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Can Stress Cause Acne?

Sneha Sunny is a medical doctor who enjoys educating and spreading awareness through her writing.

Stress could be the cause of your acne outbreak!

Stress could be the cause of your acne outbreak!

If you're an adult who struggles with acne, raise your hand.

I'm sure I'm not the only one sitting here with my hand raised, am I?

We are all familiar with acne: the little, inflamed, painful bumps on your face that usually occur during your teenage years. Unfortunately, for some of us, it manages to stick around way past our adolescence and into adulthood.

Not a good feeling, I must say!

There are various causes of adult acne, but can stress cause acne as well?

Chronic stress can cause acne. The chronically elevated level of the stress hormone, cortisol, is the main cause here. It increases the secretion of sebum, weakens our immune system, and causes inflammation. These factors provide the bacteria with a good environment to thrive and cause acne.

Stress is a normal bodily response. It's the response that gets things done. But like all things, too much of it is bad for you. When stress levels start getting incredibly high, it takes a toll on the body, giving rise to conditions like depression, heart disease, and skin conditions, including pruritus, psoriasis, hyperhidrosis, trichotillomania, and, of course, acne.1

How Does Stress Cause Acne?

Stress is regulated by two hormones: cortisol and adrenaline. Together, these two hormones initiate and maintain fight-or-flight response.

However, pimple outbreaks are mainly caused by cortisol— when they are chronically elevated.

When we are under stress our body releases these two hormones to help deal with the problem. In the short term, as mentioned before, it initiates our fight-or-flight reaction. But when cortisol levels in our blood are elevated for long periods of time, it results in systemic inflammation and a weakened immune system. Because of the low immunity, bacteria on our skin can multiply without hindrance.

Cortisol also increases the production of sebum, the natural oil produced by the sebaceous glands in our hair follicles and pores. The oil produced is thick and waxy in consistency, and can easily clog the pores. This traps the bacteria in the pores—a perfect environment for them to thrive.

So, the bacteria multiply trigger an inflammatory response, and causes an acne to develop.

Here's an infographic to sum it in fewer words:

The basic mechanism of acne formation due to stress.

The basic mechanism of acne formation due to stress.

Stress Can Also Worsen Your Acne

Increased inflammation due to stress also affects the nervous system. Hypersensitivity of the nerve endings can lead to itchy sensations—even when there are no actual skin lesions. This mechanism is also responsible for the anxiety-itch that many people who suffer from anxiety get.

These irritations can cause you to want to pick at your acne, worsening it and making it more swollen and red. Not to mention, putting your dirty fingers over your already infected pores doesn't do any good either. All of these factors together delay the healing process and quite often results in scar formation.

It's a vicious cycle: you get stressed, and acne develops. The acne causes you to stress a little more, creating more acne, and so on.

Dear Pimples,

If you are going to live on my face, I need to see some rent.

— Unknown

How to Manage Stress-Acne

I am not going to say "don't stress" because that's not always possible. You can't ask a person suffering from an anxiety attack to not be anxious. That's not how it works.

Stress is a part of our life—it's inevitable. We can't avoid it, but we can sure learn to manage it.

Here are some of the ways to prevent and treat stress-acne.

1. De-stress

Here are a few effective ways to de-stress:

  • Deep breathing: If you are feeling overwhelmed, just sit back and take a few deep breaths. Deep breathing provides an extra boost of oxygen and also stimulates your parasympathetic nervous system, which, in turn, calms you down.
  • Limit digital exposure: Staring at electronic screens for long periods of time has been shown to cause stress, depression, insomnia, etc.2 Try to take frequent breaks, and avoid using electronics before bed.
  • Go for a walk, or do some jumping jacks: Even 10 minutes of exercise has been shown to be beneficial in managing stress. Physical activity releases endorphins—the feel-good hormones—and also reduces circulating levels of stress hormones.3
  • Journaling: Jotting down your thoughts and feelings is another great way to de-stress.4 When you feel stressed, simply write down what's bothering you and how you are feeling. You will feel a lot better once you spill out the truth.
  • Meditation: Just 20 minutes of meditation each day can significantly reduce your stress level and help you have a positive attitude throughout the day.5

2. Take Care of Your Skin

When we are stressed, taking care of ourselves often becomes the least of our priorities. This plays a big part in causing and maintaining acne during stressful times. It is essential that you make a conscious effort to take care of your skin.

