A cross-sectional study of psychological stress and skin symptoms in Australian university students

Background/Objectives: University can be a source of considerable psychological stress owing to converging academic, cultural and financial pressures. A recent US college study showed an association between increased stress levels and various skin conditions using validated questionnaires. This study aimed to further investigate this relationship in an Australian university cohort.
Methods: Five-Thousand University of New South Wales students aged between 18 and 30 were randomly selected and emailed an invitation to participate in a web-based survey. To assess stress levels we used the perceived stress questionnaire (PSQ). To assess skin complaints, we used a modified version of the self-reported skin questionnaire (SRSQ).
Results: 471 students both enrolled and completed the survey. 120 were designated low stress (LS), 232 moderate stress (MS) and 119 (HS) high stress subjects. When perceived stress level and skin conditions were compared, HS subjects reported statistically significantly more pruritus, dry sore rash, scaly skin, alopecia, other rashes on face, itchy rash on hands, hyperhidrosis and trichotillomania than LS subjects. No significant differences were found for pimples, warts, onychophagia or oily, waxy patches on scalp and/or flakey scalp.
Conclusions: The results of this study demonstrated that perceived stress levels in those who answered the questionnaires are statistically significantly associated with a number of common skin complaints. While causality cannot be inferred, these findings provide valuable insights into the potential role of perceived stress for health care practitioners caring for patients with both new skin symptoms and/or exacerbation of an existing dermatosis.

Dr. Thomas Stewart