Stress Acne: Causes, Prevention, and Treatment

Stress. It's a powerful emotion that can wreak havoc on your body. One way that stress can appear is on your skin in the form of stress acne. Stress causes acne by increasing oil production and clogging pores, which leads to an overgrowth of bacteria. 

To combat this unwanted side effect of stress, we have created a guide with everything you need to know about stress acne: its causes, prevention strategies, and treatments.

What is stress acne?

Stress acne is a form of inflammatory acne that develops on the face, chest, neck, and back. It's not caused by dirt or bacteria, but stress from periods of high anxiety or stress. Your body reacts to stress by releasing hormones like cortisol which stimulates the production of sebum, the natural oil produced by the sebaceous glands next to hair follicles in the skin as well as creating inflammation. This will cause your pores to become clogged with sebum and dead skin cells which then may cause an infection leading to breakouts. Your skin may have blackheads, whiteheads, red bumps, and bumps with pustules. 

To keep stress acne from forming, you need to manage stress. Stress management includes deep breathing, a good exercise routine, and meditating for at least five minutes, or taking some time in solitude each day. 

What causes stress acne? 

Stress occurs when we are under any kind of pressure or strain, both physical and mental. Stress can be caused by a number of things including work stress, relationship stress, financial stress, and life changes like transitions in careers or illnesses among family members. Regardless of the source of your stress, when your body is stressed out it tends to inflame skin conditions such as acne, eczema, and psoriasis, making them worse. 

There are four main causes for acne and they are:

  • Bacteria, specifically Cutibacterium acnes, which naturally live in your pores and create energy from your sebum
  • General inflammation 
  • Clogged pores 
  • Hormones

The last cause, hormones, is the key component to stress acne. As you become stressed out, your body reacts by creating a hormone called cortisol which can lead to more breakouts.

Who can get stress acne?

Anyone can get stress acne but it's more common in teenagers due to changing hormones. It is also common for stress-related breakouts to be concentrated on the T-zone, forehead, chin area, nose, throat, chest, and back because they are all areas that produce lots of oil. Although it usually occurs in teenagers, acne can also happen to adults who are going through periods of high stress. 

Most people experience stress at some point in their life and anyone who is going through a high-stress period might be susceptible to getting acne, but there are certain demographics that have a higher risk of developing stress acne. These include teenagers, young adults, individuals with low self-esteem, individuals who are overweight or obese, and people who perform manual labor. Stressful periods often include stressful jobs, and feelings of hopelessness and depression. In many cases, stress occurs due to lifestyle choices such as choosing an unhealthy diet or not exercising enough.  

What is the difference between stress acne and regular acne? 

Stress causes inflammation which may result in redness on the face that can appear as pimples so it's easy to mistake for regular breakouts. Most people who get this form of acne also have more outbreaks around their mouth area where the skin is thinner than other areas. It only occurs during periods of high anxiety or increased mental pressure due to stress. Normal acne usually happens throughout puberty when hormones are surging through your body. Some people with stress acne report having fewer dry patches as well from using topical treatments.

How do you prevent stress acne? 

There are three main ways to prevent stress acne:

  • Manage stress 
  • Use skincare products that don't clog pores or make them worse
  • Reduce stress

A good way to prevent stress acne is by managing your stress levels. Taking care of yourself will help too, such as getting exercise regularly and eating healthy meals with a lot of vegetables so you don't starve your body of needed nutrients like vitamins A and C. Cortisol, the stress hormone that can cause breakouts, is also produced when you have a lack of sleep so be sure to get an appropriate amount of rest too. 

Try not to wear makeup, if possible. If you do wear makeup use light products instead of heavy ones that won’t clog pores and make stress acne worse. You should also avoid picking at your skin even if it's stress-related because stress can cause breakouts on areas where makeup settles, like around the mouth area. When you're stressed out, sebum production is increased too so you may want to use a lighter moisturizer rather than an oily one that would only increase oil levels in those problem areas which could lead to more acne.

Lastly, there are numerous ways you can reduce stress but we recommend deep breathing, a good exercise routine, and meditating for at least five minutes, or taking some time in solitude each day. 

How do you treat stress acne?

There are two ways to treat stress acne: topical treatments and prescription medications. Topical treatments kill bacteria on the skin's surface. Prescription medications include oral antibiotics taken by mouth which can affect bacterial levels deep within your pores. Prescription medications should only be used if you have moderate to severe acne breakouts with cysts since some drugs may cause other side effects like changes in moods and risk of depression among others. 

Topical treatments include benzoyl peroxide products applied directly where stress-related breakouts occur and salicylic acid creams that help exfoliate the skin. In addition, you should avoid using products that clog pores or make stress-related breakouts worse which includes both heavy and thick makeup and oily moisturizers. 

Oral antibiotics are useful for stress acne when it's moderate to severe but they also come with a number of risks so be sure to speak to your doctor or pharmacist about this option before taking any medications. If topical treatments aren't enough and oral antibiotics don't work then there is always the last resort: stronger, targeted prescription medications like isotretinoin (the most powerful form) which can lead to other side effects such as depression, among others due to its potency.

If you have a severe case then see a dermatologist for prescription creams, foams, or pills but first, try an over-the-counter topical cream or foam with benzoyl peroxide or salicylic acid before moving onto stronger medications.

Summary

Stress is often cited as one of the main reasons for breakouts in people with acne. But stress isn't the only trigger for stress acne as acne may also be caused by hormonal changes or stress hormones. There are three ways to prevent stress acne: managing stress levels, using skincare products that don't clog pores, and reducing stressors through exercise and eating healthy meals. There are ways to treat stress-related acne: topical treatments such as benzoyl peroxide products applied directly where stress-related breakouts occur as well as salicylic acid creams that help exfoliate the skin and taking prescribed oral antibiotics or acne medication. We hope this article helped clarify what stress acne is, who can get it, and how to prevent and treat it. 

Sources: 

National Institutes of Health – Significance of diet in treated and untreated acne vulgaris

JAMA Dermatology –  The Response of Skin Disease to Stress Changes in the Severity of Acne Vulgaris as Affected by Examination Stress

Harvard Health Publishing – Adult Acne: Understanding underlying causes and banishing breakouts

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