Why does stress cause acne?

How stress turns into a breakout

Stress changes hormone levels, including cortisol, often called the stress hormone. The extra skin oil feeds into the same process that causes acne at other times. Sebum, the oil that keeps skin from drying out, mixes with dead skin cells and plugs a pore. Bacteria that normally live on skin can then grow inside the blocked follicle, causing inflammation: swelling, redness and pain. Stress adds to an existing acne process rather than creating a separate kind of pimple.34

Acne tends to become more severe as stress intensifies. The relationship can also run both ways: stress worsens a skin condition, and living with that condition creates more stress. Treating the acne and managing the stress together addresses both sides of that cycle.12

Is stress the only reason you are breaking out?

No. Genetics, hormonal changes and some medications can contribute to acne. Too little sleep can also worsen breakouts, so a stressful stretch with poor sleep can involve more than one aggravating factor. Oily hair and skin products can clog pores, even when the bottle has excellent graphic design. A breakout during a stressful week does not mean stress explains every spot.134

What helps during a stressful stretch?

• Address stress alongside acne treatment. Meditation, yoga, visualization and breathing exercises can help reduce stress.
• Use gentle skin care rather than scrubbing harder. Scrubbing and picking or squeezing blemishes can worsen acne.
• Avoid oily skincare, makeup and hair products that contribute to clogged pores.
• For adult acne, a gentle cleanser containing glycolic acid or salicylic acid is an option. Strong acne products can irritate skin and be too drying for aging skin.

Stress management is a useful companion to acne treatment, not a replacement for it, so meditation does not need to moonlight as a cleanser. If stress feels too much to handle, a therapist or support group can help. You do not have to solve the stress first before getting help with the acne.2

When should you see a dermatologist?

See a dermatologist if pharmacy acne products are not working, or if you have deep, painful breakouts. A dermatologist can identify contributing factors, choose targeted treatment and help prevent scarring. If acne starts for the first time in adulthood, tell your doctor about medicines you take or have recently stopped. Medication changes can contribute to breakouts, and assuming the cause is stress could miss another factor.234