Why Stress can Cause Acne and How to Treat Breakouts

You're not imagining it.

For every ominous news headline I see, I get a new pimple. Since pandemics, epidemics, and inflation have become the new normal, my chin and the area around my mouth have been covered in throbbing red zits — no exaggeration.

I can't stop breaking out — and neither can my friends. While my group text and co-workers all have different acne histories, feeling stressed about our health along with the entire state of the world is the one thing that unites us. Of course the easiest way to get rid of stress acne is to calm down, but this is easier said than done.

While I have no control over the news cycle, I do have the power to manage my feelings. Prioritizing self-care is key, whether it be a 10-minute morning meditation session or a mid-day walk on a sunny day.

So, does stress directly cause acne? What are the best ways to get rid of these breakouts? We reached out to two leading dermatologists to find out how stress and acne are connected.

Does Stress Cause Acne?

Am I going to get sick? Is the economy going to go into a recession? There are many unknowns right now. Regularly worrying about being able to afford basic things like gas or rent due to inflation is a prime example of chronic stress. This type of stress causes a spike in the release of the cortisol hormone which stimulates the skin's oil glands and promotes acne.

"Hormones are one of the main contributing factors in acne breakouts and while we typically think about testosterone and progesterone, cortisol is the hormone which increases in the blood at times of stress or with lack of sleep and can trigger acne breakouts by binding it and stimulating sebaceous glands," says Dr. Shari Marchbein, a board-certified dermatologist in New York City.

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What Does Stress Acne Look Like?

For anyone who has a history of acne, you're probably wondering: How do you know if your breakout is related to stress? Consider what the pimples look like and where they are on your face.

"The stress acne tends to be painful, tender, cysts on the jawline, upper neck, and along the hairline," says Dr. Ava Shamban, a board-certified dermatologist in Los Angeles. However, she says medical professionals and other essential workers like supermarket employees who have been wearing masks for extensive periods of time may experience whiteheads or smaller red bumps around their mouths.

Stress can also trigger perioral dermatitis or rosacea flare-ups. "These pimples tend to be bright red," says Dr. Shamban. "You typically see these pimples around the nose and upper lip. They're red and can have a tiny whitehead and they don't leave a mark once they heal."

How to Get Rid of Stress Acne

It's unanimous: Both dermatologists agree that you shouldn't over-scrub your face, apply too many acne treatments, and never pop or squeeze the pimples because doing so causes more inflammation and potential scarring.

As for what you should do? Use over-the-counter acne treatments that contain ingredients like retinol, salicylic acid, or benzoyl peroxide. While cleansing and exfoliation will address acne, Dr. Shamban says it's just as important to hydrate skin. Use a moisturizer like Sente Dermal Repair Cream that's formulated with skin-restoring ingredients to keep sebum levels balanced.

For retinol, Dr. Shamban recommends using Instytutum Powerful RetinOil. "This oil supports gentle resurfacing of dead skin cells keeping pores clean and clear," she says. "It's super nourishing and hydrating, eliminating any dryness or the potential irritants usually associated with retinoids. Bonus: it can be used day or night without any counterintuitive reactions from sun exposure, but it is exceptional as an overnight treatment."

If you prefer salicylic acid, Dr. Marchbein suggests using St. Ives Blackhead Clearing Green Tea Scrub because it's gentle, as well as St. Ives Salicylic Acid Gel Cleanser once a day. Alternatively, "a 1-2% salicylic acid gel can also be used as a spot treatment," she adds.

CeraVe Acne Foaming Cleanser is another solid drugstore option containing benzoyl peroxide. "There are also benzoyl peroxide gels that can be used as a spot treatment," says Dr. Marchbein.

For anyone who can't resist touching or picking their pimples. Try a pimple patch like Zitsticka's, which contains salicylic acid and tea tree oil. "By occluding the pimple, these active ingredients are able to penetrate the skin more deeply allowing them to potentially work better," Dr. Marchbein explains. "Intended to be worn for up to twelve hours, these are spot treatment alternatives but for those with sensitive skin, including these ingredients against the skin may be too harsh."

VIDEO: How to Treat Stubborn Cystic Acne

How Can You Keep Oily Skin Under Control?

Since high cortisol levels kick start the skin's oil glands, you might find your face is oilier than usual. If you find yourself looking super shiny, Dr. Shamban suggests using exfoliating pads once a day like the ones from her product line AVA MD. "Swipe the pad over a clean face starting once a week and move up to two or three times at night before bed," she says. "They're made with pure 5% glycolic acid and 2% salicylic acid. These are the best basic ingredients for acne-prone skin and they help banish blemishes with regular usage."

For a quick fix, both dermatologists are fans of oil-blotting papers because no matter how many times you gently dab one of these sheets on your face, they're not going to make breakouts any worse.

How to Prevent Stress Acne

"First and foremost, get plenty of sleep. When sleep deprived, the body makes more of the stress hormone, cortisol," says Dr. Shamban. "Increased cortisol causes inflammation and stress on the body and can worsen skin conditions such as acne, eczema, and psoriasis, as well as cause an increased breakdown of collagen and hyaluronic acid (the good stuff that gives skin its glow and plumpness)."

As for when you're awake? Drink plenty of water, run, do yoga, read, and meditate. Partaking in any solo activity that helps take your mind off of the news is great for managing stress.