Your skin on stress: Pimples, wrinkles, dullness and more

Your skin on stress is not a pretty sight. Stress hormones such as cortisol can trigger breakouts, dull skin, accelerate aging and exasperate skin conditions such as eczema and psoriasis.

That' s especially true when your internal pressure cooker stays at a constant boil -- and who isn't overly stressed these days?

"Consistently elevated cortisol levels have been shown to inhibit your skin's production of collagen, hyaluronic acid and healthy lipids like cerimide," said Dr. Whitney Bowe, a dermatologist and assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai Medical Center.

"Collagen is like the scaffolding of the skin that prevents fine lines and wrinkles," Bowe explained.

"Hyaluronic acid keeps the skin plump, and cerimides are healthy fats that create a barrier to prevent skin permeability, thus locking moisture into the skin."

First line of defense

Long considered the largest organ in the body, your skin's microbiome plays a key role as the body's first line of defense against pathogens.

When the skin barrier functions properly, it traps moisture and keeps the skin hydrated, while blocking allergens, irritants, pollutants and pathogens from entering.

Stress hormones weaken that defense, slowing the production of beneficial oils that help seal hydration into the skin. When that happens, your skin may start to "leak" water in a process known as transepidermal water loss or TEWL.

As the water evaporates out, the skin can become dry and compromised, allowing pathogens to access deeper skin layers, said Bowe, the author of "The Beauty of Dirty Skin: The Surprising Science of Looking and Feeling Radiant from the Inside Out."

"When the skin barrier is not functioning properly, it leads to chronic low-grade levels of inflammation and an increase in free radicals which can damage your skin and accelerate aging as well as increase your risk of developing allergies," Bowe said.

Fight back with 'recovery nights'

Take a close look at your skin regime, Bowe suggests, especially some of your anti-aging products.

"Some of the most powerful skin ingredients known to have dramatic and amazing effects on the skin are known irritants," Bowe said. "Retinoids, including over the counter Retinol, are a dermatologist's favorite, but will irritate the skin, especially if you use the product every night.

"Alpha hydroxy acid or glycolic acid is an amazing ingredient helps brighten dark spots, evens out skin tone and helps promote collagen production, but it too can also be a known irritant," she added.

You can continue to use those, Bowe said, if you cycle through your skin care with "active nights and recovery nights."

On one night, use anti-aging solutions such as retinoids, alpha hydroxy acid or glycolic acid -- whether prescription or over-the-counter -- then skip a night or two, depending on the dryness of your skin.

"You don't want to further compromise your skin barrier by using irritating ingredients every night," Bowe said.

Recovery nights are used to pamper the skin, "using ingredients like glycerin, sunflower seed oil, jojoba oil or squalane" -- which is a hydrogenated version of squalene, a compound produced naturally by our sebaceous glands, Bowe said.

"You are using nourishing, moisturizing ingredients that are going to repair the skin barrier, support the skin's microbiome and restore a healthy pH to the skin," she said.

Baby sensitive skin

How can you tell if stress has oversensitized your skin? Start by washing your face and patting it dry.

If it feels tight, if it feels dry, and "if you apply a product on your skin and you feel stinging, you feel burning, or if you suddenly develop these like little red bumps all over your face, then your skin is sensitive," Bowe said.

Sensitive skin should avoid harsh sulfates in cleansers, Bowe said, such as SLS, or sodium lauryl sulfate, and SLES, which stands for sodium laureth sulfate.

"You also don't want to scrub your skin with a physical scrub or a spin brush," Bowe said. "People now realize that using a spin brush is actually very damaging for your skin barrier, and it makes you much more prone to having sensitive skin."

Many women shave their faces today, and that is not a good idea if you have sensitive skin, Bowe added. Nor is using a fragrance.

"It's really important to call out that it's not just synthetic fragrance, it's natural fragrance that can be harmful," Bowe said. "A lot of people assume if something is natural, it's inherently safe, and it's not going to cause any irritation or inflammation. But actually some of the most potent irritants are natural."

Be careful with essential oils

Many people turn to essential oils such as lavender, orange, lemongrass and chamomile to naturally relax, dial down stress and improve sleep. These oils are highly concentrated plant substances -- for example, it takes about 220 pounds of lavender flowers to produce a pound of lavender oil, according to the National Institute of Environmental Health Sciences.

In addition to their use in aromatherapy, manufacturers sell essential oils for use on the skin and in baths. However, if a person is sensitive or the oils are used improperly, Bowe said, these oils may lead to skin irritation and further damage to the skin barrier.

Some people have been seriously injured. Citrus oils such as orange and lemon contain furocoumarins, which when exposed to the sun's UV rays can cause chemical burns. One 7-year-old girl squeezed lemon juice on her skin while playing in the Arizona sun, and within 24 hours, she was hospitalized with first and second degree burns on her face, neck, chest, arms, legs and feet.

In addition, "essential oils are a known source of allergens," Bowe said. "In fact some of the most potent allergens in all of skincare are found in essential oils, so using them is going to increase your risk for developing skin allergies."

Watch your sugar intake

When stressed, many of us will turn to sugar and processed carbohydrates, which "unfortunately can damage the skin's collagen over time through a process called glycation," said Dr. Rajani Katta, author of "Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet."

Glycation occurs when sugar molecules attach onto fats and proteins and create advanced glycation end products, or AGEs, which can make collagen and elastin proteins less supple -- and the skin more likely to wrinkle.

"Foods rich in antioxidants and anti-inflammatory properties can help provide an extra layer of protection to your skin and can help promote your skin's defense and repair systems," Katta suggested.

Try stress-busting techniques

Get social. "Add social interactions -- real social interactions, not just on social media," Bowe suggested. "Getting out and actually going on a walk with a friend in nature, or something like that is a great way of helping to dial down stress."

Get physical. Exercise increases blood circulation to the brain and helps with the release of endorphins, the body's feel-good hormones. Exercise also pushes oxygenated blood to all your body parts, including the skin, which can boost the skin barrier's recovery process.

Get calm. Try yoga, meditation and deep breathing to calm down your stress levels, Bowe suggested: "All of those have been shown to decrease cortisol production and stress levels."

Get good sleep. "It's called beauty sleep because sleep does regenerate your skin at night," said sleep specialist Dr. Raj Dasgupta, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California.

"Surprise surprise, there's a hormone called growth hormone that gets secreted during the deeper stages of sleep that stimulates fresh skin cell growth," Dasgupta said.

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