Acne is known to cause stress, anxiety and depression. The effects of stress in causing or worsening acne have not been studied as widely. Together stress and acne comprise a vicious cycle. 

A study of 1400 Japanese teenagers, found that about half of these were experiencing acne. Those who did had poorer mental health, and they were asked what they thought triggered exacerbations of their acne. Stress, lack of sleep and sweating were the top three factors they mentioned. 

Twenty-two students at Stanford University were shown to have worse acne at exam times. Also the students who reported the worst exam stress had the worst exacerbations of their acne.  

So why might stress induce acne? 

It looks like there are both direct and indirect links. 

Stress causes increases in stress hormones, particularly neuropeptides (hormones that are made in the brain). These directly influence sebaceous glands causing more sebum production resulting in an oilier skin. Also these hormones can conversely dry the skin and reduce the function of the skin barrier which protects it against infections and other harmful substances from entering the skin. 

What about more indirect effects? 

Stress is associated with poor sleep quality, which in turn worsens acne, probably by reducing the effectiveness of our immune system. 

Stress also has an effect on our gut bacteria, upsetting a healthy balance, and this effect on the microbiome can exacerbate acne. Stress can also induce less healthy eating patterns, notably cravings for refined carbohydrates (such as white bread, cakes, pastries, biscuits and fast food) which in turn has been shown to make acne worse. 

So, if there is good evidence that stress can worsen acne by various means, what can be done to interrupt these vicious cycles? 

Perhaps obviously, anything that reduces stress may well also reduce the severity of acne. How to manage stress may often relate to its causes, and it may be that a change in life circumstances could be needed. More generally, things that help stress levels include exercise, relaxation techniques, yoga and meditation. 

If stress is exerting its effects on your skin through diet and your gut bacteria, then this can be remedied by looking after your microbiome. 

If poor sleep is contributing, then this too can be improved through various techniques collectively known as “sleep hygiene”.

Having an effective skincare regime for managing your acne should run alongside your stress management strategies – developing a quick, easy routine using clinically effective skincare should be part of your day and can become part of your winding down; applying the LUSTRE device before a 20 minute period of relaxation could be the daily habit required to minimise the stress caused by having acne – thus helping to break the vicious circle.