The Link Between Stress and Adult Acne

Breakouts can be exacerbated when your body is in a stressed state

Woman squeezing pimple in mirror

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If it seems as though you experience more breakouts when you're under a lot of stress, you may be noticing more than a coincidence. Stress doesn't cause acne outright, but research shows that stress triggers hormonal changes that may worsen acne in people already prone to pimples. While you may end up needing to take several approaches to clear your skin, reducing your stress level may end up being an important one for you for this reason as well as the prevention of other, often more serious health problems.

Stress Hormones and Your Skin

Acne-prone skin is the result of a combination of factors that lead to blocked pores, some of which are influenced by hormones—cortisol and androgens, for example—that are secreted by the endocrine system in response to stress.

These hormones escalate the production of sebum, a protective, oily substance naturally produced by glands near skin hair follicles inside of the pilosebaceous unit as part of the skin's immune system. High population levels of Propionibacterium acnes, a bacterium living in human skin that feeds of sebum, puts stress on the pilosebaceous duct and catalyzes an immune system response.

White blood cells attracted to this bacterium secrete an enzyme that may damage the wall of the hair follicle, releasing its contents into the hair shaft, leading to an inflammatory reaction.

Each of these factors individually and together contribute to the ecosystem that gives rise to and perpetuates acne.

Interestingly, there is some research suggesting that individual differences in the bacterial populations of the gut microbiome, which are impacted by stress and which play a modulatory role on systemic immunity, may also affect acne.

Signs Your Acne Could Be Affected by Stress

Seeking the help of a dermatologist is the best way to determine the best acne management plan for you. That said, if you are feeling consistently stressed, there is only benefit in considering that it could be a factor in your acne—especially if you've focused on other contributors without much success.

While you can't determine whether stress is influencing your acne conclusively, try taking note of when you get stressed and when you break out over a few weeks (consider keeping a journal). Then, compare these time points to see if there are any correlations.

  • If the breakouts tend to match up with the times that you are feeling stressed, there may be a link.
  • If the breakouts do not tend to match up with the times you are feeling stressed, the acne is more likely to be related to environmental factors. Check to see if you always get your pimples in the same spots, such as on the side of your face where you hold your phone.

Also consider that the worsening of your acne could be related to stress-driven habits, rather than the stress itself. For example, drinking more coffee or using other stimulants can also lead to an increase in your production of cortisol and have an impact on your microbiome.

Adult acne can also be worsened by overlooking your personal hygiene needs, changing your diet, or rushing your skincare routine—all things that can easily happen when you're feeling stressed.

Reducing Stress-Related Breakouts

Improving your acne, no matter the type or cause starts with a dedicated daily skincare routine. If stress is a contributing factor, reducing your levels may actually be all you need in addition to this to tame your skin.

Try to recognize and remain mindful of when you are most likely to get stressed so that you can come up with preventative strategies. This is highly personal, and doing it successfully can take time and increased awareness. Find—and dedicate yourself—to the strategies that work best for you.

In addition, to help combat any changes to your gut that stem from stress, eat healthy meals that are good for your gut bacteria.

A Word From Verywell

If these approaches are still not working, speak with your dermatologist who may suggest additional strategies, such as over-the-counter or prescription acne treatments. Acne is an issue that affects millions and millions of people, so it's also important to understand that you're not alone, that it's nothing to be ashamed of, and that it is treatable.

6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Dreno B, Gollnick HP, Kang S, et al. Understanding innate immunity and inflammation in acne: implications for managementJ Eur Acad Dermatol Venereol. 2015;29 Suppl 4:3–11. doi:10.1111/jdv.13190

  5. Dréno B. What is new in the pathophysiology of acne, an overviewJ Eur Acad Dermatol Venereol. 2017;31 Suppl 5:8–12. doi:10.1111/jdv.14374

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Additional Reading

By Elizabeth Scott, PhD
Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.