If you are someone who faces a lot of stress, or you just have acne-prone skin, a few things you can use daily to prevent acne are:

  1. Salicylic acid face washes: Salicylic acid is a beta-hydroxy acid. It helps clear up the oils, unclogs the pores, and lets them breathe. It is very gentle on the skin, so it's appropriate for everyday use.
  2. Mud masks: Mud masks soak up all the oils, and thus helps prevent acne. When your skin starts feeling oily, put on a mask for 15 minutes and wash it off. It's even better if it has charcoal in it as charcoal is really good at absorbing impurities and detoxifying.

3. Get the Appropriate Treatment

The pimples already on your face are still pimples, and they're not going to go away just by relaxing and meditating. De-stressing will prevent acne formation, but won't treat the existing acne.

It is best to consult your doctor for the appropriate acne treatment.

  • For mild cases, you can use benzoyl peroxide gels—available in 2%, 5%, and 10% formulas and prescribed depending on the severity. Note: They are not to be applied to the entire face. Use them only as spot treatments. Other formulations of clindamycin gels and adapalene gels are also very effective (and my personal favorites)—again, only for spot treatment.
  • If it's a severe acne outburst, I suggest you see a doctor. Your doctor will provide topical or oral medications to help treat your acne. Your doctor may prescribe you antibiotics, retinoids, and/or steroids, depending on the severity.
  • If your stress level is very high—higher than what you can handle—consider visiting a doctor or therapist for help. They'll be able to recommend the appropriate therapies or prescribe you anti-anxiety medication to help you calm down.

4. Watch What You Eat

Stress can cause you to overeat—particularly foods that are high in fat and sugar—since stress stimulates the release of the appetite hormone ghrelin.6

Both sugary and fatty foods will further promote acne formation.7

You might want to stress-eat, but stress-eating doesn't have to be unhealthy. Make a habit of reaching for healthier food options.

Other Causes of Adult Acne

While stress is one of the most common causes of acne in the modern world, it's definitely not the only cause of adult acne.

Here are a few other ways you can get adult-acne:

  • Hormone fluctuations: You are prone to acne during PMS, pregnancy, use of birth control pills, if there is a high level of testosterone in your body, and also in PCOS (polycystic ovarian syndrome).
  • Unhealthy diet: Packed and processed foods are not helping you in any way. They are adding to your waistline, and are also giving you acne.
  • Comedogenic products: Avoid oil-based products, especially if you have oily skin. Go for water-based products or the ones labeled as "non-comedogenic."
  • Cell phones: Our cell phone screens are actually very dirty. Now you know the cause of your acne if you are getting them only on one side of the face, where you most often put your phone when you talk. Consider cleaning the screen every now and then.
  • Environmental causes: Pollution is a huge factor, especially if you live in a huge city.

Lifestyle Changes to Reduce Break Outs

I would like to repeat one more time: we can't avoid stress in our daily lives, but we sure can learn to manage it.

  • Take some time out every day to de-stress.
  • Take care of your skin, something we forget to do when we are under stress.
  • Mind what you eat—again, something we tend to overlook.

What we do, what we eat, and how we react all play important roles in acne development. Follow these effortless steps, and your stress-acne will reduce to a great extent.

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  1. Schut, C, et al. (2016). Psychological Stress and Skin Symptoms in College Students: Results of a Cross-sectional Webbased Questionnaire Study. Acta Derm Venereol, 96(4): 550-51.
  2. Thomee, S, Harenstam, A, and Hagberg, M. (2011). Mobile phone use and stress, sleep disturbances, and symptoms of depression among young adults - a prospective cohort study. BMC Public Health, 11: 66. Retreived from
  3. Harvard Health Publishing. (Feb 2011). Exercising to relax. Harvard Men's Health Watch. Retrieved from
  4. The Huffington Post. (13 Feb 2013). 5 Ways Keeping A Journal Can Help You De-Stress. Huffpost India. Retrieved from
  5. Mayo Clinic Staff. (17 Oct 2017). Meditation: A simple, fast way to reduce stress. Mayo Clinic. Retrieved from
  6. Harvard Health Publishing. (Feb 2012). Why stress causes people to overeat. Harvard Mental Health Letter. Retrieved from
  7. Baldwin. H, and Tan. J. (2021) Effects of Diet on Acne and Its Response to Treatment. Springer Link. Retrieved from y

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2018 Sneha Sunny


Sneha Sunny (author) from India on December 12, 2018:

@vivek.. Thank you so much for the kind words! I'm really glad you found it informative. Thanks for stopping by.

Vivek on December 11, 2018:

Excellent Infographic and a really informative and well-researched article as always. Keep writing. Hubpages and this world needs qualified writers like you. :)