Stress can wreak havoc on many—if not all—aspects of our lives. And when it comes to our skin, it can manifest as a skin issue many of us know all too well: stress acne.
Whether you’re dealing with emotional or psychological stress, stress acne pops up in times of duress. What makes this form of blemish trickier to treat than say a blackhead or even hormonal acne, is that it is very much tied to our mental health and how we feel. To help us navigate how to treat this specific type of breakout, we asked three dermatologists to give us a breakdown of everything we need to know. From the symptoms to all the treatments available, here’s your complete guide on how to tackle stress acne—straight from the pros.
What is stress acne?
As New York City-based board-certified dermatologist Michelle Henry, MD, describes it, stress acne is a type of acne that is worsened by–you guessed it–stress. Chronic stress can trigger a hormone called corticotropin-releasing hormone (CRH). CRH stimulates the production of sebum as a response to stress, which can then lead to breakouts. She adds that CRH also contains proteins that contribute to inflammation.
Stress acne can occur anywhere on the body and face, but she says they are more commonly found on the forehead, nose, chin, and larger areas of the body with a higher concentration of oil glands such as the chest, back and upper arms. And while anyone, regardless of age, can get stress acne, she says it is most common for those who are already prone to breakouts.
How to tell if your acne is stress-related
According to David Kim, MD, board-certified dermatologist at Idriss Dermatology, stress acne doesn’t necessarily look any different from other types of acne you might experience. What differentiates it from the others is the amount of acne you get at once. “It will happen more acutely and rapidly than regular pimples,” Kim says. “You’ll get a great number of them at once, and they can be painful, red and inflamed.”
What causes it?
Though times of stress can trigger these clusters of breakouts to form, it’s important to note that stress itself does not directly cause acne. As mentioned previously, stress levels release CRH, which stimulates sebum production and contains certain proteins that can cause inflammation. Kim adds that our cortisol levels also increase when we’re stressed, which can also contribute to excess oil production and clogged pores.
Stress acne vs. hormonal acne
Stress acne and hormonal acne are often seen as interchangeable, but they are actually very different. Henry says that hormonal acne is often linked with one’s menstrual cycle and will generally appear around the jawline and chin. Stress acne, by contrast, can manifest as a combination of whiteheads, blackheads and inflamed pimples.
How to get rid of it
There are a few topical (and even oral) options for you to turn to when dealing with stress acne. Nkem Ugonabo, MD, MPH, board-certified dermatologist at UnionDerm and assistant professor at Albert Einstein College of Medicine, says to look for known acne-fighting ingredients such as benzoyl peroxide, salicylic acid, sulphur, and retinoids that are known to kill bacteria, clear pores and reduce inflammation. Products like CeraVe Blemish Control Face Cleanser or the La Roche-Posay Effaclar A.I. Breakout Corrector are Ugonabo’s recommendations for products to try.
Henry agrees and adds that you’ll also want to look for non-comedogenic moisturisers, like Kiehl’s Moisturiser for Acne Prone Skin with Salicylic Acid, that won’t clog pores and prevent exacerbating acne. If you’re prone to picking at your skin—something that’s a typical reaction to stress, and makes the acne even worse (ugh)—look to pimple patches. The two-in-one treatments, which come in both near-invisible styles and the bold Starface Hydro-Stars, both work to help shrink the spot and stop you picking while it heals.
If over-the-counter products don’t work, Ugonabo says to talk to your dermatologist and ask about prescription treatments that might help with more stubborn breakouts or severe acne. Henry adds that medications such as hormonal birth control, oral antibiotics, tetracycline, spironolactone and isotretinoin, all help control hormone levels to lessen the chance of breakouts.
In-clinic treatments for stress acne
Ugonabo says that chemical peels are a great option for treating acne as they can help remove dead skin cells and keep skin clear. As for laser treatment options, Henry points to AviClear and Aerolase, as they are specifically made to fight active acne. Other lasers such as Morpheus8, Infini, Clear & Brilliant, PicoSure and Exion can help with your overall complexion and smooth skin texture and uneven skin tone, while also reducing the appearance of pores and redness.
But be warned: these treatments are aggressive and lasers may require multiple treatments and long periods of time before you see big results. A good skincare routine should suffice when tackling existing stress acne. “I usually try to manage acne and acne flares with medications and skincare products,” says Kim. “When your skin is inflamed and angry, doing treatments (including lasers) can actually further inflame the skin and make it angrier.”
How to prevent it
Even with all the products and treatments at your disposal, all experts agree that the best form of treatment is preventing stress acne from popping up in the first place. And how does one do that? Reduce the stress in your life—as best you can. “You’ll want to address the underlying cause (or causes) of your stress in order to prevent regular flare-ups and stop acne from worsening,” says Henry. “Find ways to soothe and renew yourself, whether that be through mindful meditation or vigorous exercise.” She lists walking, journalling, listening to music, drawing and indulging in massage as just some of the ways to minimise the impact of stress in your life and your skin. Other methods for improving your overall mental health can also include getting enough sleep or incorporating deep breathing exercises in your daily routine.
“It’s all about lifestyle. It’s important to learn to manage stress effectively and calmly,” adds Kim. “Which I know is easier said than done.”
This story first appeared in British Vogue.
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