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The Impact of Stress and Breathwork on Your Skin

Breathwork, Stress + Your Skin

They say that stress can age you, but is that actually true? As a naturopathic doctor, I've delved deep into understanding the intricate relationship between stress and skin health. Stress, a common aspect of modern life, triggers a physiological cascade that profoundly impacts our bodies, particularly our skin. Let's explore how stress manifests its effects on the skin's health, and how we can prevent damage to our skin.

The physiological effects of stress

The underestimated influence of stress extends far beyond our mental state to impact our entire body, including our skin. When stress strikes, our nervous system undergoes a dramatic shift into the sympathetic state, commonly known as the fight-or-flight mode. This prompts the release of adrenaline, a swift-acting neurotransmitter that mobilizes our body for action. While invaluable in moments of acute danger, this response can inadvertently divert blood flow away from less vital organs, such as the gut and skin. Simultaneously, cortisol, the slower-acting stress hormone, surges, further amplifying the body's stress response. Chronic stress perpetuates this cycle, sustaining elevated levels of cortisol and adrenaline.

What’s the problem with cortisol and adrenaline? 

Both of these molecules will have many negative impacts on the body long term, including the skin. Cortisol and adrenaline suppress our immune system, which is why we are more likely to get sick when we are stressed (1). They also increase inflammation in both the gut and the rest of the body (2). They can alter our microbiome to produce less skin-beneficial things like short-chain-fatty-acids which are important for skin integrity (3). 

If these systemic effects of cortisol and adrenaline weren’t enough, the skin also has its own individual reaction to these molecules. Skin cells have receptors to adrenaline and cortisol, and when stimulated, can even start making more of these molecules on their own (1). This can result in local immunosuppression, inflammation, and more susceptibility to damage in the skin. 

The perfect example to demonstrate this is a cold sore. When someone is infected with the cold sore virus (HSV-1) it will live in the trigeminal nerve cells in the face, usually symptom free (4). But when the person is stressed or sick and the immune system weakens, the virus can take over and create symptoms of a cold sore (4). 

Other examples of the severe impact that high stress can have on our skin is in the development of skin cancer. Animal models demonstrate that stress significantly speeds up the process of developing skin cancer in mice (5). Human models show that high emotional stress results in worse immune outcomes of tumor biopsies in people with skin cancer, compared to those with less emotional stress (6). Although stress is not the cause of skin cancer, it can put the body in a position where it is not as strong to fight, and the cancer cells are more likely to thrive.

 Some of the skin changes that can occur from chronic stress include:

■      Impaired wound healing

■      Impaired collagen synthesis

■      Hyperpigmentation from increasing melanocytes 

■      Dysbiosis of the skin microbiome

■      Loss of hydration

■      Increased mast cell release of histamine leading to hives and rashes

■      Lowered lipid and ceramide production decreasing our protective barrier

■      Increased sebum production leading to acne

■      Increased susceptibility to infection or viral re-activation (herpes-simplex, HPV, etc.)

■      Increased DNA damage and DNA repair- can lead to skin cancer

How can we lower cortisol and adrenaline in our daily lives?

The good news is, we can control the levels of cortisol and adrenaline through many techniques. 

One of the best ways is through breathwork as it is accessible and easy to incorporate into your daily routine: 

One study looked at the levels of cortisol, oxidative stress, and antioxidant levels in a group of cyclists going through a rigorous race (7). Intense exercise is a known cause of oxidative stress and can increase cortisol, so the researchers examined how breathwork exercises would help lower stress hormones and oxidative stress in these athletes. Both groups of cyclists had to take a 1-hour break to sit in a quiet room halfway through the race. One group practiced breathwork during this hour, whereas the other group just sat quietly. The breathwork group had significantly lower cortisol and oxidative stress levels compared to the non-breathwork group, demonstrating the profound effect of this therapy with just one session (7). 

Vagus nerve stimulation is the main mechanism to how breathwork activates the parasympathetic nervous system (rest and digest mode), which can help lower cortisol and adrenaline (8). The vagus nerve is a giant nerve that runs from our brain to our gut, and plays a large role in improving our gut health as well. By activating this nerve as much as possible, we are able to tap into the rest-and-digest mode, and lower those chronic stress chemicals leading to overall better health and better skin!

Other ways to activate the vagus nerve include:

■      Singing/ humming

■      Gargling water

■      Cold exposure

■      “OM” chanting

Try any of these techniques daily to help calm your mind, body and improve skin health. The more you practice, the more you will develop a “muscle-memory” to relaxation techniques for a better mind, body, and skin.  

This article was written by Dr. Elizabeth Miller, a Naturopathic Doctor with a special focus in digestion, skin health and hormone health.  



  1. Pondeljak N; Lugović-Mihić. “Stress-Induced Interaction of Skin Immune Cells, Hormones, and Neurotransmitters.” Clinical Therapeutics, U.S. National Library of Medicine, 2022, 
  2. Bonaz B; Sinniger V; Pellissier. “Vagal Tone: Effects on Sensitivity, Motility, and Inflammation.” Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, U.S. National Library of Medicine, 2016, 
  3. Trompette, Aurélien, et al. “Gut-Derived Short-Chain Fatty Acids Modulate Skin Barrier Integrity by Promoting Keratinocyte Metabolism and Differentiation.” Mucosal Immunology, U.S. National Library of Medicine, May 2022, 
  4. Yan, Chang, et al. “Disturbed Yin-Yang Balance: Stress Increases the Susceptibility to Primary and Recurrent Infections of Herpes Simplex Virus Type 1.” Acta Pharmaceutica Sinica. B, U.S. National Library of Medicine, Mar. 2020,
  5. Parker J; Klein SL; McClintock MK; Morison WL; Ye X; Conti CJ; Peterson N; Nousari CH; Tausk FA; “Chronic Stress Accelerates Ultraviolet-Induced Cutaneous Carcinogenesis.” Journal of the American Academy of Dermatology, U.S. National Library of Medicine, 2004,
  6. Christopher P. Fagundes, PhD. “Basal Cell Carcinoma: Stressful Life Events and the Tumor Environment.” Archives of General Psychiatry, JAMA Network, 1 June 2012, 
  7. Martarelli, Daniele, et al. “Diaphragmatic Breathing Reduces Exercise-Induced Oxidative Stress.” Evidence-Based Complementary and Alternative Medicine : ECAM, U.S. National Library of Medicine, 2011, 
  8. Househam AM; Peterson CT; Mills PJ; Chopra. “The Effects of Stress and Meditation on the Immune System, Human Microbiota, and Epigenetics.” Advances in Mind-Body Medicine, U.S. National Library of Medicine, 2017, 
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