Stress—an unwelcome companion in this fast-paced world—may also manifest on the skin in the form of acne. Unfortunately, its impact on the skin can be a vicious cycle. If you’re breaking out because you’re stressed, unexpected pimples can stress you out even more. But don’t worry too much—Curology’s team of licensed dermatology providers are here to help.

Does stress cause acne? 

The short answer is: yes, but indirectly. A study assessed the relationship between acne and chronic stress among female medical students at King Abdulaziz University in Saudi Arabia. Results from this study showed that there is indeed a positive correlation between stress and acne severity.¹ When you’re stressed out, certain hormones are released, and that process can lead to acne breakouts.² Factors that may exacerbate the formation of acne during stressful conditions include:

Hormonal changes

When you’re experiencing psychological stress, hormones such as corticotropin-releasing hormone (CRH) and cortisol are released. It may be possible that an increase in these stress hormones might contribute to the formation of acne lesions on the skin.³

Weakening of defense systems

Stress may weaken the body’s defense system.⁴ It impairs the ability to mount a strong immune response against infection. For the skin, psychological stress deteriorates the skin barrier function.⁵ An impaired skin barrier can allow entry of chemicals, allergens, and bacteria.⁶ That may increase the likelihood of an acne breakout.

Picking or popping zits

For some, picking or popping zits may feel like a temporary stress reliever, but that habit causes more harm in the long run. Popping zits can make the acne bacteria spread underneath your skin, and cause inflammation and new breakouts.⁷

Check out our Guide To Big Zits to learn how not to pop that juicy pimple. Pro tip: hydrocolloid bandages like the Emergency Spot Patch and Emergency Spot Patch Clusters by Curology may provide fast-acting healing support for sudden blemishes by absorbing fluid and excess oil. They work as a concealer for blemishes, too!

Facepalming

In a moment of frustration or nervousness, most of us can feel the urge to facepalm. But this behavior can transfer bacteria and make acne worse. If you must touch your face, wash your hands with soap and water first.

How to prevent stress acne 

The best way to avoid these breakouts is to manage your stress—easier said than done, right? But really, anything that you can do to reduce stress can make a difference. Here are some tips to reduce stress levels.

Practice yoga

Yoga can be a powerful technique for managing stress. It relaxes the mind, which consequently may help relax muscles in the body. Yoga has been shown to reduce stress, anxiety, and symptoms of depression.⁸

Get adequate sleep

Getting inadequate sleep may disturb your skin health. Studies show a potential relationship between sleep quality and acne breakouts.⁹ Lack of enough sleep may cause stress, which may trigger acne. Recommended sleeping duration is 8 to 10 hours for teens, 7 to 9 hours for young adults, and 7 to 8 hours for older adults.¹⁰

Exercise

To manage stress acne, it may be beneficial to begin a physical exercise daily routine. Physical activity improves mental health by reducing depression, anxiety, and stress.¹¹ Don’t overthink exercise; it doesn’t have to be expensive. Simple routines such as jogging, swimming, walking, gardening, and dancing could go a long way.¹²

Does diet matter while managing stress acne breakouts?

Stress eating can trigger breakouts—unless fresh vegetables, fruits, and nuts are your idea of comfort food, in which case, we salute you. Eating too many high glycemic index foods, such as simple carbs (cookies, cake, and other sweet treats), can all contribute to acne breakouts.

The latest scientific evidence suggests that diets high in sugar, simple carbohydrate (high glycemic index) foods, and dairy make some people more prone to acne breakouts.¹³ A recent study also showed that low weekly intake of fruits or vegetables and low consumption of fresh fish were also associated with adult acne.¹⁴

Sugar, dairy, and acne

No judgment here—we can all relate to the desire to head to the freezer and treat ourselves to some ice cream, or to indulge in any other of our favorite sweets. But dairy and sugar are two big potential acne triggers.¹⁵ Here’s what you should know.

Does sugar cause acne?

Sugar can cause acne. Spikes in blood sugar can cause inflammation and trigger your body to produce more sebum. Inflammation and excess sebum production may exacerbate acne.¹⁶ In a way, too much sugar may also stress out your body, even if it makes you feel better temporarily.

Does milk cause acne?

All milk contains the hormone triggers and insulin-spikers that can lead to acne in some people.¹⁷ If dairy is a regular part of your diet and you’re breaking out, you might want to try cutting it out for a while and see if it helps. Try dairy-free, low-glycemic alternatives such as almond milk or soy milk instead.

Does alcohol cause acne?

Relaxing with a glass of wine at the end of the day won’t necessarily cause acne, but drinking alcohol (especially to excess) can have a similar effect on your body as sugar and stress. Alcohol misuse may exacerbate acne.¹⁸ Try winding down your day with a cup of herbal tea instead of a spiked hot chocolate or a hot toddy.

How to treat stress acne 

If you’re already experiencing stubborn stress acne, you may want to try out the following treatment options:

Medical therapies

If you are experiencing mild to moderate stress acne, topical retinoids, benzoyl peroxide, azelaic acid, or combinations of topicals are your drugs of choice.¹⁹ They are the first in-line treatment in the management of mild acne. For more severe incidences of acne, recommended drugs may include oral antibiotics such as doxycycline, minocycline, or even isotretinoin.²⁰ With that said, consider consulting your healthcare provider if experiencing severe acne. 

