Rachel McArthur on How Trauma Shows Up in the Skin

The skin often speaks before we do. It flushes, breaks out, and reacts in ways that reveal more than we might intend. In the first instalment of a new four-part interview series with Hinton Magazine, skincare expert Rachel McArthur explores the hidden relationship between trauma and skin health. Known for her calm, empathetic approach and deep understanding of the mind–body connection, Rachel shares how her own journey shaped the way she helps clients heal from the inside out. She reminds us that skincare is not just about appearance but about awareness, compassion, and understanding the stories our skin is trying to tell.

How did your personal journey help you discover the link between trauma and skin health?

I’ve always been attuned to feelings. From the moment a client settles under the magnifying lamp, I often notice a surge of vulnerability, apologies for picking, minimizing scars, or anxiety about the normal signs of aging. Very early on, I realized skin care isn’t just cosmetic; it opens the door to people’s stories, including shame, grief, and unresolved trauma. That understanding made it clear that my first responsibility is to create a safe, nonjudgmental space where clients feel seen and respected.

My own history being born with a cleft lip and growing up feeling different shaped how I show up in that space. It taught me empathy, discretion, and the importance of consent and trust. Over time, I began to see consistent patterns: stress and trauma can show up on the skin as flare-ups, delayed healing, compulsive picking, or heightened sensitivity. My personal journey didn’t just help me notice those links; it equipped me to meet them with compassion and steady, evidence‑informed care, so clients can heal their skin while honoring their whole story.

What are some of the most common skin conditions that you see as a direct reflection of emotional or physical stress?

Acne, picking, scarring, rosacea, eczema, psoriasis, excessive dryness or oiliness. 

Can you explain how the nervous system plays a role in the way our skin reacts to trauma?

The skin and nervous system are in constant dialogue, often called the brain–skin axis. When we experience stress or trauma, the sympathetic nervous system and the HPA axis activate, releasing adrenaline, noradrenaline, and cortisol. That cascade can show up on the skin in several ways:

• Barrier disruption: Increased transepidermal water loss, dehydration, and heightened sensitivity.

• Neurogenic inflammation: Nerve-derived signals (e.g., substance P, CGRP) and mast cell activation can trigger redness, itch, hives, or flare-ups.

• Altered oil, sweat, and microbiome balance: Changes in sebum, pH, and microbial communities may contribute to acne or irritation.

• Slower repair: Stress hormones can delay wound healing and influence collagen remodeling and scarring.

• Flare patterns: Conditions like eczema, psoriasis, rosacea, and acne often worsen under sustained stress.

• Behavior loops: Compulsive picking or scratching can be a nervous-system coping pattern, further aggravating the skin.

When the nervous system is chronically “on,” the skin can “speak” for it—via breakouts, rashes, or reactivity. Supporting nervous-system regulation often helps the skin re-stabilize.

Why do you think this connection is often overlooked in mainstream skincare conversations?

• Training emphasis: Conventional biomedical education prioritizes topical/pathology-based models, with less focus on psychoneuroimmunology and trauma-informed care.

• Time and reimbursement limits: Short appointments don’t easily allow for root-cause exploration or nuanced trauma histories.

• Siloed care: Dermatology, mental health, and aesthetics often operate separately, making integrated care less common.

• Evidence-to-practice gap: Research exists, but protocols for everyday clinical use aren’t always standardized or widely taught.

• Stigma and sensitivity: Discussing trauma requires trust, consent, and privacy topics some professionals feel underprepared to navigate.

• Market dynamics: Skincare marketing favors quick, product-led fixes over complex whole-person approaches.

• Scope concerns: Many practitioners in aesthetics worry about overstepping into mental-health territory, even when a referral or collaborative model would help.

Bringing this connection forward starts with trauma-informed environments, collaboration between skin and mental-health professionals, and education that recognizes the nervous system as a key player in skin health.

For people experiencing flare ups during stressful times what simple practices can help calm the skin?

When stress is high, start by calming the nervous system and streamlining your routine. A few minutes of breath work with longer exhales such as inhaling for a count of four and exhaling for six to eight can downshift the body and indirectly ease reactivity in the skin. Gentle grounding practices, like a brief body scan, soft humming, or a cool (not ice-cold) compress on the back of the neck, can also be soothing. Keep it simple and consistent; short, frequent resets are more effective than occasional long sessions.

On the skin, press pause on strong activities like retinoids, acids, and scrubs until things settle. Choose a pH-balanced, fragrance-free cleanser and follow with a barrier-repair moisturizer containing ceramides, cholesterol, and fatty acids. For hot spots, apply a very thin layer of petrolatum on damp skin to seal in moisture. If tolerated, add soothing ingredients such as colloidal oatmeal, centella asiatica, panthenol, or low-dose niacinamide (2–5%). Use a cool compress for 5–10 minutes to reduce heat and redness, avoid over-washing, and protect with a gentle, non-irritating sunscreen. If symptoms persist or worsen, consider checking in with a licensed clinician.

How do you approach treatment when the root cause of the issue is something deeper than the surface?

I begin with a thorough, trauma-informed intake to understand the client’s history, current triggers, lifestyle, stressors, and goals. From there, we co-create a plan that moves in small, sustainable steps and blends topical care with nervous-system support. On the treatment side, that might mean restoring the barrier first, reintroducing activities thoughtfully, and pacing any procedures to the client’s tolerance. On the inner support side, we incorporate simple regulation tools like breathwork and grounding along with sleep hygiene and routine building. When appropriate, I coordinate with or refer to trusted professionals such as therapists, nutrition professionals, or physicians to address contributing factors beyond the scope of skincare. We schedule regular check-ins, adjust based on the skin’s response and the client’s lived experience, and define success as steadier comfort, function, and resilience rather than quick fixes.

What does it mean to you when a client begins to see both physical and emotional healing in their skin?

It’s one of the most meaningful parts of my work. When the skin stabilizes and a client’s relationship with themselves softens, I see confidence, self-trust, and ease return. Daily choices become kinder and more consistent, and the benefits ripple into sleep, relationships, and overall wellbeing. Being invited to witness that whole-person transformation and to hold a safe, nonjudgmental space for it; is a true privilege.

Do you believe the future of skincare will become more rooted in emotional and psychological wellbeing?

Yes and I believe it must. Skin reflects our internal state; stress physiology, nervous system regulation, and trauma history all influence how it behaves. The future of skincare should integrate emotional and psychological wellbeing alongside evidence-based treatment: thoughtful intake that considers stressors, simple nervous-system tools, collaborative care when appropriate, and education that begins in training programs and schools. Without that whole-person lens, care stays surface-level and the skin often continues to signal distress. With it, healing becomes more sustainable, compassionate, and effective.

In Rachel McArthur on How Trauma Shows Up in the Skin, the skincare expert delves into the profound link between emotional wellbeing and the body’s largest organ. She explains how stress and trauma can appear through flare-ups, sensitivity, and slow healing, revealing the skin as a living reflection of our inner state. Her trauma-informed approach combines evidence-based treatments with emotional awareness, creating a safe space for clients to feel understood as well as cared for. As the first feature in Hinton Magazine’s four-part series, this conversation opens a powerful dialogue on how true healing begins beneath the surface.