This week’s guest blogger is Dr. Keira Barr. As a dual board-certified dermatologist and somatic trauma practitioner, Dr. Barr created the Center for Mind Skin Medicine to help rosacea patients calm the storm beneath the surface by addressing the stress, frustration, and invisible weight rosacea can carry.

If your skin feels like it’s screaming louder than your voice some days, you’re not alone. And if you’ve been trying to connect the dots between your flares, your stress, and your sleep (or lack of it), you’re in the right place.

Rosacea isn’t just about what’s happening on your skin. It’s also about what’s happening beneath it.

Stress plays a central role — not just the stress you can name, but the deeper, chronic stress your body has carried for years. When we begin to understand how stress impacts the nervous system and how that system communicates with the skin, everything starts to make more sense.

Let’s start with a metaphor that’s simple, but surprisingly powerful.

Your Nervous System Is an Elevator, Not a Light Switch

Most people think stress works like a light switch — on or off, calm or stressed. But that’s not how your body operates. Instead, think of your nervous system as an elevator that moves through three distinct “floors,” each representing a different state your body cycles through all day long:

● Penthouse (Ventral Vagal State)
When you're in the penthouse, you feel safe, supported, and connected. This is where digestion works, sleep deepens, and your skin is able to heal and renew as designed.

● Middle Floor (Sympathetic State)
This is your fight-or-flight zone. You feel anxious, overwhelmed, hyper-alert. Blood vessels dilate, redness spreads, and your skin becomes reactive. Importantly, this state isn’t “bad” — it’s the part of your nervous system that helps you move, speak up, set boundaries, and get out of harm’s way when necessary. Every inhale gently activates this system.

● Basement (Dorsal Vagal State)
When you’ve been running on empty too long, your system may drop into shutdown. You feel disconnected, depleted, or numb. Skin repair slows, immune function dips, and inflammation may linger. But even this state isn’t bad — it’s also where deep rest, intimacy, and creativity can live when blended with a sense of safety.

None of these nervous system states, whether you're feeling calm, activated, or shut down, are wrong or bad. In fact, we need access to all of them in order to thrive. The challenge isn’t that your stress response activates; it’s designed to. Stress is a normal, adaptive part of life. The real issue is when we get stuck in one state for too long — especially in fight-or-flight (hyperarousal) or in freeze and collapse (hypoarousal).

And here’s the thing: getting stuck is incredibly common, especially if you’ve been living under ongoing stress, unresolved trauma, or chronic overwhelm. Sometimes it’s hard to even recognize you’re stuck, because that reactive state becomes your new normal. You might find yourself always on edge, constantly scanning for danger, or feeling shut down and disconnected. These are your body’s ways of coping, but over time, they can contribute to inflammation, immune dysregulation, and flare-ups on your skin.

That’s why one of the most powerful steps you can take is developing self-awareness. What does stress feel like for you? How do you know when you're carrying more than your system can handle? What changes inside your body, in your environment, and in your relationships when you're stressed?

There’s no one-size-fits-all answer, your stress response is shaped by your lived experience. And how well you're able to respond to stress can vary day to day depending on how resourced you are: how well you’ve slept, whether you’re nourished, how supported you feel, how connected you are to a sense of purpose and safety. When you begin to understand these variables, you can start to recognize what you need in the moment and offer yourself the right support at the right time.

The goal isn’t to live in a constant state of calm. That’s not realistic, and it’s not even ideal. We need the energy of the “middle floor” to pursue our dreams, dance, speak up, and get out of harm’s way when necessary. We need the deep rest of the “basement” to reset, cuddle, or recharge. And we absolutely need the connection and safety of the “penthouse” to help us restore.

What matters most is movement — your nervous system’s ability to shift between states fluidly. That flexibility is what allows your body to respond to life’s challenges without getting stuck in survival mode. It’s also what creates the internal environment where your skin can begin to heal.

That’s what the following practices are designed to support. They aren’t about pushing yourself into calm. They’re about helping your system feel safe enough to shift — one breath, one cue, one moment at a time.

Three Skin-Smart Practices for Stress Relief

These simple, body-based tools send clear, consistent signals to your nervous system that it’s safe to relax, restore, and repair.

1. Soft Belly Breathing
Place one hand on your belly. Inhale through your nose for four counts. Exhale through your mouth for six counts, letting your belly soften. Repeat for one to three minutes, or longer if it feels good.

Why it works: Activates your vagus nerve — the body’s natural de-stressor — helping shift out of fight-or-flight and into calm. Improved blood flow and reduced inflammation can support your skin’s repair processes.

2. Orienting
Slowly scan the space around you. Let your eyes settle on something comforting — your favorite mug, a houseplant, a photo. Take a breath and notice: is there anything here that reminds you that you're safe right now?

Why it works: When your brain registers safety in the environment, it quiets the threat signals that drive inflammatory stress responses. That helps reduce the skin’s reactive loop with the nervous system.

3. Supportive Touch
Place your hands over your heart, wrap your arms around yourself, or gently squeeze your arms or legs. You can add a gentle rocking or swaying motion if it feels comforting.

Why it works: Gentle touch activates C-tactile nerve fibers in the skin that are designed to respond to soothing contact. This calms the stress response, releases oxytocin (the "I’ve got you" hormone), and shifts the body into repair mode.

What Your Skin Might Be Trying to Say

Sometimes the redness is just a flare. And sometimes, it’s a flare layered with years of stress, shame, and exhaustion that your body has never had a safe moment to release. That’s why your skin can feel so unpredictable, it’s not just reacting to the moment; it’s holding the memory of what you’ve carried.

What if, instead of seeing your skin as the problem, you saw it as a messenger? What if every flare wasn’t a failure or a judgment, but a conversation starter — an invitation to pause, to listen, and to tend to what’s happening beneath the surface?

You don’t have to wait for everything to be perfect before you start feeling better in your body. You don’t have to fix everything at once. You just need a way in. A moment of awareness. A single shift. Sometimes that shift looks like a breath that tells your body it’s safe. Sometimes it’s a gentle touch that reminds your system it’s not alone. Sometimes it’s simply noticing the warmth of sunlight on your face or the feel of your feet on the ground.

Small actions matter. They send signals of safety. They interrupt the spiral. And over time, those signals build a bridge between your body and your skin — between what’s felt and what’s seen. Because healing isn’t about controlling your skin. It’s about creating the conditions that help it feel safe enough to soften. And your skin? It’s always listening.

Still curious about how to put these practices into action? Visit drkeirabarr.com to explore more resources, or go directly to drkeirabarr.com/stressrelief for a free step-by-step guide you can use anytime, anywhere.