Stress delays the skin’s healing process by impairing the barrier function, or protective outer layer, says Josie Howard, MD, a San Francisco psychiatrist who specializes in psycho-dermatology. In fact, in a small study analyzing the skin of medical students during exams and then after vacation, researchers found that “wound healing was significantly delayed” during finals, says Howard.

A recent study found that high levels of anxiety could deplete your skin’s natural moisture reserves. “It can suppress hyaluronic acid production, which causes dryness and dullness,” says Jamal, not to mention that stress and anxiety can also exacerbate conditions like eczema. If you already have sensitive skin, “this increased water loss over time can also make your skin more prone to having a red, chapped appearance,” says Washington, D.C. dermatologist Noëlle S. Sherber, MD. Applying super-emollient creams with hyaluronic acid and ceramides can help offset the effects.

Beyond affecting the skin’s surface, stress can also make an impact on a cellular level. It all has to do with telomeres, the protective “caps” found at each end of a chromosome that preserve DNA, says Howard. Over time, these telomeres naturally shorten, which can cause cellular damage and bring on the signs of aging (like wrinkles). Anxiety can speed up this process. “We see a strong correlation between shorter telomeres and psychological stress,” Howard says.

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