Stress and Acne: Does Stress Affect Acne?

Does stress affect acne? This question about the stress and acne relationship has long been debated by dermatologists, medical scientists and patients alike. Actually, as a practicing dermatologist, and one particularly interested in psycho dermatology,  I feel this debate to be superfluous. The only thing that should be debated is how deep the effects of stress on acne are and vice versa!

Stress and prolonged, uncontrolled tension, anger, anxiety all are the nemesis of good health in general and healthy skin in particular. If you are stressed out, it will reflect on your skin first! Changes in the blood flow due to the emotional and neurological effects, continuous perspiration, the neuronal irritability induced by release of chemical mediators within the skin will all make the skin itchy and irritable.  Many stress related diseases like psoriasis, pruritus, urticaria, alopecia areata, atopic dermatitis etc. manifests themselves to damage the structure and integrity of the skin.

Stress and Acne: Does Stress Affect Acne?

Evidence is steadily building up that stress does indeed affect acne, deeper than was previously believed.

Many studies indicate that stress plays a very important role in causing, maintaining and aggravating acne. The largest study ever conducted on teen acne severity and stress levels by researchers from Wake Forest University School of Medicine and reported in the Acta Derm Venereol , revealed that teenagers who were under high levels of stress were 23 percent more likely to have increased acne severity.

In yet another study on stress and acne published in Archives of Dermatology, a team of researchers led by Dr Alexa Kimball from Stanford University, studied 22 university students with varying degrees of acne. They found the students had worse acne during exam periods, when they also rated their stress as higher. The link remained even after other factors such as changes in sleep hours, sleep quality, diet, and number of meals per day were taken into account.

A similar study conducted among 19 college students by Chiu A et al., also published in Archives of Dermatology, confirmed that increased stress levels were strongly correlated with increased acne severity.

Another study on stress and acne relationship, published in the Proceedings of the National Academy of Sciences, detected a possible chemical relationship between stress and acne. Stress causes the hypothalamus, a portion of the brain, to release a chemical called corticotropin-releasing hormone (CRH). This study found that the sebaceous glands in the skin respond to CRH through certain CRH-receptors present on the oil secreting cells of the gland . When the CRH come into contact with CRH-receptors ,the  sebaceous glands are triggered to produce more sebum, thus inducing an outbreak of acne.