The Ultimate Question: Does Stress Cause Acne?

The Ultimate Question

Apparently, it’s not just your imagination.

Those zits that form during your exam week. Those big red angry spots on your face just before your final interview- or your first date.

You might have noticed your skin breaking out more when you’re overwhelmed, and, actually, it isn’t just a coincidence. Stress has been closely linked with acne.

But how exactly does it happen?

Stress And Your Immune System

Stress, whether it’s psychological, emotional or physical, can cause a lot of changes in your body. One of its most specific effects involves your immune system.

When your body experiences stress, it engages in what science calls the “fight or flight response”. This reaction leads to the production of several stress hormones, including cortisol and adrenaline.

Between the two, it is cortisol that creates problems for your skin.For one, cortisol lowers your immune system. When your immunity is lowered, your body’s ability to heal and repair itself become greatly impaired.

It also makes acne-causing bacteria, particularly Propionibacterium Acne, become harder to ward off.Aside from these effects, cortisol can also enhance sebum production. It triggers excessive oil production, which can end up clogging your pores.

And that’s not all.Because your body needs energy to cope with the stress, your blood sugar level consequently increases, too. This prompts the release of insulin, in an attempt to retain your body’s balance.

The Ultimate Question: Does Stress Cause Acne?

Alternative Health Concepts

Unfortunately, as insulin is released, so is androgen- a hormone that can also affect sebum production.

But does stress cause acne?

There are no conclusive studies that can tell if stress can cause acne or not; but there are some studies that suggest it can aggravate existing acne.

One of these studies is done by the Stanford University. In the study, experts found out that patients experienced changes in the severity of their acne as stress was increased.

The same link has been established by the researchers in Wake Forest University. However, in this particular study, it wasn’t the level of sebum production that caused acne in the patients but it was their level of inflammation in response to stress.

Stress And Too Much Exercise

While engaging in a regular exercise routine can help keep you healthy, excessive exercise, however, is considered harmful for the body. This particularly includes fast running and heavy weight lifting.

These high intensity exercises overstimulate your body’s response system to produce the biochemical reactions previously mentioned.

And it’s not just your skin that’s going to be affected. You can even put yourself at risk of chronic fatigue and even depression.

So, what are the best exercise to avoid breakouts?

It’s good if you can stick with low stress exercises, such as walking and swimming. If avoiding high-intensity exercises is out of the equation, then it’s recommended that you limit the duration and frequency of these exercises.

You should also remember to practice good skin hygiene when you’re working out. While sweating can help eliminate toxins and other waste products out of your body, not washing them completely off of your skin can only encourage bacterial growth.

The Thing About Stress Eating

A lot of people find stress relief with eating. And if you are one of them, you’ll know how great indulging in bars of chocolates and bags of chips feels like.

Unfortunately, although there is relief associated with these foods, the comfort you’ll get is only temporary. And what’s bad is how emotional eating can make you choose the worst foods for your skin- sweet, fatty and high in calorie.

Exactly the things you need to avoid if you want to bust acne.

Besides the type of food, stress eating can also make you eat more than you should. The quantity and the quality of food you consume when you’re stress, in the end, don’t only compromise your skin, but it can also affect your weight.

Stress And Lack Of Sleep

When you’re under stress, the anxiety and tension can make it hard for you to sleep. For some people, although they were able to fall asleep, they still wake up feeling tired and exhausted.

Quality sleep is important to assist your body in repairing itself. When you sleep late or when you don’t get enough sleep, your body experiences stress and initiates all the reactions related to it- cortisol release, insulin and inflammation.

And it won’t be just your skin suffering.

Sleep deprivation can also affect your concentration and mental processes. It can make you feel more tired than usual and, not to mention, grumpy.

The right amount of sleep, contrary to what most people believe in, does not rely on numbers solely. You can sleep for 10 hours a day and still wake up feeling like you haven’t really had any rest.

The right amount of sleep should make you feel energized and refreshed upon waking up. You shouldn’t feel drowsy or even lethargic.

But, of course, oversleeping is bad, too. It’s been closely associated with a lot of negative physical effects, including headache and depression.

Is Stress Making You Breakout?

There are no definitive tests that can answer that question for you but there is something you can do to figure it out.

You can keep a stress journal to keep track of your daily events.By keeping a tab on things, you’ll be able to determine the reasons why your skin keeps on breaking out.

Remember, stress-induced acne doesn’t look different from any other types of acne so it will really help if you pay close attention to what’s happening around you and how it’s affecting you.

Here are some of the things you can include in your journal:

  • A list of events that are currently making you feel stressed out
  • Their effects on your physical, mental and emotional health
  • Things you do to cope

Your journal doesn’t have to be too detailed but it should be enough to help you figure out what’s causing your acne. You can keep your notes in your purse or car, where you can easily access it.

Is Stress Management Enough?

Now, you might be thinking, if stress is making you breakout, will stress management be enough to prevent acne?

The answer is “possibly”.

The effects of stress on your body is only a part of the reasons why your skin is breaking out. There are still a lot of things you need to consider if you really want to have clear skin.

But why did I say possibly?

It’s because when you’re stressed out, there are tons of things that can occupy your mind. This means less time and energy for you to take care of yourself.

You may forget to completely get rid of the makeup on your face before hitting your bed. You can miss out on using your acne products and to change your dirty pillowcases.

In comparison, when you’re not stressed, you become more aware of your body’s needs. You have the time and energy to happily take care of yourself.

And this is where stress management takes a big role. By engaging in stress eliminating techniques, you’ll be able to remove the factors that distract you from taking good care of your skin and your health.

Some of the best techniques you can use include:

  • Yoga
  • Guided imagery
  • Meditation
  • Hypnosis

Beating Stress-Induced Acne

So, now you know how stress makes you breakout but what should you do?

Aside from properly addressing stress, you need to pay more attention to your skin during this time. Adapting a special skin care routine would really help.

Here are some of the things you can do to take care of stress-related acne:

Spot Treatment

The best spot treatment products contain salicylic acid or benzoyl peroxide. They can also have antibacterial agents to kill off the bad microorganisms on the surface of your skin.

They are typically formulated to be more potent than the other products you apply to the rest of your face. The sooner you apply them, the better the results you’ll get.

Spot treatment products are best applied after cleansing and toning your face. Make sure you let all the other products dry thoroughly before spot treating.


Because stress makes your skin produce more oil than usual, it begins to get clogged and dull. During times like this, your reliable facial cleanser may not be enough to clear your skin.

To look fresher and more radiant, exfoliation may be necessary. You can use either a physical or a chemical exfoliant, depending on your skin type.

For sensitive skin, however, it may be best to stick with chemical exfoliants as they can provide a gentler way of shedding dead skin cells.

Boost The Good Bacteria

When you’re stressed, it becomes easier for toxins to get released into your bloodstream. This, in effect, triggers inflammation.

To boost your immune system, it can help if you can add probiotics to your diet. These good bacteria have anti-inflammatory and antibacterial properties.

They are also found to be helpful in enhancing your skin’s barrier while addressing acne and rosacea.


Stress, in a way, is considered good for you. It can make you more alert and focused to perform at your best.

Unfortunately, when stress happens frequently and for long periods of time, it becomes detrimental to your health, particularly your skin. During these times, it’s essential that you know how to give your skin the extra care it needs to stay clear and radiant.

How do you handle stress? What extra skin care do you do to look fresh?

The Ultimate Question: Does Stress Cause Acne?

Dr Kathleen May Eusebio-Alpapara

A board-certified dermatologist who practices both medical and cosmetic dermatology

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