Skin Stresses: Specialist Matt Traube Explains Anxiety’s Impacts on the Skin
Matt Traube, MFT is a licensed child and adult psychotherapist who specializes in psychological aspects of skin conditions, anxiety and phobias, teenage and young adult issues, and the psychological impact of undiagnosed conditions. He is the author of the psychologytoday.com blog “Healthy Mind, Healthy Skin,” and his work has been featured in multiple magazines and psychological websites. Read his original article, “Anxiety and the Skin,” here and check out his website to learn more!
To begin, how did you decide to pursue the study and treatment of the psychological aspects of skin conditions as a career? What motivates you?
“My interest in treating people who experience psychological aspects of skin conditions stems from
my father, Dr. Ted Grossbart. He was a pioneer in the field of psycho-dermatology and incredibly gifted therapist. I am always amazed at how many people around the world have benefitted from reading his book, Skin Deep. Many of the conditions I work with are challenging to treat. Anytime I can help someone make an improvement, it is very rewarding as a therapist.”
Read Skin Deep here. It’s free!
You state in your article, “Anxiety and Your Skin,” that “when we no longer feel safe or in control, the skin can respond.” Can you explain the connection between anxiety, adrenaline, and skin problems?
“Feeling unsafe, stressed or anxious can trigger the central nervous system. Numerous skin conditions are influenced by the activation of the central nervous system. This is thought to be, at least in some conditions, a result of an inflammatory stress response that can occur.”
In your practice, have you found that the treatment of anxiety is correlated with an increase in overall health of the skin?
“I am not sure if learning how to manage anxiety is correlated with an increase of overall health of the skin, but I do believe certain skin conditions are exacerbated by increased anxiety and stress. It is not uncommon for me to hear that someone’s acne, eczema, rosacea, psoriasis, or skin picking increased during a particularly anxious time.”
It has been found that the existence skin problems trigger more anxiety in some individuals, thus creating a snowball effect of ever-increasing anxiety and worsening skin. What would you suggest as the best way for people to extract themselves from this negative cycle, decrease anxiety, and enjoy better skin?
“I think it is helpful to determine if personality characteristics exacerbate the skin issue or if the skin issues are exacerbating the personality traits. People suffering from skin conditions often feel like others trivialize the problem. This results in hiding the significant amount of emotional pain they experience. In many cases, the first step is increasing awareness. Over time, we all fall into patterns and can gradually lose sight of how our feelings morphed into facts. For instance, if we become convinced we are unlovable because of our skin condition, anxiety and depression are common results. When we increase our awareness and learn that in fact, many people with a variety of skin conditions are deeply loved by others, we can begin to change our relationship with our skin condition and decrease our anxious feelings.”
You specialize in the psychological aspects of skin conditions, such as skin picking and hair pulling, and you are affiliated with the Trichotillomania Learning Center. What advice can you give our readers who suffer from anxiety as well as Body-Focused Repetitive Behaviors such as these?
“Many body-focused repetitive behaviors such as skin or hair pulling can be increased by anxiety. When we feel anxious, we try to find salvation in what feels normal. If you grew up eating when you felt anxious, as an adult, you may find yourself reaching for food to cope with your anxiety. If skin picking or hair pulling has been a common behavior for many years, increasing the behavior during anxious moments can help regulate the uncomfortable feelings. I see these coping mechanisms as both behavioral and emotional. We want to address the actual behavior as well as the underlying feelings that can be exacerbating the behavior.”
In your opinion, what is the best form of therapy to treat both anxiety and skin issues? Are there any up-and-coming or under-used treatment methods that you’ve found work well?
“Treating anxiety and skin issues require different approaches. With anxiety, the biggest 
improvements come from learning how to safely address the specific anxiety that someone is experiencing. A big piece of the work is actually learning how to face the anxiety provoking situation and re-training the brain to respond appropriately. Skin issues can respond to several psychological approaches such as cognitive behavioral therapy, hypnosis, and guided imagery.”
