Does Stress Cause Acne? What Is The Link Between Them?

Medically reviewed by Dr. Dhaval G. Bhanusali, MD FAAD
by Ramona Sinha

Do you know which is the most misunderstood relationship in the world? Any guesses? Well, it’s the relationship between stress and acne. Even if you are blessed with exceptional skin and follow a strict skin care routine, it’s not unusual to wake up with a breakout. Stress is one of the most common triggers of unexpected acne. So, if you are wondering why you have a breakout out of the blue, it could be because of stress. What’s the connection between the two? Let’s get to the bottom of it.

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Stress Acne: Can Stress Cause Acne?


Before I start, let me make it clear that stress alone cannot cause acne. The severity of acne depends on various other factors like changes in your hormone levels, weather-related factors such as excessive heat and humidity, makeup and skin care products, pollution, personal hygiene factors, and pre-menstruation. However, stress can definitely trigger breakouts. The higher your stress levels, the more pronounced your breakouts.

There are a lot of things going on inside your body. When you are stressed, your body responds to it by triggering some biological drivers that are the real culprits behind your breakouts. Two such biological factors that cause acne are the hypothalamic-pituitary-adrenal axis and the corticotropin-releasing hormone.

A study involving post-adolescent working women claims that chronic stress increases the production of adrenal androgens (a set of hormones) that enlarge the sebaceous glands. This increases sebum production and, subsequently, results in comedones or acne (1).

Emotional stress can also contribute to acne as it activates the hypothalamic-pituitary-adrenal axis (also called the HPA axis). To combat the stress, the HPA axis increases the cortisol level (stress hormone) in your body. At the same time, corticotropin-releasing hormone (CRH), a peptide hormone involved in your body’s stress response, stimulates the sebaceous glands. This, in turn, causes acne (2).

In fact, compared to healthy skin, CRH expression was found to be high in the sebaceous glands of acne-prone skin (3). Moreover, CRH also induces the production of cytokines IL-6 and IL-11 in your keratinocytes (skin cells that produce keratin) (4). This triggers inflammation, a critical factor in the development of acne.

Sometimes, stress can take a real toll on your skin and turn into a vicious cycle. Read on to find out how exactly it does so.

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Acne Excoriée: How Does Stress Mess With Your Skin?


Picking on pimples is a common practice. You know that it’s bad, and yet you cannot resist the temptation of picking at your zits. People tend to pick at their acne when they are stressed. They find the marks and zits embarrassing and can’t stop themselves from picking at them in a bid to remove them. This compulsive picking of acne is known as Acne Excoriée. This condition is also known as Picker’s Acne. It is an aggravated form of acne that is caused by scratching and picking at pimples.

In a study conducted in 2015, researchers found that stress factors were higher in subjects who had acne excoriée. They reported more stressful events in their personal life (like financial issues and marital conflicts) compared to those without acne and other dermatological issues (5).

The bad news here is that the healing process slows down when you are stressed. This means that the pimples last longer and have a higher chance of turning severe. But the good news is, you can easily manage stress-related acne.

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How To Manage Stress-Related Acne

There are many things that you can do to manage stress-related breakouts. An excellent way to start is by eliminating stress. Here are a few things you can do to eliminate acne caused by stress.

1. Find Ways To Relax Yourself


This one’s a no-brainer. Engaging in activities that relax you is the best thing that you can do for yourself. What makes you feel relaxed? Playing with pets? Hiking? Meditation? Working out? Yoga? Find out what calms your mind and dedicate some time to it every day. I know that managing stress is not as easy than it sounds, especially when there are multiple stress-causing factors in your life. But start by taking one step at a time. Start by indulging in your preferred relaxation activity once a week and work your way up to doing it daily.

2. Sleep Well

Stop being a night owl and catch some Z’s. Sleeping not only relieves stress but also helps in healing your body. When you sleep, your body goes into the repair-and-heal mode. Also, night-time is when you need to apply the acne spot treatment creams and ointments prescribed by your doctor. These work overnight to treat your acne and prevent scars.

3. Do Not Touch Your Face


Picking on your acne when you are stressed will only add to your woes. Touching your face unnecessarily and incessantly transfers bacteria from your hands to your face, thus worsening your breakouts.

4. Don’t Compromise On Basic Skin Care

Though it sounds basic, it is a crucial factor in keeping your skin clean and germ-free. When you are stressed, you tend to forego your daily skin care routine. This can aggravate your pimples and lead to other skin issues. If the thought of following a strict skin care routine freaks you out, relax! Just following a few essential steps can go a long way in treating your acne. Wash your face twice a day with a mild, soap-free cleanser. Apply sunscreen when going out, exfoliate every week, and moisturize in the morning and at night. Use cleansers that contain acne-fighting agents such as sulfur, benzoyl peroxide, and niacinamide.

5. Check Your Diet


When you are stressed, you tend to binge on junk food like chocolates, chips, cookies, pastries, and anything else that tempts your cravings. However, when you are battling breakouts, you need to stay away from foods that have a high glycemic index. These foods worsen existing acne. So, try to have healthy snacks and food items instead.

Lastly, avoid self-medication and trying out every acne solution you can get your hands on. While you can try over-the-counter products, it is better to consult a dermatologist first and follow a proper treatment routine. This is because some stubborn forms of stress-related acne may also need oral medication for proper healing.

The next time you start freaking out, remember that stress can not only shoot up your blood pressure but also cause and aggravate acne. So, when you feel like you are on the verge of giving in to stress, slow down. Take a step back. Take a deep breath and do something that can take your mind off the stressor. After all, life is happier when you are stress-free!

Hope this article has helped you understand how stress can affect your acne condition. Have any questions or suggestions? Leave a comment in the comments section below.

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  1. Postadolescent acne in women.”, Cutis, US National Library of Medicine.
  2. The association between stress and acne..”, Clinical, Cosmetic and Investigational Dermatology, US National Library of Medicine.
  3. Involvement of the corticotropin-releasing hormone..”, The British Journal of Dermatology, US National Library of Medicine.
  4. Corticotropin-releasing hormone affects..”, Life Sciences, US National Library of Medicine.
  5. A Study Of Stress In Patients With Acne..”, ResearchGate
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Ramona Sinha

Ramona is a journalist-turned-content writer. She holds a Master’s degree in English Literature and has been writing for the digital world for over five years. She specializes in writing for Skin Care. She has done a certificate course titled ‘Dermatology: Trip To The Skin’, offered by Novosibirsk State University. She believes that beauty begins with a good skin care regimen and is on a mission to eliminate all toxins from her routine. She helps and guides readers in selecting products and ingredients specific to their skin type/issue. When Ramona is not working, her books and passion for music, good food, and traveling keep her busy.