about mental health. Adjectives previously reserved to describe an individual’s personality or emotional state are now tapped to talk about how our largest organ is looking and feeling. We say it’s stressed out, tired, temperamental, angry, irritated, and the list again goes on (and on and on). But what exactly is the reason behind this, and why does it matter?

The mind-skin connection really all boils down to biology. “We know from a medical standpoint that the brain and skin have a common embryonic origin,” explains Josie Howard, MD, a San Francisco psychiatrist with an expertise in psycho-dermatology. According to her, that means that when an embryo is forming in the womb, similar cells are involved in the creation of both the brain and skin. That link continues to manifest in very apparent ways throughout our lifetimes. “The history of skin and mental health isn’t a short one,” says Richard Fried, MD, PhD, a dermatologist and clinical psychologist in Yardley, PA. “One hundred years ago it was stated that acne causes more [mental] suffering than [physical suffering]. Within the past few decades, we’ve [recognized] the more subtle interactions between stress and skin,” he says.

Most directly, stress affects the skin through a hormone known as cortisol, which is often referred to as the “stress hormone.” When it flairs up for fill-in-the-blank reason (work, relationships, you name it), cortisol spikes and the skin responds. It’s been well documented that the uptick in this hormone can leave your complexion feeling dull, dry, or broken out, but these days we’ll probably just say it’s looking “burnt out” rather than using those physical monikers. “The language we use [to describe skin] is paralleling an interest in the mind-body connection,” says Dr. Howard. It’s a sign that, not only do we know that the skin is part of a connected system, we’re able to more actionably take charge of what we need to do for skin to feel better.

And mainstream brands are taking note. Walk into a Sephora these days, and you’ll see a slew of products meant to tackle stressed-out skin and even dermatologist-led brands like Dr. Dennis Gross are working on solutions to meet modern needs presented to skin. “The positive is that we’re shifting away from using symptoms to describe skin and focusing more on the cause, which gives you more control,” says Dr. Howard. “If you say your skin is red, then that’s unexplained and out of your control. But if you say it’s stressed, then it allows you to think about the fact that maybe it’s a reflection that you’re stressed and what you need to do to address this. Shifting from the symptom to the cause can be empowering.”

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However,  projecting all stress and anxiety onto skin isn’t always productive. Dr. Howard cautions that there’s a potential for over-thematization in describing skin this way. “People will say, ‘oh my skin is stressed,’ because really they’re stressed and they’re projecting it onto something tangible,” she explains. Rather than getting a facial or buying an expensive cream every time you deal with the impacts of stress on skin, she adds that it’s, instead, more important to get to the root of whatever your stress may be, so that you can deal with it and it won’t continue to show up to pester you.

The bottom line? “We need to be mindful about how a shift in language shifts the focus of our attention, and make sure that’s done in a positive and productive and empowering way,” says Dr. Howard. Go ahead and call your skin stressed or freaked out or temperamental instead of dry or dehydrated, but be sure to consider why that is and address that from both the inside and out.

Think your skin is stressed out? Here are five ways that a dermatologist says to spot stressed-out skin in the wild and this is the way that one dermatologist is working to make stress-out skin a thing of the past.

Author Melanie Rud | Well and Good
Selected by CWC