Breaking out? The relation between stress and acne

Medically reviewed by Andrea Brant, LMHC
Updated April 26, 2024by BetterHelp Editorial Team

Stress can be linked to several health challenges, and it can also be linked to the skin. Because stress can cause inflammation within the body and may cause other physiological changes, stress may contribute to acne just as acne may contribute to stress. Understanding how the two overlap may help you understand your body and mental health more profoundly.  

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Feeling weighed down by excess stress?

Understanding skin and acne

Skin is considered the largest organ in the body. While it is often treated as a shield against the outside world, the skin is far more akin to a sponge. Although wrapped around your muscles and skeleton, it is porous and can readily absorb what it encounters. For this reason, paying close attention to what goes onto your skin can be as crucial as paying close attention to what you put into your body.

Your skin comprises several layers, two of which are the most relevant to acne: the epidermis and the dermis. The first layer, your epidermis, is tough and elastic and is responsible for making new skin cells and warding off foreign items. The dermis, the second layer, is more resilient. This layer of your skin is responsible for sweat and oil production, providing blood to your skin, growing hair, and housing nerve endings. The dermis and epidermis can be susceptible to inflammation, bacteria, and clogged pores, all of which may lead to acne. 

What causes acne?

In general, what is acne? There are several types of acne that you may experience, but regardless of how it manifests, acne is often the result of clogged pores. When other factors come into play, blocked pores can become inflamed, painful, and prone to infection.

Acne often begins as a blockage deep within your pores or hair follicles. These follicles may become plugged because of a buildup of dead skin cells, oil, or dirt, resulting in a blackhead (when the plug is exposed to oxygen and becomes dark) or a whitehead (a colorless bump with no visible head). The leading causes of acne include:

  • Excess sebum (oil) production
  • Genetics or hereditary factors
  • Hormonal imbalances
  • Inflammation or irritation
  • Acne-causing bacteria, which feed off dirt and oil on the skin
  • Heavy or oily cosmetic products or failing to remove them altogether each night
  • Excess sweating and high temperatures
  • Humidity
  • Inconsistent skin hygiene

Many factors might predispose you to one or more of these causes. Hormone production during puberty, for example, may cause the skin to become oilier and lead to more clogged pores and breakouts. In addition, inflammation stemming from touching your face often might cause more clogged pores to swell into full-blown blemishes.

The connection between your skin, stress, and acne

The exact link between stress and acne is not entirely known, but there are several theories on why the two might correlate. Stress may impact your relationship with acne in the following ways.

Eating habits 

Stress might lead you to change your eating habits, whether you eat more or less than usual, rely on quick or processed foods, or work in an oily kitchen. Though the link between confident diet choices and skin changes is only partially understood, a diet lacking in specific nutrients, exposure to oils, and processed foods may cause a higher risk for acne and stress. 

Hygiene habits 

Experiencing high stress levels can make it challenging to maintain a consistent routine. Skin prone to acne may benefit from regular or daily care to keep pores unclogged and inflammation at bay. If you’re genetically prone to acne and are experiencing stress, you might struggle to care for your skin and start to have more acne. 

Inflammatory responses 

Stress can raise inflammation levels in the body by inciting the same mechanisms that lead to the fight-or-flight response. When your body is on high alert, inflammation may cause acne to develop.  

Poor sleep 

Stress might leave you tossing and turning at night or otherwise keep you from getting proper rest. Sleep can be an essential time of healing for your body, so too little of it may cause a risk of acne.  

While stress alone may not be the only cause of acne, it can lead to changes in your routine that have the potential to impact your skin. If you are stressed, keeping your health on target can be essential for your mind, body, and skin. 

Does stress directly cause acne?

Although stress is not necessarily directly involved in acne production, it can create an ideal environment for acne to thrive. Because stress responses often cause inflammation and physical illness, the mechanisms involved in stress can negatively impact your skin and other body parts. 

As stress comes and goes, so might your acne. One study found that students reported more acne breakouts during testing than at other times during the school year. Another study discovered that while stress may not directly cause changes to the amount of sebum (oil) the skin produces, it can worsen the severity of acne by changing the makeup of sebum in a way that may produce a more significant inflammatory response.

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How to reduce stress

One of the ways to reduce stress-related acne flare-ups is to reduce stress itself. However, reducing stress can seem easier said than done. In these cases, you can use a few strategies to offer yourself relaxation and inner peace, including the following. 

Exercise

Moving your body is one of the most straightforward ways you may be able to limit stress. Building exercise regimens, practicing meditation exercises, and swimming are a few ways you can improve your mood, brighten your skin, and reduce inflammation. Several studies demonstrate that these physical practices can have significant and lasting benefits. 

Reduce stressors 

Finding ways to cut back on stressors in your life may be possible. Limiting television and computer use may help you unwind and spend more time on activities that bring you genuine relief. In addition, ending relationships that cause you significant stress may be beneficial. 

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Feeling weighed down by excess stress?

Therapy 

Stress relief techniques like the above options can be valuable. However, in some cases, they might not reduce stress. Likewise, acne’s effect on self-esteem can make it challenging to feel in control of your situation. For some, the insight and guidance of a mental health professional, like a therapist, can help. However, if you feel stressed about seeing a therapist in person, a few alternatives, like online therapy, may be more affordable and convenient. 

Online therapy through platforms like BetterHelp can be accessed from anywhere with an internet connection. As stress about work and other responsibilities is a common cause of acne, online therapy often allows you to schedule therapy sessions outside of standard business hours, which can be beneficial in allowing you the time to unwind after a long day instead of adding more appointments to a busy early schedule. 

In addition, studies have backed up the benefits of online therapy, including for those who may have lowered self-esteem due to acne. One study found that online therapy effectively lowered psychological stress levels for some participants. With less stress on your plate, you may be able to focus more on developing strategies that can treat the root of your acne safely and successfully.

Takeaway

Acne is not a one-size-fits-all condition; some may find that their breakouts tend to be worse during periods of stress, and others may not. Many factors go into the development of acne, and stress might be one of them. However, by limiting your stress and working to get the care to feel supported and empowered, you can see improvements in your skin and overall well-being.
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