Present Tense: How to See the Skin as a Window to Your Inner World

What do you see when you look in the mirror?

Do you see your radiant, soulful self smiling back at you? Or do you see your flaws and imperfections staring you in the face?

Whatever your answer to this question, the reality is that no amount of moisturizer, toner, or serum will change it.

The way you see yourself may be affected by a bad breakout or a new dark patch, but the truth is that your fundamental perception of yourself comes from somewhere deeper.

That said, your skin can often reflect what’s going on below the surface.

With a little bit of mindful attention along with compassionate care, you can tap into the mind-body connection that facilitates your skin’s relationship with your inner world.

The science behind the mind-skin connection

The idea that the mind and emotions are connected to the state of your skin isn’t some ‘woo woo’ theory. There’s plenty of scientific evidence to support the profound relationship between the psyche and the skin.

For instance, a 2016 studyTrusted Source found that higher levels of mindful awareness were associated with reduced psychosocial distress and improved dermatological quality of life.

Out of 120 adult dermatology outpatients in the study, 33.4 percent reported clinically significant social anxiety.

Researchers found that lower levels of present moment awareness were related to higher levels of skin shame. They also noted that mindfulness interventions could benefit people experiencing psychosocial distress while living with a visible skin condition.

Another 2016 study noted that the stress hormones cortisol and corticosterone play a significant role in skin health, affecting:

2013 studyTrusted Source reported that 85 percent of dermatology patients agreed that managing psychosocial distress was a major factor in living with a skin condition.

According to older 2007 researchTrusted Source, 30 percent of dermatology patients have signs or symptoms of psychological problems. The authors note that it’s often difficult to distinguish whether the primary cause of these problems is the skin or the psyche.

Wound healing and mindfulness

In addition to affecting visible skin conditions and how you may feel about your skin, mindfulness has also been shown to positively affect wound healing.

A small 2018 studyTrusted Source of 49 adults found that those who underwent an 8-week Mindfulness-Based Stress Reduction (MBSR) program showed greater reductions in skin permeability as well as lower levels of interleukin (IL)-8 and placental growth factor compared with a control group.

These findings suggest that increasing mindfulness with MBSR may benefit the early stages of wound healing, though more research is needed.

Psoriasis and mental health

According to a 2019 reviewTrusted Source of 24 clinical trials and three case reports involving 1,522 people with psoriasis, researchers noted that psychological factors both worsen and result from psoriasis, indicating a complex cause-and-effect relationship.

Researchers noted several promising interventions for psoriasis management, including:

They also called for further study to determine the efficacy, practicality, and economic feasibility of these treatment options.

2020 reviewTrusted Source noted a significant relationship between psoriasis, depression, and low self-esteem. A study mentioned in the above review of 127 psoriasis patients noted that 9.7 percent of patients wished they were dead, while 5.5 percent experienced suicidal ideation.

An older 2010 studyTrusted Source indicated that daily stressors influence psoriasis symptoms by affecting cortisol levels at moments of high stress.

2016 studyTrusted Source noted that stress increases inflammatory, sympathetic nervous system, and adrenal responses that worsen psoriasis symptoms. The authors also noted that more than 50 percent of people with psoriasis also have sleep issues, further contributing to stress.

Eczema and the effects of stress

Eczema is another skin condition that’s affected by stress.

According to 2021 researchTrusted Source, many people with atopic dermatitis (AD)—another term for eczema—experience itching along with worry about itching, also known as itch catastrophizing.

In the study, 155 people with AD received treatment at a rehabilitation center. Three mindfulness orientations were associated with lessened itch catastrophizing.

These were:

  • acting with awareness
  • accepting and non-judgemental orientation
  • non-reactive orientation

The authors concluded that psychological interventions that increase acting with awareness might have a buffering effect on itch catastrophizing, which in turn could lead to lower itch intensity in patients with AD.

