Say goodbye to stress acne

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How are stress and acne related?

Tips for reducing spots caused by stress

Our skin is our largest organ and a mirror of our physical and mental wellbeing. 

As anyone who has experienced it knows, living with blemish-prone skin and acne can be very stressful. You can read more about that in the psychological impact of acne.

In this article we look at the impact that psychological stress in either our personal or professional lives can have on our bodies in general and our skin in particular. We explore the relationship between stress and acne, how stress might either cause or exacerbate blemishes and some of the things we can try to help reduce stress and minimise its impact on our skin.

What is stress and how does it develop?

What is stress and how does it develop?

Stress is a very individual matter: for some it is a stimulant, while for others it is a pressure.1 When it is a pressure, people react differently. Some panic in the face of seemingly minor problems, while others remain calm when dealing with greater difficulties.

There is a difference between 'good stress' (eustress) and 'negative stress' (distress). In stressful situations the body produces hormones such as adrenalin and cortisol, blood pressure rises and the body goes into alert mode. For our ancestors it was advantageous for survival to be in this state in dangerous situations and to be able to fight or flee.


Stress these days has diverse causes. These can include: psychological burdens, frustration at work, distress in one's private life, problems with relatives or friends and illness. Pressure continues to grow as people feel they are expected to look great, be healthy, do sport, maintain friendships, be well-informed, etc. − and all the same time. It’s clear that many of us find it increasingly difficult to come to terms with these continually growing demands. And the consequences are apparent: the number of psychological disorders culminating in burnout has been rising for years.2

How could stress cause or trigger acne?

Stress can disrupt the metabolism: you may have trouble sleeping, your digestion suffers, you can feel depressed and perhaps irritable and out of balance. And, for many people, it’s not long before the effects show on the skin. It becomes itchy with a tendency towards redness and blemishes appear.

Emotional stress has long been associated with acne but research suggests that, until recently, science has underestimated the impact it has on acne severity.1

When we’re stressed, our bodies produce hormones (such as cortisol and adrenal androgens), neuropeptides (nerve proteins such as endorphins and insulin) and inflammatory cytokines (small proteins that trigger inflammation) which influence the behavior of the sebaceous glands and can aggravate acne.1 

You can find out more about the sebaceous glands in the causes and triggers of acne. You can also read more in acne and hormones.

Numerous research reports, many of which are questionnaire-based, suggest that acne patients associate their condition with stress, with between 50% and 80% of them agreeing to statements that stress makes acne worse.1 One study shows that patients with acne reported a lag time of two days between a stressful episode and the exacerbation of acne. 1

Stress can also cause some people to pick at their blemishes which can spread bacteria and cause more inflammation so that mild acne symptoms get worse. This is known as Acne Excoriée and you can find out more about it in the different types of acne.

Once blemishes have been triggered, research has also show that stress slows down wound healing by up to 40 %3  so blemishes are likely to take longer to heal.


Research by the University Clinic of Dermatology at Stanford University School of Medicine reveals a pathogenic (i.e. disease-causing) correlation between chronic stress and the worsening of acne.(4)

When the stress levels of the participating students rose – around exam time and under acute performance pressure along with the associated lack of sleep and changes in eating habits – increased pain intensity and a significant prolonging of the wound-healing process was observed. On top of this, skin condition worsened. 

What does stress acne look like?

Stress acne is likely to take the form of an increased number of blackheads (closed comedones), whiteheads (open comedones) and pimples. You can find out more about the appearance of these different types of blemishes in the development of acne.

There are many different forms of acne and you can read more about them in the different types of acne.

When stress goes down quality of life goes up

Person holding a cup of tea while reading a book to relax
Tea and a good book: the epitome of relaxation for many people

A more relaxed life has many possible benefits. For example, did you know that approximately 20 minutes of relaxation can help to accelerate the healing of small wounds5 . Relaxation promotes regeneration and helps to reduce pain.

But what do we mean when we talk about 'relaxation'? It’s a personal thing and one person’s idea of relaxation differs from another’s. Some of us find listening to music calming, others need complete silence to switch off.

Types of relaxation

It’s perhaps helpful to differentiate between physical, emotional and cognitive relaxation:

- Physical relaxation means that tension in the muscles reduces, blood pressure and heart rate decrease and breathing slows down.
- Emotional relaxation is a soothing feeling of wellbeing, inner peace and serenity
- Cognitive relaxation occurs when you get to grips with the thought processes that are fueling anxiety so you feel less stressed and more grounded.

Stress occurs when any one of these is off balance. Clearly, stress isn’t always a bad thing - it’s part of life. An athlete, for example, won’t achieve his or her goal in a state of physical relaxation and cognitive stress can also be a stimulant for some people and in some situations. But constant, daily stress is not healthy. It’s important to work out what combination of physical, emotional and cognitive relaxation works for you personally and to try and achieve that state more often.

