Breakouts When Stressed Out

acne_stressPeople with acne-prone skin have noticed for years that when they are overly anxious and/or under stress, their complexion gets worse.  Many recent studies show that it is not their imagination.  Although emotional stress itself will not cause a new case of acne to develop, it will worsen acne in someone who already has this disorder.

Studies from Stanford University found that acne-prone college students had more flare-ups during exams compared to other test-free (and therefore stress-free) times during their academic periods.  Similarly, studies of high school students in both Singapore and Sweden showed that cases of acne worsened during exam periods compared to low-stress times like vacations.

Despite this correlation, skin scientists still do not know the exact mechanism of how stress causes acne. It is known that sebum (i.e. skin oil) combined with dead skin cells can plug skin pores.  This plug can become infected by skin bacteria and form a pimple or infected cyst.

It is also known that the sebaceous cells that produce sebum under the skin have receptors for hormones including stress hormones such as cortisol.  However, the high school studies were not able to document increases in sebum production under stress, leading investigators to think that there may be other causes such as skin inflammation.

pimple_popperOne other significant aspect of stress and acne is that when people have increased acne pimples and they are under stress, they are more likely to “pop” and pick at their pimples.  While this produces some momentary relief to the individual, this habit can turn mild acne into very bad scars.

Basically, when a pimple is popped and picked at, multiple layers of skin are disrupted in order for the accumulated pus to reach the skin surface.  While this may not seem significant in the moment, all these skin layers need to heal and as with any other injury to the skin, a scar will form.

While there are many types of scars, acne scars tend to be disfiguring in that they are in very visible areas such as the face, neck, chest and back.  Acne scars also tend to be shallow pockmark or deeper ice-pick in appearance, making them more difficult to cover up in the short term or to treat with scar reduction technologies in the long term.

Acne cannot be treated with stress or anxiety-reducing medications such as Valium.  However, the best approaches to treating acne are to first realize that an acne flare may be coming in stressful times, and to then do your best to maintain ongoing acne treatments.

My biggest recommendation is to not pick or pop acne flareups if they occur.  I see many patients in their 40s and 50s who wish to eradicate acne scarring, and all of them wish they did not succumb to temptation by popping their pimples as teenagers.

If you would like more information concerning active acne or acne scarring treatment, call (207) 873-2158 for a free initial consultation to address your individual needs.

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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