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Writer's pictureMatteo Catilo
Jul 266 min read

Is Stress Making Your Acne Worse?

A young lady sitting at her desk with a stressed demeanour. Her eyes are closed and she's holding the bridge of her nose between her fingers

You're having a stressful week. A work deadline is fast approaching, your sleep is suffering, and an argument with a loved one is on your mind. To make things worse, you notice more bumps and pimples sprouting on your skin.


As someone who suffers from acne, you may wonder if your stress is to blame.


Relatively few studies have looked into how stress impacts acne, and the reasons why acne worsens can vary from person to person.


If you do have acne, however, scientists suggest that stress can aggravate your symptoms. But how exactly do your stress levels impact acne severity, and what can you do about it?




What is Acne?


Acne is a disease that begins in your pores. These are small holes in the skin that help remove sweat, oil and unwanted toxins. Tucked inside each pore is a sebaceous gland, a tiny organ that makes an oil called sebum.


Things go wrong when excess sebum, hair, dead skin cells or bacteria clog the pore. This irritates the pore, causing it to swell and grow a bump on the skin. These bumps are what we refer to as acne.


Many factors can make pore-clogging more likely. Inflammation, genetics, overactive sebaceous glands and hormonal changes can all contribute to acne formation.



Types of Acne


Several types of acne bumps can develop on the skin. Some are more serious than others, and dermatologists classify them as either 'Mild', 'Moderate' or 'Severe'.


Mild


  • Blackheads  ─ Dark-looking bumps blocked with sebum and dead skin. The bump is open, so oxygen drifts in and reacts with the debris inside. This reaction (oxidation) gives the bump its dark colour.


  • Whiteheads  ─ A white or yellow bump that grows when excess sebum and dead skin cells block and close off the pore.



Moderate


  • Papules  ─ Inflamed, cone-shaped bumps that feel tender when touched. They can be red, brown, purple or the colour of your skin.


  • Pustules  ─ A papule that collects a blob of pus on its tip. The pus is a mix of dead white blood cells that were fighting the infection, as well as other debris.



Severe


  • Nodules  ─ Large, red bumps that form in the deeper layers of the skin. When touched, they feel hard and painful. Nodules can lead to permanent scars.


  • Cysts  ─ Like nodules, cysts are large, painful, and begin growing further down in the skin. They can also produce scarring. Unlike nodules, they feel softer and are pus-filled.





How does Stress Impact Acne?


Researchers have found that stress is not a direct cause of acne. In other words, if you've never had acne before, stress is not capable of giving you the condition. If you already have acne, though, stress can aggravate your existing breakouts.


The exact reasons why are unclear, but scientists have some possible explanations.



It Triggers the Release of Pro-Inflammatory Hormones


During an episode of stress, your brain transmits signals to other parts of the body. One key system that detects these signals is the HPA axis. This is a collection of three organs that help the body respond to stress ─ the Hypothalamus, the Pituitary Gland, and the Adrenal Gland.


When activated by the brain, these organs work together to pump out useful hormones, including cortisol, adrenaline and dopamine. Cortisol controls your stress levels, while adrenaline and dopamine help activate your fight-or-flight response.


While these hormones help regulate stress, they also boost inflammation and sebum production in the skin. This excess sebum can clog your pores and create acne bumps.



It Weakens your Skin Barrier


Your skin's top layer, the skin barrier, is a sheet of dead cells that stops germs and irritating chemicals from invading the skin. It also prevents essential substances like water from escaping.


Stress hormones reduce the amount of fats and proteins in the skin barrier, which impairs its structure. This allows more acne-causing bacteria to enter the skin.


An impaired barrier also loses more water, making it harder to repair itself and heal from acne-related skin damage.



It Makes Your Nerve Cells Release Pro-Inflammatory Molecules


While the HPA axis secretes hormones, your brain is also firing signals to the nerve cells in your skin. In response, they assemble curl-shaped molecules called neuropeptides.


Neuropeptides can impact activity in the skin. When sebaceous glands detect neuropeptides, they release inflammatory chemicals and increases sebum production.




Acne Can Make Stress Worse


Acne and stress have a two-way relationship. Stress can make acne worse, but having acne can also intensify stress. This can trap you in a cycle that can feel difficult to break out of.


Our skin is one of the most visible parts of our body. Its appearance can influence how we perceive ourselves and how we think others perceive us. Having acne can thus distort your self-image, make you self-conscious and lower your self-esteem.


If left unmanaged, this problem can cascade into other mental health issues. Researchers have found that people with acne are more vulnerable to:


  • Loneliness

  • Social anxiety

  • Relationship problems

  • Depression

  • Body shame

  • Internet addiction

  • Obsessive Compulsive Disorder (OCD)

  • Thoughts of committing suicide


If you are dealing with any of these issues, it's important to seek help from a mental health professional, like a therapist. Therapy is a supportive, non-judgmental space to work on understanding and managing your condition.




How Can You Manage Your Stress?


Everybody experiences stress. It's how your body helps you deal with different pressures and challenges across the day. However, stress can be a health concern if it becomes overwhelming and impacts your daily functioning.


If this is the case, seeking guidance from a physician or mental health professional can help you cope.


Incorporating these strategies into your daily routine can also reduce stress:


  • Getting enough sleep

  • Relaxation techniques such as meditation, breathing exercises and yoga

  • Talking to trusted friends and family about how you are feeling

  • Daily exercise

  • Keeping a journal about your stress. This can help you identify meaningful patterns, like what triggers it

  • Eating a healthy diet

  • Reducing your alcohol and caffeine intake.


If you are trying to improve your acne by managing your stress, it's important to remember that acne is a complex disease. Many underlying issues can worsen acne, and stress is only one of them.


These techniques should also not replace standard medical acne treatments, and are best used alongside them.


Talking to a healthcare provider or dermatologist can help you find a treatment plan that works best for you and your skin.




A Quick Review


While stress doesn't directly cause acne, it can make existing breakouts worse.


During a stress response, a surge in hormones and neuropeptides can trigger inflammation and excess sebum production in the skin. Stress also makes the skin barrier more fragile, allowing water to escape and acne-causing bacteria to invade. In combination, these processes can agitate your acne.


Managing your stress can help improve your acne, but it may not be enough to treat it alone. Combining stress-management techniques with medical treatments can be a more effective approach.


If you are struggling with acne, stress or other related mental health conditions, don't hesitate to seek help from healthcare practitioners and mental health professionals. They can equip you with the guidance and support you need to cope with your skin-related issues.


 

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