Say goodbye to stress acne

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.

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

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. 

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.

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.

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.