When jotting down the macros and micros of our appreciations into a gratitude journal, the subject of skin rarely, if ever, comes up. For most of us, any reflection on our complexion usually results in worrying about oncoming wrinkles or wincing at persistent acne. But is it time for some gratitude, a wellness practice that has gone mainstream, to make its way into our beauty routines? According to a growing list of make-up moguls, beauty influencers and even medical practitioners, this might just be the secret to skin that is worth being grateful for. "Skin gratitude came with age,” says Amal Salameh, a beauty influencer from the UAE. Salameh spent her teenage years worrying about acne, and then her early thirties focusing on age lines. Now she’s trying to mute that self-critical internal voice. “My approach to mindfulness has shifted over the years. Instead of panicking about booking a Botox appointment, I decided to take another route of practising self-affirmations that encourage me to embrace ageing,” she says. She’s learning to let laugh lines serve as a reminder of time well spent. Salameh is only one of many in the beauty industry who link gratitude to good skin. Emily Weiss, founder of Glossier beauty company, told <i>Vanity Fair</i> that she spends five minutes a day writing down what she is grateful for. Mara Skincare founder Allison McNamara also told the UK newspaper <i>Evening Standard</i> that she journals daily. Influencer Christina Grasso told lifestyle website <i>The Cut</i>: "I absolutely consider gratitude to be a part of my personal beauty routine.” While Jessica DeFino, who wrote the article, professed: “Every morning, I start my meditation by taking a few deep breaths and saying in my head: ‘Thank you, skin.’ I think about how everything my skin does is literally meant to protect me and try to find the positive in the perceived ‘flaw’.” This is not the first time that the cosmetics industry has latched on to an in-vogue wellness practice – think crystal facial rollers, mindful skincare and plant-based products. But this time, it’s not about simply repackaging the trend into something sellable with an Instagrammable shine and shimmer, because adding gratitude into your routine is completely personal and free of charge. And there is evidence to support its “superpowers”, too. But what does Gratitude, with a capital G, really mean? While we all have moments of gratefulness, after being the recipient of a kind gesture or a thoughtful gift, this kind of gratitude goes further. It starts with taking that reactive emotion of appreciation and thankfulness, and applying it to everyday life. Whether it’s thinking of the most mundane day-to-day wins or the metamorphic moments in your life, setting time aside each day to actively cultivate feelings of gratitude can lead to a happier disposition. This can include physical journaling, mentally registering positives or verbalising empowering affirmations, as Salameh references. Affirmations simply involve saying out loud, “I am thankful for the lesson this has taught me”, or “I appreciate myself and I am worthy of success”. But what does all this thanks have to do with looking our best? Josie Ong, creator and host of <i>Affirmation Pod</i>, a weekly podcast that talks listeners through a series of positive statements and guided meditations around subjects such as health, career and sleep, tells <i>The National</i>: "You've probably heard that gratitude is an attitude, but it actually impacts your beauty, too." One of Ong's most recent episodes titled <i>How Do You Feel About Your Body?</i> urges people to love, respect and value the skin they're in. "We've all had times we felt empty inside, and no amount of make-up or skincare could heal that. A grateful life shows up in our skin, our eyes, our smile," she says. More than simply citing slogans that might pop up on your Instagram feed, Ong extends the power that expressing thanks has on our beauty beyond the spiritual realm and into the scientific. “Gratitude works because it reduces cortisol levels. When cortisol levels are high, it accelerates the ageing process by breaking down collagen and elastin. It also impairs your immune system’s ability to repair skin cells.” There is mounting research to support Ong's explanation. Studies published on websites such as Science Direct, Positive Psychology and National Library of Medicine respectively conclude that gratitude leads to better quality of sleep, lower stress levels and greater feelings of happiness, thanks to dopamine and serotonin release, while a 2017 Science Daily study is titled simply <i>Expressing Gratitude Makes us Healthier</i>. Continued practice can even rewire our brains; an Indiana University experiment evidenced that three weeks of gratitude journaling can change our mindset. Sleeping well, reducing stress and increasing happiness, as Ong says, can manifest in our outward appearance through brighter skin, thicker hair and stronger nails. When speaking at the American Academy of Dermatology, as recorded by Science Daily, dermatologist Flor A Mayoral said: “In treating hundreds of patients over the years with skin conditions such as eczema, rosacea, acne and psoriasis, I have seen first-hand how stress can aggravate the skin and trigger unexpected flare-ups that, in effect, create more stress for patients. “Learning how to manage the effects of stress on your skin can help alleviate some of the anxiety and symptoms.” She spoke of studies that show that skin under stress takes a longer time to heal itself, that stress hormones lead to excess oil production and even linked it to hair loss and brittle nails. So, if more gratitude means less stress, then that is surely a win for our skin? Founder of skincare brand Murad, Dr Howard Murad is a physician who specialises in inclusive health and dermatology, and is an avid advocate of a multipronged approach to good skin. "It's not only important to treat and nourish the skin topically<b>,</b> but also to be kind to your mind and look after your emotional well<b>-</b>being," he tells <i>The National.</i> It’s a belief based on the material over the metaphysical; evidence gathered during his own research. “Based on scientific findings from positive psychology, we developed 11 positive insight cards that we expected to reduce stress,” he says. “We carried out a four-week study intervention using these insight cards to assess the impact on emotional well-being, using physiological and subjective measures of stress.” What was the result? Simply reading the prompt cards twice a day actually reduced stress levels and improved overall wellness in the sample group. However, rather than a revelation, the results served as evidence that the psychology of gratitude and the physiology of beauty are intricately linked. “I’ve always talked about cultural stress – the stress we experience on a daily basis, and the impact this has on our skin,” says Murad. While his products work to treat the visible signs of stress on the skin, by targeting dryness, wrinkles, dullness and puffiness, the dermatologist himself always recommends that patients be “kind to their minds and look after their emotional well-being” for the best results. So, how to cultivate the practice of gratitude for healthy skin? “On a not-so-good skin day, I remind myself of everything I went through in my skin journey,” Salameh says. “From its patience with me on days I forgot to drink enough water or when I skipped SPF … I tell myself I need to be as kind to my skin as it has been with me.” She stresses the importance of doing a wellness check when that negative voice creeps in, because the “mind can play tricks on us sometimes”. Whether it’s journaling for five minutes every day like the make-up moguls or reciting positive affirmations like the wellness experts, it seems a little gratefulness goes a long way.