Tips for reducing stress

If everything seems to be going crazy around you, and everyone wants something from you at the same time, it’s not easy to keep your cool. Here are some things that you can do to try to stay calm and become more resistant to everyday stress:

    1. Are you being hard on yourself?

    How do you see yourself? Do you have unrealistic expectations of how others see you? These can be good questions to ask yourself to ensure you’re not being too hard on yourself. Many blame the media for setting unrealistic beauty goals. It’s stressful to constantly feel like you’re failing to live up to these goals − especially if your skin is prone to acne. You can find out more about the psychological impact of acne here.

    Try to remind yourself, regularly, that nobody’s perfect. Focus on your strengths, celebrate the positives and try not to dwell on the negatives. This important step can make you happier in yourself, more comfortable with others and reduce your chances of getting stress acne.

    2. Meditation

    Many people find that meditation is the answer for cognitive stress in everyday life. The word ‘meditation’ comes from the Latin ‘meditatio’ meaning ‘to think’ or ‘to be deep in thought’. Meditation is about switching off, listening to yourself and focusing on your body and especially your breathing. It’s important to meditate in a place where you’re really comfortable and to do so in peace and quiet.

    3. Autogenic training

    Autogenic training is a technique that enables you to control your breathing and heartbeat and relax your body with verbal commands. Sometimes compared to hypnosis, it involves a series of six exercises that take time, practice and commitment to master but, once learnt, can be an effective way of achieving deep relaxation, managing chronic stress and avoiding stress spots.

    4. Yoga

    Yoga is a healthy mixture of rest and movement which can have a positive and calming effect on physical and mental wellbeing. It can also be beneficial for your skin. Just a few daily yoga exercises can deliver amazing results, and many remain loyal to this technique for the rest of their lives.

    5. Get your beauty sleep

    Anyone who’s felt moody and irritable after a restless night knows how important a good night’s sleep is for relaxation and balance. Your skin also needs sleep to recover and regenerate. Studies have found that too little sleep can favour inflammation − one of the causes of acne1.

    Just how much sleep you need depends on the individual but between six and eight hours are normally considered optimal. Here are a few suggestions to help you get off to sleep quickly and deeply:
    - Make sure your bedroom is completely dark
    - Somewhere between 15°C and 18°C is the ideal temperature
    - Only use your bedroom for sleeping: don’t work, watch TV or play computer games in the same room.

    6. Try to be more relaxed about work

    The world we work in becoming faster and more complex. We’re expected to complete more tasks in less time and the pressure to be 'always on' can be considerable. This makes some people miserable, frustrated and stressed and can cause stress spots. Try to excel at your role without letting stress get you down. The key to maximum productivity and minimum stress is to plan your day so you have a structure to follow and know what you’re going to work on when. Try to take short breaks throughout the day.

    7. Treat yourself to a wellness day

    Find a comforting ritual that helps you to reduce your stress and treat yourself to it whenever the pressure is getting too much. It could be a relaxing bath with a face mask followed by a pampering session, a monthly trip to a spa, sauna or thermal baths or regular massages. Whatever it is, take time for your body and mind to be in the moment. This will help to relieve tension, reinvigorate your spirits and avoid stress acne. 

    8. Keep fit

    We all know how good we feel after a long walk or run in the fresh air: our minds are alert, our bodies feel alive and our skin looks fresh and glowing. But exercise isn’t just for the body, is improves our mood too by releasing happiness hormones that promote calmness and boost self-esteem. You can read more about this in acne and sport.


    9. A healthy diet

    A healthy diet can help your body to cope better with stress. So what should be on the menu? Nutrient-rich, balanced and natural foods and plenty of fresh and raw produce. They supply the vitamins and minerals that are so important in stressful periods. Coffee, tea, sugar and energy drinks are counterproductive because they tend to stimulate the body rather than help to relax it.

    Healthy eating is particularly important for those with acne. You can find out more in acne and diet.


    10. Work life balance

    Your work-life balance is the relationship between your professional and private life, which should be balanced as much as possible. It may not be problem to neglect one or the other in the short term, but a long term imbalance leads to dissatisfaction and stress. The way you manage time is often a critical factor, so try not to get caught up in time-wasting activities: monitoring social media, updating posts and browsing the internet all take longer than you might think. Try setting yourself clear priorities. This will help to sort what’s important from what is less so.

    1) Impact of psychological stress on acne. Jović et al. Acta Dermatovenerol Croat 2017; 25(2): 133-141
    3) Marucha PT, Kiecolt- Glaser JK, Favagehi M. Mucosal wound healing is impaired by examination stress. Psychosom. Med. 1998;60:362-5.
    5) The Effects of Relaxation Before or After Skin Damage on Skin Barrier Recovery: A Preliminary Study, Robinson, Hayley MSc; Jarrett, Paul FRCP, FRACP; Broadbent, Elizabeth PhD, Psychosomatic Medicine: October 2015 Volume 77 Issue 8 p 844-852


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