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Gray hair and wrinkles

When we see that first gray hair pop up or notice an unwanted wrinkle for the first time, the blame is often directed towards one thing: stress. But does stress really cause wrinkles to form and hair to prematurely turn gray? Dr. F. Clarissa Yang, Chief of Dermatology at Tufts Medical Center, has the answers.

As a dermatologist, can you tell if someone is stressed by looking at their skin? 

Dr. Yang: There are many different causes of stress – psychologic distress, illness, lack of sleep, environmental factors (food, smoking, sun, etc.).  All in all, these stressors can take a toll on the body and manifest dermatologically from increased frown lines to loss of hair to worsening of inflammatory skin conditions.

Are you seeing more people with stress-related skin/hair problems these days?

Dr. Yang:  I am not sure I can definitively tell you that stress related skin/hair problems are increasing, but there are studies that show the average stress level by generation is increasing, and we do see many conditions in clinic that are stress-related.   


Many of us have had break-outs at stressful times. What causes these? And what type of person is most likely to get these breakouts? 

Dr. Yang: Stress and lack of sleep raises the body’s overall cortisol levels, which increases the risk of acne, as well other issues, such as more rapid aging and weight gain. While these symptoms affect all demographics, women have a higher tendency to have hormonally induced acne past the age of puberty and have higher rates of affective disorder.

Can stress cause wrinkles? How and why does this happen? 

Dr. Yang: Mental stress or anxiety can result in physical manifestations, such as deeper wrinkles or frown lines.  Stress increases cortisol levels, which speeds up the aging process. Stress has also been shown to decrease our telomere lengths. Telomeres are protective caps at the end of our DNA chromosomes.  As we age, telomere length gets shorter. Additionally, environmental stresses, such as UV light, cause oxidative stress. There can be a loss of collagen, elastic fibers and hyaluronic acid in the skin, resulting in a loss of tightening and increased wrinkling.  

Do those wrinkles that are the result of stress, go away if the stress goes away? Or are they permanent?  

Dr. Yang: With short-term stress, there is always some reversibility. But the longer the person is under stress, the more permanent the wrinkles become.

Is stress later in life more likely to cause wrinkles because the skin is older?

Dr. Yang: It may look like we have more wrinkles later in life, but most of the time, the stresses are cumulative and only become more prevalent later in life. So stress in your younger years eventually catches up with you! However, there is better reversibility and regeneration when we are younger, so people are less likely to notice differences.  

What can people do to counter the effects of stress on the skin?

Dr. Yang: Get a good night’s sleep, manage stress, eat well with high nutrient and anti-oxidant rich foods, and avoid environmental stressors, such as smoking and UV exposure. There also are topical creams that can help slow down or reverse some of the early signs of wrinkles. Sunscreens, retinoid based products, alpha hydroxy acid products, peptides, antioxidants and many other cosmeceuticals can help slow down the aging process. Additionally, there are cosmetic procedures that help rejuvenate the skin and aid in regeneration. 


Does stress accelerate the graying of hair?

Dr. Yang: While likely the biggest factor in graying of the hair is determined by genetics, stress does cause accelerated aging. Gray hair is a symptom of this. 

Is there anything that can be done to counter the graying effect?

Dr. Yang: There really isn’t much that is known to counter the effect of natural graying hair, but taking measures to manage stress and nutrition are important. There is some evidence to suggest that certain trace minerals (iron, zinc, copper, calcium) or vitamin deficiencies (B vitamins) can result in premature graying. 

Do you counsel your patients about de-stressing? What do you advise them to do? 

Dr. Yang: I do mention the importance of reducing stress when it is affecting patients’ skin conditions. Additionally, I may suggest things such as meditating, doing yoga, eating a healthier diet, getting more sleep, and seeking a social support group to help de-stress. If the patient needs to see a mental health professional to help with their stress, I will appropriately refer them.