In your practice, you treat and work closely with a lot of Millennials. Why is it important that this generation educate themselves on the link between anxiety and the skin?
“Millennials face a subset of issues previous generations did not have to face. With the arrival of social media, skin seems to be more influential than ever. The unrealistic pressure to have flawless skin can cause challenging mental health issues. Learning how to manage anxiety and perfectionism will hugely help heal many psychological aspects of conditions.”
Thank you Matt Traube for giving this interview! Definitely check out his blog and website for more!
I’ve found that I can really relate to this article. I’ve noticed definite trends and correlations between the healthiness of my face when I’m in the middle of a stressful time period of my life versus a calm one. Not only does my emotion and hormones play a role in how my face reacts to stress, but additionally, my diet changes and affects my acne as well. I’ve found that being aware of this has made a positive and negative impact on my life. I would pay attention to my diet more and blame it less on other things. However, I would also pay more attention to my face and how other people saw me.
I really liked how the questions in this interview were set up to address social issues and impacts on a teen.
I think that there is a correlation between anxiety and skin problems, and it is true that this day millennials are more interested and have more of these problems because of social media and having to portray “perfection” in everything including skin. Do you think that stress and anxiety is the only factor in having these skin conditions or could there be other underlying issues going on? Does Matt Traube have any research done on relieving or curing people’s skin conditions through his psychotherapy sessions?
I was also wondering about biological predispositions for bad skin. There is of course biological factors towards skin types, so I wounder how his research controlled for these instances. I’m wondering if he took people who generally have good to great skin on average and observed them in a longitudinal type study to see if they even produced skin problems when stressed and compared it to people who generally have poor to fair skin.
In this interview with Matt Traube, the correlation between anxiety and skin become very clear. He provides detailed responses and gives accurate examples. As someone who suffers from severe skin-picking, this article opens my eyes regarding my condition and gives me insight into why I may pick. He states that “Many body-focused repetitive behaviors such as skin or hair pulling can be increased by anxiety. When we feel anxious, we try to find salvation in what feels normal.” This could not be more true as I have found myself ready to pick in front of the mirror time and time again after a particularly stressful event.
While Matt Traube provides many accurate responses, I still have a few questions. He says that “I think it is helpful to determine if personality characteristics exacerbate the skin issue or if the skin issues are exacerbating the personality traits.” From this statement, is he questioning anxiety and depression or someone’s basic personality traits? Would a person’s personality naturally lead them to skin-picking and other variations?
Ultimately, this article was an interesting and thorough read.
Sierra
I was thinking the same thing since I’m a skin picker myself. I’ve found relief watching youtube videos on pimple popping! (lol) When he mentioned and explained the reason of normalcy completely clicked. Our brain wants to be at ease with whats normal, because our brains are lazy, in my class we learned the term Cognitive Miser. Our brains like to take short cuts and minimize work. So instead of trying to deal with whatever is making us anxious, (because that’s hard work) we focus on our skin, or he even mentioned over eating, because it’s become the norm for some people. When it’s the norm, it means we repeated it enough times it comes easy to us, we don’t have to think about doing the act, it’s automatic.
“…skin seems to be more influential than ever. The unrealistic pressure to have flawless skin can cause challenging mental health issues,” this is what I was thinking when I first starting reading this article. I immediately went into thinking about the social pressures of flawless skin and beauty standards. When he mentioned Trichotillomania and skin picking it was like a click from the multipath model in my head.
It’s a social, cultural, biological and psychological issue dealing with our bodies, specifically our skin, and the anxieties we face, new and different anxieties than in the past.
I appreciate this article for reminding me to examine aspects from the different modal paths instead of focusing on the one.
I am curious though if he has looked into how an increase in anxiety, so adrenaline correct, triggers a skin response. Examining through and evolutionary, biological lens had to be of some purpose? Or it’s just a random mutation?
Right on the second question there is something incredibly important when dealing
with this kind of issues, and that is the correlation between the phsychological and
the physical, two parts of the same body that have been continuosly separated from centuries (the Descartes’ diferentiation of the horse and the horseman).
