Association Between Skin Pre-Aging, Psychological Stress Less Widely-Known Among Young Women


Research indicates that despite reports of high psychological stress among women in their 20s and 30s in China and Japan, awareness of stress’s effects on aging remain higher among health professionals.

Siti S. Anwar, PhD

Credit: LinkedIn

Siti S. Anwar, PhD

Credit: LinkedIn

About half of young women reported mild to extremely severe levels of stress, but awareness of the association between stress and skin aging was higher among healthcare professionals than young women in general, according to new findings.1

A somewhat recent concept, skin that is “pre-aging” describes self-perceived signs of aging skin that can become visible in the early 20s and 30s and affected by psychological stress.2

Despite the association, this study’s investigators noted a prior lack of clarity on how aware young women and healthcare professionals (HCPs) are about the link between skin aging and psychological stress. Therefore, they sought to evaluate perceptions in this study.

This research was conducted in China and Japan, and it was authored by Siti S. Anwar, PhD, from Johnson & Johnson Pte. Ltd, Ascent, in Singapore.

“In this study, we focused on Chinese and Japanese women to provide further insight into our earlier study, in which we found that women in China and Japan perceive preaging to involve skin changes that start in the early 20s,” Anwar and colleagues wrote.

Background and Findings

The investigators used online surveys conducted by IQVIA to recruit female participants aged 18-34 from both China and Japan. They determined eligibility criteria to be having no major self-reported illnesses or skin disorders, residing in a major city, and not having participated in other skin product-related research.

The research team reported on both age and gender during screenings, and duplicate entries were prevented by the team. They also invited healthcare professionals with about ≥3 years of experience, ≥75% of time on direct patient care, and a caseload of ≥30 patients per month (≥10 aged 18-34).

The researchers also performed data quality control to ensure no duplicate entries were included in the final sample. The surveys were conducted between December of 2020 and February of 2021.

The surveys were designed by the investigators to take about 20 minutes and were written in English but later translated into Chinese or Japanese. The survey for young women used questions on the topics of skin health, demographic characteristics, and mental health/stress, while the survey for healthcare professionals delved into patient issues, inflammation, skin issues, stress triggers, and the impacts of COVID-19.

They included structured questions and some open-ended and/or free-text questions. The surveys were not skippable by the recipients, and incomplete questionnaires were not recorded by the research team.

In the end, the investigators conducted their online surveys with the help of 403 young women in the 18–34 year age-bracket, 60 dermatologists, and 60 psychologists that had been living in several cities in Japan and China.

The research team ended up learning that stress levels were reported as normal by 52.6% of young women and mild–extremely severe by 47.4%, in total. They noted that skin manifestations that were associated with pre-aging were reported by the mild–extremely severe stress study group, with the top 3 manifestations being the following:

  • Rough skin (39.3% compared to 24.1% for the less stressed group)
  • Slower metabolic rate (28.8% versus 14.2%)
  • Dull skin (43.5% versus 29.2%)

Skin manifestations perceived to show the strongest stress associations included the following: dark under-eye circles, dull skin, and slower metabolic rates. Meanwhile, HCPs perceived the strongest associations with stress to be acne, skin rashes, and dry skin.

“Overall, our findings have provided new insights into the perceptions of young women and healthcare professionals about the association between stress and skin aging,” they wrote. “Raising awareness about this association among young women in particular could help mitigate skin preaging in this population.”


  1. Anwar, SS, Apolinar, MA, Ma, L. Perception, understanding, and association between psychological stress and skin aging: Quantitative surveys of Asian women aged 18–34 years, dermatologists, and psychologists in China and Japan. J Cosmet Dermatol. 2023; 00: 1- 11. doi:10.1111/jocd.15732.
  2. Anwar SS, Smith SD, Pongprutthipan M, Kim JY, Yuan C, van Steensel M. Preageing of the skin among Asian populations. JEADV Clin Pract. 2022;1(2):88-95.
Related Videos
Linda Stein Gold, MD, and Bruce Strober, MD, PhD
Linda Stein Gold, MD, and Bruce Strober, MD, PhD
Linda Stein Gold, MD, and Bruce Strober, MD, PhD
Signs and Symptoms of Connective Tissue Disease
Connective Tissue Disease Brings Dermatology & Rheumatology Together
What Makes JAK Inhibitors Safe in Dermatology
Potential JAK Inhibitor Combination Regimens in Dermatology
Therapies in Development for Hidradenitis Suppurativa
"Prednisone without Side Effects": The JAK Inhibitor Ceiling in Dermatology
Discussing Changes to Atopic Dermatitis Guidelines, with Robert Sidbury, MD, MPH
© 2024 MJH Life Sciences

All rights reserved.