Are breakouts worse with stress?
Acne and stress
What causes acne?
Acne impacts up to 85% of individuals between the ages of 12 and 24. There are many components that contribute to acne at the level of the skin, which include an overproduction of oil (or sebum), shedding of our skin cells, infection of hair follicles by a bacteria called p.acnes, and inflammation.
Other areas of our health however also contribute! This may include hormones, inflammation, gut health (and the health of our microbiome), diet, smoking, genetic predisposition and psychological stress.
In the past stress, anxiety, depression and acne have been looked at as products of acne - those with worse acne often have worse anxiety or depression. However we are starting to understand that increased stress and worse mood might also contribute or cause some acne.
How does stress contribute?
Have you ever experienced a break out while undergoing an exam period or big move? Well it’s likely that your stress is contributing! Recent research has shown that not only does stress worsen acne exacerbations, but that this can happen within two days following a stressful event.
We don’t fully understand why - but we do know that psychological stress can alter how our immune system functions at the level of the skin and therefore alter the barrier of the skin. This can leave us susceptible to more acne lesions - as the integrity of the skin barrier and immune system is impacted, opening us up to the possibilities of more infections from p.acnes bacteria.
Additionally, when we under go stress, our body releases a slew of hormones and chemicals that alter many pathways which overlap with acne. This leads to short terms changes in the way we metabolize glucose or blood sugar, increased inflammation, and other immune system changes which eventually show up in our skin surface.
The act of skin picking, or compulsively popping and picking at acne lesions occurs more often in individuals with underlying mental health (anxiety, depression, emotional problems) and in adolescent girls. This skin picking leads to increase excoriated acne - acne that is scabbed or scarred from the physical trauma of picking at the skin.
It’s been found that research based stress reduction techniques (such as cognitive behavioural therapy) can lead to improvement in both mental health and acne. This benefit in acne comes subsequently from an improvement in mental health - when patients are feeling better they are able to follow the treatment protocol overall but specifically the instructions: don’t pick.
Need support with your stress or acne?
Consider working with our naturopathic doctors, and/or nurse practitioner psychotherapist for support with your mental, physical and skin health!