Dr. Natalia Jimenez
Specialist in Clinical and Aesthetic Dermatology, and Laser Treatments
Dr. Natalia Jimenez is an Assistant Dermatologist at the Ramón y Cajal University Hospital and a clinical and aesthetic dermatology consultant at Grupo Pedro Jaén in Madrid.
Today, Dr Jimenez talks to us about the impact of stress on skin.
Behind the Woman
Tell us about your career and the people who inspired you…
During my fellowship in Norwich, UK, it became clear that Dermatology was my future.
I loved the way it combines surgery, clinical observation and aesthetic concerns. Early on in my career, I became fascinated by the important role that the skincare routine plays in skin health and this remains the central point in my discussions with patients today.
Three physicians have significantly shaped my professional journey.
Dr. Pedro Jaén (Head of the Ramón y Cajal University Hospital Department of Dermatology) is famous in Spain for his avant-garde approach to Esthetic Dermatology. He trained me and transmitted his passion for this particular field, which wasn’t that developed at the time.
Dr. Pablo Boixeda (Pedro Jaén group) is a leader in Laser Dermatology and author of numerous studies about its application in different dermatological conditions (like acne and lupus) who taught me about laser therapy.
Finally, Dr. Sergio Vañó Galván, a young Dermatologist specializing in Trichology, highlighted the role doctors can and should play in social media.
Focus: Stress & Skin
What are the main stress factors for the skin?
Genetics are a key factor, but today we also know that the “exposome” (a combination of factors that affect the skin) is equally, if not more important to skin health.
The skin is one of the body’s largest and most complex barrier organs and is the first line of defense against environmental external stressors (extreme heat, cold, humidity, UV rays, pollution). But it is also affected by internal stressors: an unhealthy diet, hormonal imbalances, lack of sleep and psycho-social stress. Together, these constitute a network of factors that make up the skin’s exposome and that can lead to stressed skin.
Have you noticed some changes in the definition and the impact of stress on the skin?
Today, stress is omnipresent in our lives and has certainly been exacerbated by the global pandemic. Over recent years, experts are placing more importance on the effect of stress on health and more specifically on skin health. We say that when our mental health is not at its best — it shows up on the skin.
How does stress manifest itself on skin?
We know that stress influences skin aging but the exact mechanism that leads to stress-induced skin aging is, for now, unknown. Skin aging is a complex process, and while partly determined by “natural factors” like genes and hormones, it is certain that environmental factors promote aging by causing oxidative stress in the skin. In the short term, stress-induced oxidation leads to dehydrated skin that loses its glow. If the “stress” becomes chronic, the skin will develop wrinkles and spots.
What is the impact of psychological stress on skin?
The skin and the brain are intrinsically connected since the embryological period. They come from the same layer of cells (ectoderm) and this inter-relationship is maintained throughout our entire life.
Certain medical conditions worsen when people are “under stress.” Psoriasis is a perfect example: many of my patients come to the clinic with a flair of lesions that are linked to a stressful episode (either work or personal). The same goes for acne, atopic dermatitis, and especially rosacea and hidradenitis suppurativa… in all these conditions, mental health is deeply linked to skin health.
Which are your recommended skincare solutions? How and when do you recommend using them?
I recommend that all my patients make time for a skincare routine because if you have time for yourself, you can reduce your stress level.
By following a ritual that uses different actives like antioxidants, vitamin C, sunscreen, and retinol, you are going to reduce the level of oxidative stress in your skin.
-Deeply cleansing skin twice a day
This is something that we either do too quickly or skip altogether. This step is critical to removing impurities, dust, pollution particles and other contaminants that accumulate over the day and night. I recommend cleansing skin twice a day — both in the morning and before bed. If not cleaned properly, built-up impurities contribute to skin oxidation.
-Applying Antioxidants in the morning
This should be used in the morning after the cleaning of the skin and before applying sunscreen — which needs to be done every day! All these steps help improve the skin’s capacity to defend against environmental stressors. Vitamin C is a well-documented antioxidant that is proven to combat skin pigmentation and aging.
-Using a Retinol serum at night
Retinol should be used at night. Depending on the patient’s skin type, I will suggest a higher or a lower concentration. Sometimes I don’t recommend using it every day but on alternate days with a hyaluronic acid product.
-A Hydrating mask to rehydrate
Finally, a mask with a high concentration of hyaluronic acid increases skin hydration and its natural resilience while adding immediate radiance and a plumping effect.
The ideal “me time” moment to recharge your batteries and your skin!
Which lifestyle changes can be beneficial in a stressful environment?
Patients have told me that they see skin improvements when combining a skincare routine with exercise. I am a big believer of the importance of integrating skincare in a more holistic approach including taking take time for running/walking but also paying attention to selecting the right nutrients for your body and for your skin.
In my opinion, a good skincare routine is not enough — you need a healthy lifestyle, too. Good nutrition, avoiding sugar and lipids, and oral supplements when necessary. In the summer, I advise taking polypodium leucotomos (fern extract) — an antioxidant with numerous studies published on its efficacy on keeping skin supple.
Do you recommend nutraceuticals to all your patients?
I recommend this fern extract to all my patients with sensitive skin and who have a tendency to have polymorphic solar eruptions, but also for patients with melasma or for those who just want to improve their sun protection. Of course, it doesn’t replace actual sunscreen — but it is a great way to have extra protection. In my opinion, this is much better for the skin than other supplements like oral collagen which is the hot trend of the moment…
How can Dermatologists help communicate on this topic?
It is our responsibility to highlight that a skincare routine is not enough. Skin is the biggest organ of our body and it is constantly affected by internal and external contaminations. A healthy way of life is essential for us and for our skin.
And finally, what is your definition of healthy skin?
For me, this is skin with a correct level of water to function properly; a strong barrier and last but not least, one with neither dark spots nor redness.
- Chen J. et al. Oxidative stress in the skin: impact and related protection. Int J Cosmet Sci 2021;43:495-509
- Passeron T et al. Adult skin acute stress responses to short-term environmental and internal aggression from exposome factors. JEADV 2021; 35: 1963-1975.