From eczema to spots to wrinkles, why the pandemic is wreaking havoc on our skin – Telegraph.co.uk

Until last year, Anna Robertson never had problems with her skin. But in October, with the strain of lockdown culminating in the end of her marriage, the mother-of-three from Wiltshire, 47, noticed patches of rough, scaly, itchy skin. They started on my nose and spread to my eyelids, she says. Managing the sale of our house, working and looking after the children, aged seven, 12 and 15, during the pandemic has been incredibly stressful. I saw a private dermatologist who diagnosed stress-related eczema.

In the year since the coronavirus pandemic began, experts have reported a huge rise in skin complaints, from sudden outbreaks of eczema to acne to increased signs of ageing none of which is being helped by the current cold weather.

Increased screen use, changes to our diet, increased alcohol intakeand masks are all thought to raise the risk of breakouts and skin problemsthough, in many cases, stress is thought to be the key driver as it was for Anna, who'd never had eczema before in her life.

Dr Alia Ahmed, consultant dermatologist at the Frimley Health Foundation Trust, says she has seen an uptick in patients presenting with stress-related skin problemssuch as eczema, psoriasis, acne, alopecia (hair loss) and urticaria (hives).

I have also had to increase the potency of treatment for some patients to control their skin condition, says Dr Ahmed, who also runs a private practice. My patients both men and women are experiencing high levels of stress. The pandemic adds to existing problems like financial worries, poor sleep and diet and lack of motivation to exercise.

Dr Mayoni Gooneratne, a former NHS surgeon and founder of The Clinic private health and skincare clinics in London, adds: I have seen more acute conditions like eczema and other types of dermatitis than before. Ageing has become accelerated too.

Dermatologist Dr Hiba Injibar, founder of the Dermasurge Clinic on Harley Street, says the number of people enquiring about adult acne at her practice has gone up by 30 per cent. She says that, despitecoming into contact with fewer pore-blocking pollutants because we're at home, more people have fallen victim to adult acne this year due to falling out of their skincare routines and because stress is a major cause of cystic acne. There is also the added issue of maskne [acne caused by mask-wearing] and acne on the brow caused by visors, she says.

Its well known that stress has a major effect on skin, with psychodermatology where psychological techniques are used to treat skin complaints increasingly popular.Studies have shown that emotional stress slows wound healing and can increase acne severity and some research suggests antidepressants have the side-effect of improved skin.

The brains stress response causes the release of various chemicals and hormones, including the stress hormonecortisol, that drive inflammation both in the body and the skin, Dr Ahmed explains.

Our skin becomes less able to defend itself, delaying the healing process and driving allergic responses.

Stress hormones can also alter the production and breakdown of collagen and elastin, causing premature ageing, lines, wrinkles, increased pigmentation and dull skin, and reduce production of hyaluronic acid which results in dehydrated skin.

The longer the pandemic lasts, the more likely that our skin will suffer, says Dr Ahmed. Long-term or chronic stress results in the body entering a permanent stress-response state, which can aggravate existing skin problems through a poor natural immune response, ongoing inflammation and loss of an effective skin barrier.

Stress can also encourage unhealthy lifestyle habits and poor sleep one in four of us are struggling to sleep well during the pandemic, according to researchers at Southampton University. Its a vicious circle: stress hormones correlate with lack of sleepand sleep deprivation activates their release. This is one of the reasons why poor sleep is associated with signs of premature aging, lack of hydration, larger pores, textural changes, and changes in blood flow to the skin. In addition, lack of sleep can disrupt the process of skin repair overnight, says Dr Ahmed.

For Nicola McCamley, 30, lockdown brought back the acne she thought she had beaten years ago. I stopped running and going to the gym, which was how I managed stress, and was glued to the news on TV. Everything felt so uncertain and frightening. I wasnt sure how the pandemic would affect my financial stability, and I was worried about my family.

Soon, she saw changes in her skin. It started with red and bumpy spots on the side of my face which then spread down my neck and even onto my chest. I was so upset.

She saw a dermatologist, at the Woodford Medical chain of cosmetic clinics, who ruled out allergies as she was not using any new productsand advised it was caused by stress.

How can you tell if your skin is stressed? In terms of acne, a telltale sign that emotions are the cause is when it shows up around the lower face and jaw, says Dr Gooneratne.

Dr Ahmed advises keeping a symptom diary to see if flare ups have correlated with a stressful time in your life.

Treatment requires a holistic approach, she adds. I treat the mind and skin together, as stress can trigger skin disorders which in turn cause stress, creating a vicious circle.

For eczema, Dr Ahmed recommends using gentle soap substitutes, emollients and treatment creams that may contain steroids.Acne treatment can include topical or oral antibiotics, topical retinoids, or oral isotretinoin and rosacea treatment that can include topical antibiotics, antiparasitic medications or azelaic acid, oral antibiotics or low dose oral isotretinoin.

These chronic conditions benefit from treatment that manages the signs and symptoms as well as addressing the psychological impact with interventions such as stress management techniques, relaxation therapies and mindfulness, she says.

For premature aging, useful skincare ingredients include retinoids, vitamin C and hydroxy acids, says Dr Mayoni. Plus, when clinics are open, an injectable skin hydrating and plumping cosmetic treatment will help to give your skin a real zing.

Dr Ahmed says simple lifestyle changes can help too, including drinking 2.5 litres of fluid a day to keep skin hydratedand reduce anxiety taking regular exercise, and getting plenty of sleep.

Try meditation or mindfulness to help combat stress, she adds. I often recommend the Headspace App to my patients.

Create positivity around you. Surround yourself with your favourite scents, music or colours at home to improve your mental health.

Find an achievable act that makes you happy, incorporate it into your morning routine, and another into the evening. This way you start off the day with mood enhancement and you have the same to look forward to in the evening.

Anna was prescribed a mild steroid cream, but says things really improved when she completed her house sale. I started doing yoga with an online teacher and used a meditation app which have both helped me feel less anxious. My skin is much better, she says.

Nicolas acne improved after treatment, too, but she also addressed her lifestyle. My skin problems made me realise I had to tackle my stress, so I started running again, I exercise at home and limit the amount of news I watch - and my skin looks great.

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From eczema to spots to wrinkles, why the pandemic is wreaking havoc on our skin - Telegraph.co.uk