Does stress exacerbate acne?

Yes, it seems to. Many patients report that emotional stress makes their acne worse. In one survey of 4576 consecutive patients with various dermatologic problems, 55% of those with acne reported that episodes of emotional stress were closely related to exacerbation of their acne. A prospective cohort study, published in 2003, of 22 university students with acne during exams showed increased acne severity that was significantly associated with increased stress levels. Another study in high school students also found that increased stress correlated with increased acne severity. There did not seem to be an increase in sebum production during times of stress in this study. New data regarding the physiology of sebaceous glands indicate that these skin organs have receptors for numerous neuropeptides (NPs), and these receptors modulate inflammation, proliferation, and sebum production and composition, as well as androgen metabolism in human sebocytes. Further elucidation of these neural skin connections may help our understanding of the connection between stress and acne


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Yosipovitch G, Tang, M, Dawn AG, et al: Study of psychological stress, sebum production and acne vulgaris in adolescents, Acta Derm Vereneol 87:35–39, 2007.