Stress does not cause acne, but it can trigger or worsen it by changing a person’s hormone balance.

Stress can affect a person’s hormonal balance and the skin’s immune function. When a person is stressed, the body releases cortisol. This may lead to a worsening of acne.

This article discusses who gets acne and what factors cause it. We explore what the research says about the links between stress and acne and provide tips and advice about managing the conditions.

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According to the American Academy of Dermatology Association (AAD), acne is the most common skin condition in the United States, affecting up to 50 million people annually.

Acne occurs due to clogged pores, and scientists believe hormones play a role in its development. It usually begins in puberty and affects many adolescents and young adults. However, the AAD explains that it can occur at any stage of life:

  • Neonatal acne: This type of acne occurs in around 1 in 5 newborns, usually appearing between the second and fourth weeks of life. It goes away on its own without causing scars and does not increase the risk of developing severe acne later in life.
  • Infantile acne: Rarely some children develop acne between 3 and 6 months of age. It may cause deep acne nodules and cysts and lead to permanent scars.
  • Teenage acne: The most common type develops during puberty due to androgens hormones increasing the size of the skin’s oil glands.
  • Adult-onset acne: This is most common among females going through menopause and those with polycystic ovary syndrome due to fluctuating hormone levels. However, it can also occur in males and may develop as a side effect of medication or hair and skin products.

Additionally, other factors may cause or worsen acne. These include:

  • family history
  • age
  • medications
  • smoking
  • diet
  • environmental irritants
  • pressure from sports helmets, tight clothes, or backpacks
  • stress

According to the AAD, stress cannot cause acne, but it may worsen it if it already exists. Studies suggest that when stress intensifies, the severity of acne increases.

However, limited research has attempted to identify how stress is linked to acne and could potentially cause or worsen it. For example, research in 2020 and 2007 suggests that there could be several mechanisms involved:

  • Hormones: Neuropeptides and hormones involved in stress reactions stimulate the sebaceous glands to produce oils.
  • Inflammation: Stress may increase inflammation of the sebaceous glands.
  • Skin’s defenses: Stress hormones may have adverse effects on the skin’s antimicrobial defenses.

According to a 2018 study, undesirable stressful life events and psychiatric illness were more apparent in acne patients aged 12 to 45 years compared with the control group.

Similarly, another, small 2018 study found that a stress management technique improved symptoms in nearly all female participants.

A 2020 study points out that there is not a one-way relationship between acne and stress. While stressful life events such as university exams or getting married may increase acne lesions, the psychological effects of having acne can interfere with someone’s quality of life, leading to anxiety and depression.

In addition, the researchers found that patients with acne experienced social withdrawal, loneliness, and internet addiction.

A 2020 international panel discussion suggests that doctors should question acne patients about their sleep, stress, and emotions, as these may be triggering factors that they can address.

Other research in 2017 and 2020 supports the idea that psychological factors influence the development of acne.

The evidence suggests that an interdisciplinary approach to acne is necessary, involving dermatologists, psychologists, and psychiatrists.

People can speak with dermatologists, healthcare professionals, doctors, or pediatricians for advice on treating acne.

Depending on the person and the severity of the condition, they may use the following treatments:

The National Institute of Arthritis and Musculoskeletal and Skin Diseases advises that people living with acne can help take care of their skin by:

  • cleaning the skin gently with a mild cleanser morning, evening, and after exercise
  • shampooing hair regularly
  • avoiding rubbing or touching acne lesions
  • shaving carefully
  • using sunscreen and avoiding sunburn
  • choosing oil-free and noncomedogenic cosmetics
  • talking with a doctor if they feel anxious about the condition

Most people deal with everyday stress, but to handle it positively, experts suggest the following for a person:

  • taking deep breaths or doing a breathing meditation to calm the body and mind
  • taking time for themselves
  • getting enough sleep
  • eating a healthy diet
  • engaging in physical activity or exercise
  • talking with friends or family members
  • volunteering in the local community to make friends and feel good about helping others
  • using lists to be organized
  • trying not to deal with stress in unhealthy ways, such as overeating, drinking alcohol, or using drugs or cigarettes
  • getting help from a mental health professional if they need it

Stress may trigger or worsen acne. Doctors can prescribe medications to treat the physical symptoms of it.

In addition, people can use tips from experts to manage stress and seek help from professionals.

Maintaining a healthy lifestyle that includes exercise and a balanced diet and not relying on alcohol or drugs to deal with stress may be helpful starting strategies.