Managing Stressed Skin

Stress has a wide range of clinical impacts on the skin including acne, inflammation, impaired skin barrier, hyperpigmentation, and suppressed immunity and wound healing. Understanding how stress affects the skin is key to knowing what to do—or avoid—to ensure it doesn’t worsen. 

What is Stress?  

Stress is defined by the National Cancer Institute as the body's response to physical, mental, or emotional pressure and can be acute or chronic. Chronic exposure to stress is what takes a particularly large toll on the skin.1 

When we're experiencing stress, our body releases cortisol, which depletes water in the skin. This process, known as trans epidermal water loss (TEWL), causes skin to appear rough, flakey, or irritated. However, this production of cortisol also stimulates the production of sebum, making the skin more oily than usual, which can lead to retention hyperkeratosis and acne. This oil-water imbalance can alter the skin’s pH and results in various clinical impacts on the skin.2 

  • Stress also causes free radical production in the body, leading to oxidative stress and the weakening of collagen and elastin fibers. This presents in the skin as fine lines and wrinkles, sagging, and texture changes. When stress on the body becomes chronic, this free radical production leads to DNA damage and the potential for cancer.  

The Dos and Don’ts of Treating Stressed Skin 

To combat the signs of stressed skin in the treatment room, focus your services on enhancing the skin’s barrier and avoid active ingredients that could worsen existing conditions.  

  • Do use 
    • Ceramides 
    • Lipids 
    • Fatty acids 
  • Don’t use 
    • AHAs 
    • BHAs 
    • Benzoyl peroxide 
    • Essential oils that may be irritating  

To heal stressed skin, you must first address the stress itself. Topical products will likely not be effective, especially if the skin is experiencing a particularly bad break-out or reaction. Offer relaxation techniques to help your client de-stress. This can include aromatherapy, sound therapy, the addition of heated or weighted blankets to your spa table, and offering warm tea or water post-service. 

Following are some Dos and Don’ts you can recommend to your clients to help manage, reduce, and prevent stress: 

  • Do 
    • Get a facial or massage 
    • Drink plenty of water, eat a balanced diet, and exercise 
    • Practice deep, mindful breathing 
    • Meditate and get good sleep 
    • Get outside 
  • Don’t 
    • Eat too many heavily processed foods 
    • Consume too much alcohol and caffeine 
    • Listen to loud music 
    • Get too much exposure to bright, fluorescent lighting 


  1. National Cancer Institute, “Stress,” accessed July 2023, 
  2. Rachel Graubard, Ariadna Perez-Sanchez, and Rajani Katta, “Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology,” Dermatology Practical & Conceptual 11 no. 4 (October 2021) 
  3. Jessica DeFino, “This Is Your Skin on Stress,” New York Times, December 8, 2020,


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