Association between stress levels & skin problems in college students

College is a stressful time in the lives of students, and a new study by researchers at the Lewis Katz School of Medicine at Temple University (LKSOM) and Temple University found that heightened levels of psychological stress are associated with skin complaints.

The study, published by the international, peer-reviewed journal Acta Dermato-Venereologica aimed to assess the relationship between perceived psychological stress and the prevalence of various skin symptoms in a large, randomly selected sample of undergraduate students. “Previous studies have demonstrated an association between stress and skin symptoms, but those studies relied on small patient samples, did not use standardized tools, are anecdotal in nature, or focused their analyses on a single skin disease,” says Gil Yosopovitch, MD, Chair of the Department of Dermatology at LKSOM, Director of the Temple Itch Center, and corresponding author of the study.

The questionnaire-based, cross-sectional study was conducted at Temple University during the 2014 fall semester. Five thousand undergraduate students were invited to participate in a web-based survey in which they reported their perceived psychological stress and any skin complaints. Four hundred twenty-two students were included in the final sample size.

Respondents were divided into groupings labeled as low stress, moderate stress and high stress. Compared to low stress subjects, the high stress group suffered significantly more often from pruritus (itchy skin); alopecia (hair loss); oily, waxy or flaky patches on the scalp; hyperhidrosis (troublesome sweating); scaly skin; onychophagia (nail biting); itchy rash on hands; and trichotillomania (hair pulling). There was no association between perceived psychological stress levels and the presence of pimples, dry/sore rash, warts and other rashes on the face.

Despite study limitations (e.g., low response rate, absence of physical assessment of respondents), Dr. Yosipovitch says the results are important for dermatologists who treat undergraduate-aged patients. “Our findings highlight the need for health care/dermatology providers to ask these patients about their perceived levels of psychological stress. Disease flare or exacerbation while on treatment in the setting of increased stress may not necessarily reflect treatment failure.” Dr. Yosipovitch adds, “These findings further suggest that non-pharmacologic therapeutic interventions should be considered for patients presenting with both skin conditions and heightened levels of psychological stress.”


Association between stress levels & skin problems in college students Other researchers contributing to the work include Dr. Christina Schut from the Department of Dermatology and Temple Itch Center at LKSOM, and the Institute of Medical Psychology at the Justus-Liebig-University in Giessen, Germany (during the time of data collection, Dr. Schut was supported by a grant from the German Research Foundation - Deutsche Forschungsgemeinschaft (DFG); SCHU-2932/1-1); Dr. Nicholas K. Mollanazar, Mansha Sethi, Dr. Leigh Ann Nattkemper, and Dr. Rodrigo Valdes-Rodriguez from the Department of Dermatology and Temple Itch Center at LKSOM; and MacKenzie Mocini Lovell and Dr. Gina L. Calzaferri from the Office of Institutional Research & Assessment at Temple University.

About Temple Health

Temple University Health System (TUHS) is a $1.6 billion academic health system dedicated to providing access to quality patient care and supporting excellence in medical education and research. The Health System consists of Temple University Hospital (TUH), ranked among the “Best Hospitals” in the region by U.S. News & World Report; TUH-Episcopal Campus; TUH-Northeastern Campus; Fox Chase Cancer Center, an NCI-designated comprehensive cancer center; Jeanes Hospital, a community-based hospital offering medical, surgical and emergency services; Temple Transport Team, a ground and air-ambulance company; and Temple Physicians, Inc., a network of community-based specialty and primary-care physician practices. TUHS is affiliated with the Lewis Katz School of Medicine at Temple University.

The Lewis Katz School of Medicine (LKSOM), established in 1901, is one of the nation’s leading medical schools. Each year, the School of Medicine educates approximately 840 medical students and 140 graduate students. Based on its level of funding from the National Institutes of Health, the Katz School of Medicine is the second-highest ranked medical school in Philadelphia and the third-highest in the Commonwealth of Pennsylvania. According to U.S. News & World Report, LKSOM is among the top 10 most applied-to medical schools in the nation.

Temple Health refers to the health, education and research activities carried out by the affiliates of Temple University Health System (TUHS) and by the Katz School of Medicine. TUHS neither provides nor controls the provision of health care. All health care is provided by its member organizations or independent health care providers affiliated with TUHS member organizations. Each TUHS member organization is owned and operated pursuant to its governing documents.


Jeremy Walter
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Temple University Health System

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