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Stress & Anxiety = Acne?

Henry Vyner, MD, Psychiatrist
Stress & Anxiety = Acne?

Any teenager and common sense will tell you that they outbursts of acne during periods of stress. Let’s take a look at acne and see how stress and anxiety are related to acne. Do stress and anxiety cause acne? Do stress and anxiety exacerbate existing acne? Does acne cause stress and anxiety?

What is Acne?

Acne is a skin disorder. Every year 50 million American develop acne.

Acne is caused by an elevation of androgen hormones. Testosterone is an androgen hormone and the production of testosterone increases in both boys and girls at the beginning of adolescence. This is why so many teenagers get acne.

The function of testosterone is that it generates the development of male characteristics. For example, it causes the growth of hair, a deepened voice, spermatogenesis and increased muscle mass. Testosterone is synthesized in the testes.

But even though testosterone is primarily responsible for male characteristics, girls and women have testosterone in their body too, and this is why adolescent girls get acne too. Women have lower levels of testosterone than men, and it is present in women for two reasons. 

The first reason is that testosterone is a precursor to the estrogens. The estrogens are made from testosterone. The second reason is that it plays a role in causing sexual arousal in women.

Here’s why testosterone causes acne. Every pore in your skin is connected to a follicle that lies beneath the surface of your skin. Each follicle contain a hair and a gland that produces an oil called sebum. The gland that produces the oil is called a sebaceous gland, and the oil is called sebum. The function of the oil is to keep your skin soft. It is your body’s natural skin moisturizer.

When there is an increased production of androgens, as there is in puberty, it causes your sebaceous glands to produce more oil. As a result, there is an excess of oil in the follicles beneath your skin, and the oil flows out of your follicles towards your skin.

As the oil leaves your follicles and moves toward your pores, it drags deal cells and bacteria with it. They block the pore, and get stuck in it. This can cause blackheads and bumps on your skin.

The final step to acne is that your body mounts an inflammatory response to the amalgam of oil, dead cells and bacteria that are stuck in your pores. The inflammation causes pimples, and the swelling, redness and pain of acne.        

  

Stress and Acne

Stress does not cause acne, but it can play a role in causing outbreaks of acne if you already have acne.The reason that stress causes outbreaks of acne is that stress causes an increased production of the androgen hormones by the adrenal glands, and as we already know increased levels of androgens causes an increased production of sebum in your skin, and that sets the whole process going that causes acne. 

This is why stress causes outbursts of acne. Continued stress will also make your breakouts last longer and be more severe. 

Recently, there have actually been scientific studies that have established that stress is associated with acne. For example, a study done at Stanford in 2003 found that students had more outbreaks of acne during exams. Students who reported high levels of stress during their examinations were more likely to have outbreaks of acne during those examinations.A similar study done of high school students in Singapore also found an association between stress and acne.

Anxiety and Acne

There is an association between acne and anxiety. When a person has acne it can cause them anxiety about appearance. And that causes increased levels of stress hormones, and the increased level of stress hormones causes increased sebum secretion and increased acne. In other words, it is a vicious cycle. Acne causes anxiety and stress. Stress causes more acne. And on and on it can go.

Reduce Your Stress and Reduce Your Acne

The best thing to do when you get acne is to try not to worry about it, and to take measures that will improve the quality of your life and reduce your chances of having acne: eat well, get a good night’s sleep and reduce your level of stress.

Meditation has been shown to be reduce acne. Another good path to pursue is to try cognitive restructuring. Take a look at the reasons that your acne is causing you anxiety, and challenge their validity. Perhaps you let those reasons go and stop believing them.

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