Another 2021 studyTrusted Source noted that social deprivation and stress have a negative impact on atopic eczema symptoms, as do air pollution and the effects of climate change.

Additionally, a 2018 literature reviewTrusted Source found a positive correlation between the experience of stress among mothers and eczema risk for their children.

Another small 2021 study of 31 people with eczema found that:

  • 22.6 percent had mild depressive symptoms
  • 16 percent had mild to moderate depressive symptoms
  • 38.7 percent had moderate to severe depressive symptoms
  • 22.6 percent had severe symptoms

In addition, study participants reported high levels of:

  • sleep pattern disorders
  • indecision
  • low self-esteem
  • self-criticism
A holistic approach to skin care

There’s ample evidence pointing to the link between the skin, stress, and even mental health. But how can you take that knowledge and apply it to support the health of your skin?

According to Katie Silcox, Ayurvedic specialist, founder of Shakti School, and New York Times Best-Selling author of the book “Healthy, Happy, Sexy: Ayurveda Wisdom for Modern Women,” the skin acts as a window to our inner state.

“In Ayurveda, we see the skin as a boundary and also a screen upon which our emotions may present,” she says. “Skin health can dramatically improve when we refocus our mindset and make a commitment to mindfulness.”

Naturopathic medical doctor Charles Tabone of Pause Studio agrees.

“Skin is a primary concern for many individuals, as it’s a direct reflection to the outside world,” he says. “Our bodies are always speaking to us, and noting changes in skin health helps reveal what may be out of balance internally.”

The skin is the largest organ of the body and the first line of defense against toxins and environmental pollutants, Silcox points out. The skin can also show us the imbalances that exist within the body.

“So often unconscious emotions and stressors that build up during the day can come out through our skin,” she says.

For example, Tabone points out that emotional stress, poor sleep, or a compromised immune system can result in a recurrence of cold sores.

Dryness can suggest dehydration or a deficiency in healthy fat consumption. Acne can suggest food sensitivities or an imbalance in bacterial colonies on the skin. Poor wound healing may imply a lack of essential nutrients.

“The skin is often a report card on how our bodies are handling the insults of life,” Tabone says. “Internal balance can outwardly manifest in radiant skin.”

The gut-skin connection

Both Silcox and Tabone believe there’s a strong link between the health of the gut and the health of the skin.

“The skin is a reflection of the integrity of the digestive system,” says Tabone. “By healing [the] gut, systemic inflammation can be drastically reduced, which will help promote more healthy skin.”

The skin “can give us an indication of the state of toxins in our blood and blood plasma,” says Silcox. “In a way, the imbalances we see in our skin can be helpful signs that we need to care for our digestion and food/drink intake.”

There’s science to support this perspective as well.

2021 studyTrusted Source noted that skin diseases lead to alterations in both the skin and the gut microbiome. Imbalance in the skin and/or gut microbiome is also associated with altered immune response.

This promotes skin diseases like:

According to 2020 researchTrusted Source, there’s a significant association between alterations in gut microbial composition and psoriasis, though the study authors called for more large-scale studies and uniform standards.

2019 review notes that the emotions of stress, including depression and anxiety, may aggravate acne by altering the gut microbiota and increasing intestinal permeability, which could contribute to skin inflammation.

How to listen to your skin

Want to learn to listen to your skin so you can give it the care it needs? Silcox and Tabone suggest focusing on a few key areas, including:

  • practice mindful skin care
  • eliminate toxins
  • reduce stress
  • get high-quality sleep
  • eat foods to support the skin and gut
  • balance sun exposure and sun protection
  • drink plenty of water

Mindful skin care

When it comes to her skin care routine, Silcox keeps it simple.

Her four steps include:

  1. A toxin-free daily cleanser that contains aloe vera, chamomile, rose, and calendula.
  2. A natural, oil-based serum made with a mix of organic sunflower and coconut oil.
  3. A sugar-based exfoliant twice a week.
  4. A natural clay mask to pull deeper toxins as needed.

