Stress Management Effects on Health The Link Between Stress and Adult Acne Breakouts can be exacerbated when your body is in a stressed state By Elizabeth Scott, PhD Elizabeth Scott, PhD Twitter Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing. Learn about our editorial process Updated on October 07, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change. Learn about our Medical Review Board Print B2M Productions / /Getty Images 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. Could Anxiety Be Giving You a Rash? 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. Jović A, Marinović B, Kostović K, Čeović R, Basta-Juzbašić A, Bukvić Mokos Z. The Impact of Pyschological Stress on Acne. Acta Dermatovenerol Croat. 2017;25(2):1133–1141. PMID:28871928 Ganceviciene R, Graziene V, Fimmel S, Zouboulis CC. Involvement of the corticotropin-releasing hormone system in the pathogenesis of acne vulgaris. Br J Dermatol. 2009;160(2):345–352. doi:10.1111/j.1365-2133.2008.08959.x Ju Q, Tao T, Hu T, Karadağ AS, Al-Khuzaei S, Chen W. Sex hormones and acne. Clin Dermatol. 2017;35(2):130–137. doi:10.1016/j.clindermatol.2016.10.004 Dreno B, Gollnick HP, Kang S, et al. Understanding innate immunity and inflammation in acne: implications for management. J Eur Acad Dermatol Venereol. 2015;29 Suppl 4:3–11. doi:10.1111/jdv.13190 Dréno B. What is new in the pathophysiology of acne, an overview. J Eur Acad Dermatol Venereol. 2017;31 Suppl 5:8–12. doi:10.1111/jdv.14374 Lane JD, Adcock RA, Williams RB, Kuhn CM. Caffeine effects on cardiovascular and neuroendocrine responses to acute psychosocial stress and their relationship to level of habitual caffeine consumption. Psychosom Med. 1990;52(3):320–336. doi:10.1097/00006842-199005000-00006 Additional Reading O'neill AM, Gallo RL. Host-Microbiome Interactions and Recent Progress Into Understanding the Biology of Acne Vulgaris. Microbiome. 2018;6(1):177. doi: 10.1186/s40168-018-0558-5 Salem I, Ramser A, Isham N, Ghannoum MA. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol. 2018;9:1459. doi: 10.3389/fmicb.2018.01459 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. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Stress Management Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.