Stress and Acne: An Examination and Solutions
In the realm of skin conditions, acne is one of the most prevalent, affecting up to 50 million people in the United States annually, according to the American Academy of Dermatology Association (AAD). While acne is primarily associated with teenagers going through puberty, it can affect people of all ages, including those going through menopause and those with polycystic ovary syndrome due to fluctuating hormone levels.
Acne is not directly caused by stress, but it can worsen existing acne or make it more persistent. This is because stress triggers a series of complex mechanisms that negatively impact the skin.
Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol secretion in the bloodstream. Chronic elevation of cortisol exacerbates skin inflammation and can increase sebum production by the sebaceous glands, both of which contribute to acne flare-ups.
Psychological stress also disrupts the epidermal (skin) barrier, delays its repair, and promotes inflammation. This leads to increased skin sensitivity and heightened reactive responses, worsening existing acne or triggering new lesions.
Stress alters neurotransmitters that regulate skin blood flow and oil production, causing vasodilation and hyperseborrhea (excess oil), which can clog pores and provoke acne.
Moreover, stress affects the gut microbiome and gut barrier integrity, which in turn influences systemic inflammation and skin health. Imbalance in this axis can exacerbate acne severity.
Chronic stress may interfere with wound healing, delaying resolution of acne lesions and increasing the risk of scarring. Stress-related cortisol effects on the skin can also manifest as changes in collagen production and skin texture, further compounding skin barrier dysfunction.
Managing stress and targeting these pathways can help reduce acne severity and improve skin health. Strategies for managing stress include taking deep breaths or doing a breathing meditation, taking time for oneself, getting enough sleep, eating a healthy diet, engaging in physical activity or exercise, talking with friends or family members, volunteering in the local community, using lists to be organized, and getting help from a mental health professional if needed.
In addition to managing stress, people living with acne can help manage their skin by cleaning it gently with a mild cleanser, shampooing hair regularly, avoiding rubbing or touching acne lesions, shaving carefully, using sunscreen and avoiding sunburn, choosing oil-free and noncomedogenic cosmetics, and talking with a doctor if they feel anxious about the condition.
Topical medications for acne treatment may include antibiotics, benzoyl peroxide, retinoids, salicylic acid, or sulfur. Oral medications for acne treatment may include antibiotics or corticosteroids. Superficial chemical peels or surgical procedures may be used to treat acne scarring, and laser and light therapies are also used in acne treatment.
If you are struggling with acne, it is recommended to consult with dermatologists, healthcare professionals, doctors, or pediatricians for advice on treating acne. Remember, stress cannot cause acne, but it may worsen it if it already exists.
References:
[1] Stress and Acne: A Comprehensive Review. Journal of Investigative Dermatology. 2019.
[2] Psychological Stress and Acne: A Review. Dermatology Research and Practice. 2018.
[3] Cortisol and Skin Aging: A Review. Journal of Clinical and Aesthetic Dermatology. 2017.
[4] The Gut-Brain-Skin Axis in Dermatology: From Mechanisms to Clinical Practice. Journal of Clinical and Aesthetic Dermatology. 2018.
Stress, while not directly causing acne, can exacerbate existing acne by activating the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol secretion and inflammation in the skin.
Apart from stress, a healthy diet containing nutrients and avoiding unhealthy diets is crucial for maintaining skin health and reducing acne severity.
Stress can affect the gut microbiome and gut barrier integrity, which in turn influences the skin's health and acne severity.
Managing stress, along with maintaining good mental health, is essential for overall skin health, as it can help improve skin barrier function, reduce inflammation, and prevent acne flare-ups. Additionally, practicing self-care strategies like using a mild cleanser, shampooing hair regularly, and incorporating fitness and exercise into daily routines can aid in maintaining skin health and reducing the impact of acne.
