Introduction
Skin problems can be some of the most frustrating conditions to deal with. They are not only painful but can also negatively affect your mental health. Recent studies have shown how skin conditions and sleep are interlinked.
What are the most common skin conditions?
Dermatological conditions are some of the most common problems that people report to their healthcare provider. Fungal infections were found to be the most common problem, which can manifest as itchiness or a bad smell.1
Acne is another. It can come in many forms, and the symptoms and treatment change based on the individual. Some symptoms include large areas of diffuse redness and nodular proliferation.
Atopic dermatitis and eczema are also very common. Atopic dermatitis is the most common manifestation of eczema and usually develops in children, but even adults can be affected. It results in dry, itchy, and cracked skin.
Other skin conditions include alopecia (hair loss), rosacea (reddening of the skin), psoriasis, and sexually transmitted infections. It is also important to note that some tumours manifest on the skin, making it extremely important to notify your healthcare provider whenever something distressing presents itself on your skin.
Poor sleep worsens the skin’s health
Increased stress hormone levels
Stress hormones worsen skin conditions. When referring to stress hormones, we mean specifically cortisol, a glucocorticoid released from the pituitary.2 Disruptions such as stress can lead to an overproduction of cortisol. The skin is the largest sensory organ and has many receptors, making it highly receptive to cortisol. This increase leads to inflammation in the skin cells, which can trigger conditions such as acne, eczema, and psoriasis.
Sleep is inherently linked to stress. Since we are diurnal animals, the stress hormones should peak in the early morning and drop to their lowest at around midnight. Sleep has an inhibitory effect on cortisol release, so the deeper and longer you sleep, the less cortisol is produced.3
Therefore, disruptions in your sleep due to long working hours, mental health conditions, and economic problems will directly affect the release of cortisol and, therefore, inflammation of the skin. Seeing as the body likes routines, it will get used to shorter sleeping hours with time. Infrequent sleeping patterns are more problematic than sleeping little hours.
Excess inflammation
In most skin conditions, inflammation is necessary to jumpstart the pathogenesis of skin disease. A common example is acne vulgaris. Recent studies have shown how inflammatory mediators are released in the skin to create the perfect conditions for the development of papules and pustules, which we associate with acne.4 This is because it leads to the formation of micro comedones, which act like seeds from which the acne stems. Therefore, it can be used to generalise that inflammation is necessary for conditions like acne to thrive.
Increased allergen sensitivity
Allergens are particles that the body is sensitive to and reacts by stimulating an inflammatory response. The sensitivity to allergens mediates how large and how quick the response is. So, you might get a small red patch where an allergen came into contact with your skin or have a much more exaggerated full-body response.
Even though research in this field is scarce, some studies have looked at the development of allergic disease in humans and its link to lack of sleep. A study showed a 27% increased likelihood of people with insufficient sleep developing allergic disease, which can in turn lead to skin conditions like eczema.5
Increased risk of flare-ups
It is found that sleep can worsen skin conditions, but skin conditions can also worsen sleep. Therefore, the two are intrinsically bound. A study found that skin disease symptoms, such as itchiness and discomfort, worsened during the night in patients with less sleep, which in turn can prevent patients from sleeping.6 This itch-scratch cycle only worsens the outlook on your skin condition, leading to more inflammation which can trigger flare-ups.
Summary
Skin and sleep are bound together at a chemical level. A lack of sleep can lead to the development of skin problems due to the release of cortisol and the aggravation of inflammation. Therefore, it might be beneficial to try to get a good sleeping routine if you are struggling with inflammatory skin disease.
References
- Richard MA, Paul C, Nijsten T, Gisondi P, Salavastru C, Taieb C, et al. Prevalence of most common skin diseases in Europe: a population-based study. J Eur Acad Dermatol Venereol. 2022 Jul;36(7):1088–96.
- Hirotsu C, Tufik S, Andersen ML. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci [Internet]. 2015 Nov [cited 2022 Oct 31];8(3):143–52.
- Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets [Internet]. 2014 Jun [cited 2022 Oct 31];13(3):177–90.
- Tanghetti EA. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol [Internet]. 2013 Sep [cited 2022 Oct 31];6(9):27–35.
- Xi Y, Deng YQ, Chen SM, Kong YG, Xu Y, Li F, et al. Allergy-related outcomes and sleep-related disorders in adults: a cross-sectional study based on NHANES 2005–2006. Allergy Asthma Clin Immunol [Internet]. 2022 Mar 22 [cited 2022 Oct 31];18:27.
- Gupta MA, Gupta AK. Sleep-wake disorders and dermatology. Clin Dermatol. 2013 Feb;31(1):118–26.
