Lockdown, stress, and women's dermatologic health
Covid-related conditions and associated stress factors are causing skin and hair problems – especially in young women. While maskne gets the bulk of the media attention, DermatologistOnCall doctors are also seeing an increase in flaring skin conditions among this demographic, notably cystic acne, psoriasis, urticaria (hives), shingles, hair loss, and nail damage.
Rates of acne among young women are rising.
While breakouts are typically associated with teens, the number of women in their 20s, 30s, and 40s seeing acne treatment on the DermatologistOnCall platform is climbing. These women generally have similar complaints - painful breakouts, which typically feature deep, cystic pimples found along the jawline, lower cheeks, and neck. This stubborn, cystic acne usually requires prescription medication to clear and can cause scarring if left untreated.
The underlying factor: pandemic-related stress.
When women become stressed, their bodies produce cortisol. Cortisol causes androgen levels to rise, causing the skin to produce excess sebum or oil. That oil creates many issues, including clogged pores and feeding the bacteria that live on the face. Clogged pores and bacterial growth lead to acne.
Stress also is a trigger for chronic ailments like psoriasis and acute conditions like urticaria - more commonly known as hives. Again, cortisol release is the culprit. Cortisol increases inflammation in the body. That inflammation causes chronic conditions to flare. Cortisol also triggers histamine release, leading to acute issues like hives.
The side effects of stress are also causing skin issues.
Not only does stress have this direct impact on the skin of women, but it also leads to disrupted sleep schedules and poor diet. Food and sleep are critical to healthy skin, hair, and nails. The pressure put on young women, especially mothers, is enormous. Many are still working from home, overseeing school-aged children's education, and balancing increasingly tight budgets.
Covid and Covid-related stress is literally making hair fall out.
Women, in particular, are experiencing noticeable hair loss – to the point of clogged shower drains and fistfuls of hair in the shower. This is primarily due to Telogen Effluvium, which occurs when stress prematurely forces hair follicles into the resting stage of the growth cycle (telogen). Typically, about 5% of hair follicles are in this phase at any given time. When this stress-related condition occurs, upwards of 50% of hair follicles enter the phase, causing them to prematurely shed.
Typically, this type of hair loss happens to women after childbirth – however – the pandemic creates a similar stress situation on their bodies. This is due to contracting Covid, which can be especially brutal on the body, or because of pandemic-condition stress. In most cases, hair growth will return to normal in 9 – 12 months.
While hair issues are most noticeable, the condition also creates symptoms seen in the nails. A beau line (a distinct groove that extends across the nail's surface) may form across fingernails when the individual's system first impacts their system. Since it takes about six months for a nail to grow out, patients can actually determine when the stress caused the telogen effluvium to occur.
Store-and-forward telemedicine is an effective, convenient tool for treating dermatologic issues.
Even with dermatology offices opening back up, many women cannot come into a brick-and-mortar office due to the lack of childcare options, busy schedules, and fears of catching and spreading covid to their families. With so much on their plates, it can be challenging to find time for an in-office visit.
Online dermatology visits make care accessible to these women while taking the guesswork out of formulating an effective routine. A visit takes only a few minutes and can be done at any time – especially after the kids are in bed.
DermatologistOnCall physicians are board-certified dermatologists. With just a few photos and a patient's medical history, they can diagnose and treat women dealing with any of these pandemic-related conditions. If prescriptions are needed, the orders can be sent to a nearby pharmacy or to a mail-order pharmacy and delivered to the doorstep.