On top of that, she focuses on a realistic mindset.

“I do my best to be mindful to thank my skin for enduring all of the weather, seasons (and tears!) of both the day and my life,” she says. “I also try to be realistic with my facial practices and not expect to have perfect golden youthful skin forever.”

Silcox points out that a big part of Ayurveda and spiritual living is accepting that change is inevitable and the body can’t last forever.

“That said, we can do our best to care for our body and our skin,” she adds.

Tabone focuses on receiving the messages from his skin and adjusting accordingly.

“I use occasional blemishes as cues to understand food sensitivities, hydration levels, or emotional stress I may be navigating,” he says.

He’s also a fan of dry brushing to encourage healthy blood flow and lymphatic drainage.

Eliminate toxins

“The skin is one of our major detoxification organs,” says Tabone. “By minimizing the amount of toxins coming into the body while promoting healthy elimination via liver function, our body’s burden of toxicity can be reduced and more optimal skin health will follow.”

In his skin care routine, Tabone focuses on maintaining a healthy skin barrier and microbiome with gentle products.

“I’m a strong advocate for not putting substances on your skin that you wouldn’t eat,” he says. “I promote the health of my own skin flora by avoiding the overuse of soaps when bathing.”

Silcox suggests avoiding excessive alcohol intake.

“Alcohol is not great for the skin, as it can contribute to liver damage as well as dehydration of the overall tissues of the body,” she says.

Stress reduction

“When we’re stressed, we may express feelings through the skin with heated responses like sweating, blushing, or getting hives and rashes,” Silcox says. “We may also feel the cold constriction of fear and anxiety on our skin which can lead to dryness and more wrinkles.”

Silcox suggests navigating emotions by making time to pause and experience them. This can help you process and digest emotions rather than repress them, which means they’re less likely to show up on the skin later.

“Heightened emotional states can impair the function of our organs, which can increase inflammation and overwhelm normal detoxification pathways,” says Tabone.

He enjoys meditating in an infrared sauna.

“Paying attention to the sensations in the body and navigating the mental game when the heat gets intense is a wonderful practice in mindfulness,” he says.

However, you don’t need a sauna to start a meditation practice.

In fact, Tabone emphasizes that you can make your entire skin care routine a mindfulness practice.

“Spending a few minutes to consciously care for your body can bring calmness, help you be present, and promote better health,” he adds.

High-quality sleep

It’s called ‘beauty sleep’ for a reason.

According to Tabone, sleep is one of the core pillars of health.

Making sure you’re getting enough high quality sleep that involves 7 or more hours and complete sleep cycles can reduce stress and encourage skin repair.

Foods to support the skin and gut

When it comes to skin health, Silcox focuses on eating anti-inflammatory foods.

Her favorites include:

Tabone advocates healthy fats, noting that fat-soluble vitamins play an important role in skin integrity.

“I also focus on nose-to-tail animal consumption,” he says. “The different building blocks present in muscle meats, organs, connective tissues, and bones supply the nutrients necessary for optimal body function.”

Sun exposure and sun protection

“Sunlight is also incredibly valuable, and I try to get ample early and late day sunlight exposure as well as moderate peak sun exposure,” says Tabone.

At the same time, it’s essential to stay protected with sunscreen with SPF 30 or greater and sun protective clothing, no matter the weather.

Drink plenty of water

“Drinking ample clean water is also incredibly important,” says Tabone. “I consume purified water that’s been enriched with trace minerals to promote cellular hydration.”

Even if you don’t have access to purified, enriched water, hydrating with whatever water you have available is essential for healthy skin.


“You don’t need the latest and greatest device, supplement, or procedure for optimal skin health,” says Tabone. “Your body is always trying to find balance and heal itself.”

His recipe? A balanced combination of diet, movement, nature, rest, and community.

When asked to boil it all down, Silcox has one piece of advice.

“Chill out,” she says with a laugh.

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