Stress Acne is Real and Why You May Be Breaking Out Right Now

Curated by Claudia Shannon / Research Scientist / ishonest

At this point, it is not an exaggeration to say that we are all living in a time of unprecedented stress. While the global coronavirus pandemic continues to evolve and our collective feelings of uncertainty about the future continue to mount, it's easy to feel helpless. Which is why we'd argue that now, more than ever, it's important to practice what we at ishonest always advocate: Taking care of yourself.

Of course, stress manifests itself in many ways and everyone experiences it differently, but for the purpose of this story, we're talking about stress acne. Not the stress-induced pimple that pops up right before a big test in school or presentation at work. Rather, the kind of impact that long-term feelings of underlying stress, coupled with universal uncertainty in the world, can have on our skin.

Why do feelings of stress show up on our skin?

The level of stress that prompts a flare-up can vary from person to person, and you may notice your skin changing just a few hours after a stressful event, says Laurel Naversen Geraghty, a board-certified dermatologist in Medford, Oregon. Even before your mind registers anxiety, those feelings may manifest on your skin.

"Your body reacts to stress by elevating certain hormones, such as cortisol, to put it in a state of 'fight or flight,'" explains Janelle Vega, a board- certified dermatologist in Coral Gables, Florida. "The oil glands in the skin actually have receptors for this hormone, so an increase in stress will increase the formation of oil in the skin."

But that's not all — acne is also largely influenced by general inflammation, and stress messes with that, too, specifically by directly increasing "inflammatory mediators" in the skin cells, Vega explains. Moreover, feelings of stress have a general depressive effect on the body's immune system, which "may make your acne worse by lowering your body's ability to fight inflammation," explains Sandra Lee, a board-certified dermatologist based in Los Angeles. (You may also know her as Dr. Pimple Popper.)

Additionally, feelings of stress can even cause us to treat our skin differently from the outside, in. For some people (myself included), when the outside world feels too stressful to bear, for too long a period of time, we might neglect our normal skin-care routines — or forgo it altogether. For others, stress can manifest in touching the skin more frequently or aggressively.

"Acne is exacerbated by picking [the skin], and picking is usually stress- triggered," Lee explains. "Oftentimes we pick at our skin and don't even realize we are doing it [because] we are deep in thought stressing about something else."

Not only will picking the skin exacerbate existing breakouts, but it also carries "a definite risk of causing permanent scarring," Lee explains. "So it's important to stop doing this, but it's difficult because it's often closely related to stress."

How to cope with — and tame — stress breakouts

"Keeping routines can be profoundly helpful in times of unprecedented stress and uncertainty," Rieder says. "When we have seemingly lost control of [many of] the elements that give us peace, including our occupations, finances, and health, normalcy in any sense is welcome [and] things that we take for granted and often do automatically are important to maintain."

Perhaps number one on this list is sleep — both getting enough of it and also trying to stick to regular sleep-wake hours. Sleep is crucial to our health for many, many reasons, however, as pertaining to overall skin health, the importance of getting your Zzz's ties back to cortisol. This is because when we're sleep-deprived, our bodies produce an increased amount of cortisol, which, as previously established, can spiral our skin out of balance.

Next on the list of important routines to maintain is "eating regular meals [and] having dedicated time both to yourself and for socializing, exercising, and practicing self-care in the way that you best respond to," Rieder explains. In terms of self-care, he personally recommends activities like meditation, yoga, deep breathing, exercise, and skin care, but the entire idea here is to take the time — regularly — to take care of yourself in a way that feels good to you.

It's also worth noting that one factor that can be both a source of self-care and stress is technology. While streaming an online exercise class is a highly recommended form of self-care among all the experts we spoke to, spending too much time on your phone or computer is not — especially when it feels like terrifying news updates pour in on an hourly basis. Still, it's also important to stay informed.

Again here, it's about striking a balance that feels right to you and prioritizes your mental health. Rieder's recommendation: "Find one or two news sources that are trustworthy and spend no more than 30 minutes daily informing yourself," he says.

"It is easy to get attached to your only source to the outside world — your phone and television — during a time like this," Vega agrees. "While it is good to be connected, you also need to detox from the overwhelming stress of the world in general."

The best topical treatments to treat stress acne

That doesn't mean that you should use all three at once, however. Instead, Vega recommends using retinol as a long-term solution, and keeping either a salicylic acid or benzoyl peroxide product in your medicine cabinet to use as a spot treatment as needed.

If you do find yourself reaching for, touching, or picking at your skin more often than normal, Lee suggests covering trouble spots with a bandage, "or better yet, apply an acne spot treatment, a dollop of cream right over the pimple or the red bump," she says. "If you reach up to pick at the bump, you will be reminded that there is cream on the area and hopefully this will remind you to not pick at your skin."

To proactively prevent — and ease — the effects heightened emotions have on skin, Naversen Geraghty recommends sticking to a creamy cleanser, a soothing moisturizer (with hyaluronic acid and ceramides), and a zinc-based mineral sunscreen, since chemicals may be more likely to irritate. (We like Neutrogena Ultra Gentle Hydrating Creamy Facial Cleanser, CeraVe Hydrating Hyaluronic Acid Serum, and Solara Suncare Time Traveler SPF 30, respectively.) Easy does it.

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