The vocabulary in use whithin the medical comunity does help in creating that separation:
it is either in the body, or solely in the mind. There are two nice articles on this
matter, the one from L. Eisenberg (1977) “Disease and Illness. Distinctions between
professional and popular ideas of sickness” and again in “The Mindfull Body:
a prolegomenon to future work in Medical Anthropology”, by N. Scheper-Hughes (1987).
Both of the articles explore the ways we tend to look at malfunctions in the human
body by separating them either existing in one or another plain, but almost like
never in the same.
Recent advances in medicine of today show us that that’s not the case
anymore, and the perspective regarding the human mind and how it can have serious
repercussions in our physical body, is taken into a great account. We now understand that
one can influence the other and vice-versa, and, on this case, how anxiety and stress
can increase a certain skin condition, and that by having some sort of skin
condition can also lead to more anxiety.
“People suffering from skin conditions often feel like others trivialize the problem”.
This is another fulcral point on the matter, that is of the social/society’s standards
of what one should look. I can give my mother’s example: she has vitiligo, but it’s
nothing compared to what some people have. Her hands are almost completely white
and her legs are full of little white spots. A few months ago, a spot appeared
right under her lip and she panicked because she thought she was going to be uglier.
Even without knowing the correlation between stress and skin, I could understand
why that spot appeared. She spent a significative amount of money in lotions and creams
and other natural treatments only to see it get worse. And the she got even more
frustrated. Needless to say it didn’t help. When she bought another lotion I started
telling her that yes, it was working and the spot was smaller. It wasn’t, I just wanted
to see her getting more relaxed. In a few months the spot disappeared and not another
one appeared on her hands. I don’t think it had anything to do with the lotion.
But I could see how frustrated she was on her looks. Vitiligo itself has some
serious conplications on our mental state exactly because of the impact those spots
have on daily lives.
“In many cases, the first step is increasing awareness.”, which is a significant
solution, although a difficult one, in my point of view. This is where social media
stands out: it doesn’t just expose ourselves to the world, leaving us more insecure
about the way we look, but it can also help us see that we are not the only ones
going through a specific condition/problem. Nowadays, we see more and more people
talking about their problems and insecurities in a way to show others that they’re not
alone. It is increasing awareness step by step.
I could feel really excited while reading this interview because it focuses on one of my favourite subjects, the correlation between mind and body. I would advise you all to read the article “Social Skin”, by T. Turner (1980).
I can really relate to this article it can be just as simple as when I get to stressed out or anxious I can end up getting more pimples or a bigger breakout of eczema. One other thing I do know is that when people are stressed your immune system weakens and I know that can cause breakouts and other things to happen to the body. This article is good but the only thing that would make this even better are sources to be seen and available, also this could’ve went deeper into how being anxious can effect the entire body in multiple ways physically.
To be honest this article speak to me on personal level. I do feel like there’s a significant different during when I really-really stress and when I was calmer. As someone that has a very sensitive skin, not only that i need to be cautious with what I’m eating, my mood is also heavily impact my skin condition.
It is also true that the effect of having some skin conditions can be snowballing into a greater issue that people may expect. I also notice on the last question on how the skin condition affects the millennials more severely compare to the older generation. It was a very tough moment for me personally to upload the good profile due to my acne. I knew that some people goes to some extent to have a clear skin by going thru certain ‘alternative’ medication that does not guarantee the safety just for the sake of having flawless skin.
Overall, the article really tackles the current impact on today’s teen society. I do enjoy reading this article.
Now I actually understand why I used to react the way I did back in high school. I am a person who suffers from eczema all over the body and when I got home from school I used to tear my skin apart, scratching it really bad to the point where it used to bleed. My family and doctors were confused as to why my skin wasn’t getting getting better only getting worse and spreading through the body.
But at the age of 23 Now, I’ve realised that when I’m stressed I scratch or when I’m really anxious or nervous. And reading this article only further solidified my theory.
Thank you for your research regarding this information.