Psychodermatology – The Brain-Skin Connection

October 19, 2015


Psychodermatology – The Brain-Skin Connection
By: Dr. Jen Newell

I see many women in the clinic for holistic dermatology and one of common denominators among them is the presence of chronic stress. It is one of the most ignored causes of skin concerns from wrinkles to acne, dark bags under the eyes to hives and rashes. Unfortunately, it can be challenging to see the connection between psychological influences and the health of the skin but it is significant and frustrating.


How Your Brain Can Sabotage Your Skin:

Stress exerts its effects on the skin mainly through the hypothalamic-pituitary-adrenal (HPA) axis.

When stress is sensed neurons in the hypothalamus secrete hormones, which stimulate the pituitary. The pituitary responds by releasing its own hormones, which are transported to the adrenal glands and stimulate the production of cortisol and corticosterone (yup, more hormones) and catecholamines. Normally, cortisol levels have a daily oscillation/circadian rhythm that follows a predictable patterns; chronic stress disrupts normal cortisol production and that normal pattern. Elevated cortisol product damages collagen within the skin (collagen provides structure and youthfulness to the skin) and increases the appearance of lines and wrinkles…stress makes you look older. Additionally, cortisol decreases the skin’s natural production of hyaluronic acid, which is responsible for maintaining the skin’s moisture – therefore, stress makes the skin dry and dull in appearance. So basically, when the brain perceives stress, its actions cause us to age more rapidly.

In skin, multiple neuroin?ammatory conditions can be triggered or aggravated by stress, such as: psoriasis, atopic dermatitis, acne, contact dermatitis, alopecia areata, itch or Pruritus, and erythema. With regards to acne, a recent study revealed an increase in acne severity associated with the degree of stress – so the more stressed you are the worse your skin will appear.


How Your Skin Can Sabotage Your Brain:

The brain-skin connection is a 2 way street; not only does our brain/psychological functioning impact the health and appearance of our skin but the appearance of our skin can significantly impact out mental health and emotional well-being. I see in all of my acne and dermatology patients another commonality; not only are they stressed but their skin is often one of the greatest sources of that stress and social stigmatization. Skin disorders erode self-esteem, cause depression and anxiety and lower quality of life.

Because of the relationship between the brain and skin, it is important to take a mind-body wholistic approach to treatment and care. Treating a skin concern is much more than just topical treatments. One must also address stress and associated anxiety and self-esteem issues that may arise. This is where Naturopathic Medicine and an integrative team of healthcare providers excels, by taking into consideration all aspects of health and how they interact with one another. If you have acne or other skin concern and are not happy with the results you have gotten from conventional care or strategies, I would encourage you to book a free 15 minute consultation with a Naturopathic Doctor; they can both work to help treat the concern but also make referrals to the appropriate resources and support that would also be of benefit.


Dr. Jen Newell, ND

Dr. Jen Newell is passionate about helping people embrace health, feel amazing and easily incorporate “real” food into their busy lives. Her mission is to make health accessible and achievable, and to inspire patients to live an active, vibrant and healthy life.

Jen has a clinical focus on digestive health, food sensitivities and healthy nutrition; mental health and stress-related illness; women’s health, hormone balance and fertility; optimal aging; and dermatology. She focuses on integrating healthy foods into one’s diet in a medicinal and therapeutic capacity and providing individuals with nutritional support that is easy to incorporate into a busy day. Dr. Newell practices at the Integrative Health Institute in Downtown Toronto.




Chiu A, Chon S Y, Kimball A B. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch. Dermatol. 2003;139 (7):897–900.

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