Academic anxiety can exacerbate dermatological conditionsThomas Lohnes/Getty ImagesEven if you dont wear your heart on your sleeve, your skin may betray your mental state.There is a very strong connection between the brain and skin, and a connection between stress and skin diseases, says Gil Yosipovitch at the University of Miami, Florida. This is evident, he says, in his encounters with patients: I always ask, for instance, does anything aggravate your itch? And many patients will tell you its stress. This observation is also borne out in clinical studies.On a physiological level, it all comes down to hormones. Psychological stress, whether it be chronic or acute, causes our bodies to produce hormones called glucocorticoids, which keep us more alert and provide energy for the fight-or-flight response in dangerous situations. But they also harm the skin in two ways.Anxiety-induced acne and eczemaFirst, they can diminish the functioning of the epidermis. This top layer of skin locks in moisture and serves as the first layer of defence between our bodies and the environment. Consistently high levels of some of these hormones, like cortisol, can also cause inflammation. Second, glucocorticoids decrease the production of antimicrobial proteins in the skin.The combined effect is skin that is dry or inflamed, is prone to infections and heals more slowly, leading to a heightened susceptibility to clinical skin conditions. There is a direct connection between stress and a tendency to get sick, says Peter Elias at the University of California, San Francisco.In a review of 21 studies, Yosipovitch