Behavioral therapies

These therapies try to change unhealthy behaviors by changing the thought patterns that trigger emotional stress. Habit reversal therapy is one common behavioral therapy.²¹ It makes you aware of unhealthy behaviors and teaches new alternative behavior patterns to replace the old ones. That may help reduce habits such as picking at the skin and facepalming that may trigger inflammations and cause or worsen acne breakouts.²²

Mind-body therapies

Mind-body therapies aim to improve your overall well-being by improving the relationship between your mind and body.²³ They will help your mind in informing better physical functions. These therapies include meditation, mindfulness-based stress reduction (MBSR), hypnotherapy, biofeedback, and guided imagery.²⁴ Meditation, for instance, is like a soothing balm for your mind, helping it relax and find peace. Meditation will help reduce stress and, consequently, those pesky acne flare-ups by lowering cortisol levels.²⁵

Check on your skincare routine

Adopting a good skincare routine may kick-start your journey of regaining healthy skin.

Curology’s recommended skincare regimen is simple. In the morning, cleanse, moisturize, and protect your skin from harmful UV rays with sunscreen. In the evening, cleanse, treat, and moisturize. 

Curology has various skincare products to help you kickstart your skincare routine. Our skincare products include moisturizers, cleansers, and a broad spectrum SPF 30 sunscreen. Consult our dermatology providers to help you get a prescription that suits your skin type.

Keep calm and put cream on

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Get your personalized skincare routine with Curology

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Treating your skin right can help you to prevent and treat acne, even when you’re under pressure. Using a personalized prescription formula is one of the best ways there is to treat and prevent new breakouts. If you haven’t given Curology a try yet, sign up for a trial* today. Your skin will thank you!

P.S. We did the homework, so you don’t have to: 

1. Zari, S. and Alrahmani, D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clin Cosmet Investig Dermatol. (2017, December 5).

2. Rao, A., et al. Endocrine Disrupting Chemicals, Hormone Receptors, and Acne Vulgaris: A Connecting Hypothesis. Cells. (June 2021).

3. Rao, A., et al. Endocrine Disrupting Chemicals, Hormone Receptors, and Acne Vulgaris: A Connecting Hypothesis. Cells. Ibid.

4. Dhabhar, F.S. Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection and immunopathology. Neuroimmunomodulation. (2009, June 29).

5. Choe, S.J., et al. Psychological Stress Deteriorates Skin Barrier Function by Activating 11β-Hydroxysteroid Dehydrogenase 1 and the HPA Axis. Sci Rep. (2018, April 20).

6. Strugar, T.L., et al. Connecting the Dots: From Skin Barrier Dysfunction to Allergic Sensitization, and the Role of Moisturizers in Repairing the Skin Barrier J Drugs Dermatol. (2019, June 1).

7. Institute for Quality and Efficiency in Health Care (IQWiG). Skin care for acne-prone skin. InformedHealth.org. (2019, September 26).

8. Shohani, M., et al. The Effect of Yoga on Stress, Anxiety, and Depression in Women. International Journal of Preventive Medicine. (2018, February 21).

9. Schrom, K.P., et al. Acne Severity and Sleep Quality in Adults. Clocks Sleep. (2019, December 6).

10. Hirshkowitz, M., et al. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health. (March 2015).

11. Mahindru, A., et al. Role of Physical Activity on Mental Health and Well-Being: A Review. Cureus. (2023, January 7).

12. Sharma, A., et al. Exercise for Mental Health. The Primary Care Companion to the Journal of Clinical Psychiatry. (2006, n.d.).

13. Meixiong, J., et al. Diet and acne: A systematic review. JAAD Int. (June 2022).

14. Di Landro, A., et al. Adult female acne and associated risk factors: Results of a multicenter case-control study in Italy. J Am Acad Dermatol. (December 2016).

15. Penso, L., et al. Association Between Adult Acne and Dietary Behaviors: Findings From the NutriNet-Santé Prospective Cohort Study. JAMA Dermatol. (2020, August 1).

16. American Academy of Dermatology Association. Can the Right Diet Get Rid of Acne? (n.d.).

17. American Academy of Dermatology Association. Can the Right Diet Get Rid of Acne? Ibid.

18. Kazakevich, N., et al. Alcohol and skin disorders: with a focus on psoriasis. Skin Therapy Lett. (April 2011).

19. Eichenfield, D.Z., et al. Management of Acne Vulgaris: A Review. JAMA. (2021, November 23).

20. Eichenfield, D.Z., et al. Management of Acne Vulgaris: A Review. JAMA. Ibid.

21. Graubard, R., et al. Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatol Pract Concept. (2021, October 1).

22. Graubard, R., et al. Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatol Pract Concept. Ibid.

23. Graubard, R., et al. Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatol Pract Concept. Ibid.

24. Graubard, R., et al. Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatol Pract Concept. Ibid.

25. Pascoe, M.C., et al. Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. J Psychiatr Res. (December 2017).

26. Yosipovitch, G., et al. Study of psychological stress, sebum production and acne vulgaris in adolescents. Acta Derm Venereol. (2007, n.d.).

27. Fox, L., et al. Treatment Modalities for Acne. Molecules. (2016, August 13).

28. Sutaria, A.H., et al. Acne Vulgaris. StatPearls. (2023, August 17).

29. Heller, M.M., et al. Stress as an influencing factor in psoriasis. Skin Therapy Lett. (May 2011).

30. Chen, Y. and Lyga, J. Brain-Skin Connection: Stress, Inflammation and Skin Aging. Inflamm Allergy Drug Targets. (June 2014).

31. American Academy of Dermatology Association. Adult acne. (n.d.).

32. American Academy of Dermatology Association. Adult acne. Ibid.

33. American Academy of Dermatology Association. Adult acne. Ibid.

34. American Academy of Dermatology Association. Adult acne. Ibid.

Camille Dixon is a certified Physician Assistant at Curology. She received her Master of Medical Science in Physician Assistant Studies from Midwestern University in Downers Grove, IL.

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Written by

Curology Team

Medically reviewed by

Camille Dixon, PA-C