More than 85 million people in the U.S. are affected by skin diseases. Couple this with the fact that acne affects about 50 million Americans annually, and it is clear that skin conditions are widespread in not just the U.S., but also worldwide.
And many skin conditions — ranging from psoriasis to eczema to acne to dermatitis to rosacea and more — are often triggered by inflammation.
“While inflammation is a natural and vital part of keeping our skin healthy, there are times the immune system becomes overreactive and attacks normal skin, or continues to fight pathogens and allergens even when they have disappeared,” says Jenny Sobera, M.D., dermatologist and chief medical officer at FaceMDPlus.
What is Inflammation?
“The hallmarks of inflammation include redness, swelling, tenderness and warmth,” says Hadley King, M.D., board-certified dermatologist in New York. “Exactly what this looks like will vary depending on the person and the cause of the inflammation.”
The common symptoms associated with inflammation are typically expressed in pesky rashes, pain and dryness that may range from mild to severe and can last anywhere from a few weeks to an indefinite amount of time.
In the case of acne, this can look like inflamed pimples that are red and tender. Rosacea flares will often present with redness and are sometimes accompanied by bumps swelling and a burning or warm sensation. With eczema or seborrhea, the inflammation will often appear more chronic, with dryness and flaking. And with contact dermatitis, the acute inflammation may present in fluid-filled bumps, itching and stinging.
A lot of the time, the skin is a reflection of what’s going on inside.
What Causes It?
In general, not all skin inflammation is caused by internal inflammation in the body — it depends on someone’s predisposition to inflammation — but depending on the condition, the state of the skin can be an indication of things going in systematically. “Most of the time, psoriasis and rosacea — and sometimes acne — are genetic, including some types of dermatitis,” says Anna Guanche, M.D., celebrity dermatologist at Bella Skin Institute in Calabasas, California. “A lot of the time, the skin is a reflection of what’s going on inside,” she adds. “There are certain inflammatory rashes where we discover that the patient has lupus, or another autoimmune inflammation, based on patterns we see on the skin. However, there are conditions like rosacea or acne, where there can be inflammation on the skin, but we don’t really detect inflammation inside the body.”
But acute skin inflammation — which can be resolved in one to two weeks — is typically skin’s reaction to environmental factors, such as your skin coming into contact with poison ivy or poison oak.
Choosing the Right Skincare
When it comes to skincare, choosing a routine that prevents and/or reduces skin inflammation is very important for people prone to overreactive skin. “Look for products that are cream-based and avoid products with active ingredients for acne or anti-aging,” says King. “It is best to use gentle products and minimize the amount of rubbing or friction. I recommend a gentle soap and lukewarm water, gently splash the face to rinse and then pat dry and apply a soothing moisturizer with ceramides.” If your skin is inflamed, it is best to avoid active ingredients like salicylic acid, benzoyl peroxide, retinol or other retinoids. “Use products with the least number of ingredients, and don’t add new products all at the same time,” says Debra Jaliman, a board-certified dermatologist in New York City. “You won’t know which one is aggravating your skin, so space them out if you’re starting a new regimen.”
But overall, a few ingredients that soothe inflamed skin are: ceramides, which improve skin barrier and promote less dryness and inflammation; hyaluronic acid, which improves skin’s hydration, therefore reducing inflammation; and green tea, chamomile, vitamin E and niacinamide, which all are anti-inflammatory.
Eating the Right Foods
“Diets certainly affect inflammation, whether it’d be skin inflammation or other inflammatory conditions, such as arthritis or heart disease,” says Sobera.
Dendy Engelman, M.D., a board-certified dermatologist at Medical Dermatology and Cosmetic Surgery in New York, says it is best to follow a Mediterranean diet and avoid preservatives. Among the list of inflammatory culprits are fried and fatty foods, sugar, alcohol, white bread and processed foods, and diets with an excess of omega-6 fatty acids, which is found in corn, sunflower, soy and many salad dressings.
“There is a lot of buzz these days about anti-inflammatory diets,” says King. “I think a healthy diet that consists of vegetables, fruits, healthy grains, lean proteins and healthy fats is anti-inflammatory because of the vitamins, antioxidants and healthy fats found in these foods.”
That being said, it is a common misconception that certain foods cause skin inflammation in everybody. “Different foods trigger inflammation in different ways for different people,” says Sobera. For example, studies show that skim milk worsens acne in teenagers, and gluten is another example of a type of food that causes problems for some and not others.
Do Stress and Sleep Play a Role?
When we are stressed, our body goes into emergency mode and this has an effect of aggravating most skin conditions — but the mechanism behind it is not yet clear to dermatologists besides the fact that stress is known to elevate cortisol levels, and cortisol levels affect the immune system, which is responsible for creating inflammation.
“Although we do not yet have a thorough understanding of the mechanisms, we do know that stress can impact most inflammatory skin conditions, including acne, rosacea, psoriasis, eczema and more, by causing flares in all of these conditions,” says King. “And lack of sleep plays a role because it’s a cause of stress to the body.”