Stress pimples will usually pop up in the oiliest areas of the face, like the forehead, nose and chin. Your T-zone might look greasier and more congested too. Doctors say that if you're getting clusters of pimples all at once, stress can be a factor—hormonal pimples happen one at a time.
Given the increase in oil production, she says your skin will usually look greasier and slightly more inflamed. Zeichner adds that stress acne can also look like a combination of blackheads, whiteheads, red bumps, and pus pimples.
The relationship between stress and acne has been misunderstood by many. Stress can't directly cause acne. However, studies have shown that if you already have acne, stress does make it worse. Researchers have found that wounds, including acne, are much slower in healing when a person is under stress.
Stress, anxiety, and fear might also worsen acne by triggering the production of cytokines, tiny proteins that stoke inflammation, including inflammation of the area around sebaceous glands, the glands that produce oil. Stress-related disruptions in healthy habits play a role, too.
When your body is under stress, it produces hormones called androgens that affect various parts of the body, including the skin. In the skin, these hormones may stimulate hair follicles and oil glands, leading to more inflammation and development of acne.
An increase in stress severity was strongly correlated with an increase in acne severity, which was statistically significant (r=0.23; p<0.01). Subjects with higher stress scores, determined using the PSS, had higher acne severity when examined, and acne severity was graded using the GAGS.
Also essential to keep in mind: Try not to stress even more over your stress acne. It may take a while, but it will go away eventually.
What does hormonal acne look like? Whiteheads, blackheads, papules, pustules, cysts and nodules are all common hormonal acne symptoms. Normally, whiteheads and blackheads do not cause pain, inflammation or swelling, but if they do, then they are most likely forming into cysts and pustules.
Stress rashes often appear as raised red bumps called hives. They can affect any part of the body, but often a stress rash is on the face, neck, chest or arms. Hives may range from tiny dots to large welts and may form in clusters. They may be itchy or cause a burning or tingling sensation.
Due to stress's affect on the body, most people experience stress acne breakouts rather than a single blemish. The excess oil production related to stress breakouts can increase the likelihood of developing cystic acne, though the majority of patients experience blemishes nearer to the surface of the skin.
Identifying Stress Acne
Says Dr. Bowe of her clinical experience, “I have noticed that stress acne is often more cystic, meaning it is beneath the skin as compared to blackheads or whiteheads. The cysts are deep and often tender or even painful, and they tend to be very persistent.
Anxiety, depression, and other stressful health or life situations don't actually cause acne, but they can definitely worsen it. Acne itself is caused by clogged skin pores. It's not clear why, but in people with acne, the skin has a hard time getting rid of dead skin cells.
The acne-anxiety relationship has been a crucial part of various medical discussions for decades. Some researchers suggest that acne has a direct impact on a person's emotional well-being while others suggest that high levels of stress or anxiety may lead to the increased production of oil, resulting in acne breakouts.
While stress alone isn't the cause of acne pimples — age, hormones, acne-producing bacteria and other factors are at play — it's evident that stress can trigger breakouts and make existing acne issues worse.
You can tell if acne is hormonal or bacteria by its severity if flare-ups occur during hormonal imbalances, and whether topical treatments resolve the issues, or if systemic medications are needed.
While androgens are essential to the development of acne, routine screening of women with acne or hirsutism usually reveals normal levels of androgens. The serum level of DHEAS, testosterone, and DHT in women with acne ranges from high to normal.
Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues. Cortisol also curbs functions that would be nonessential or harmful in a fight-or-flight situation.
It's been shown that unhealthy sleep habits can trigger insulin resistance, increase stress, spike cortisol levels, and impact hormones that are typically associated with acne.
Stress can increase the production of substances that activate oil glands within the skin of acne patients. Consumption of dairy and high-glycemic foods is also linked to acne. Certain hair or skin products can clog pores and cause comedonal acne (blackheads and whiteheads).
Acne is caused by your skin making too much sebum (oil), which, along with dead skin cells, clogs the pores — making them the perfect place for bacteria to grow. Hormones, family history and underlying health conditions can play a role in developing acne. It can also be a side effect of taking certain medications.
Severe acne is associated with increased depression, anxiety, poor self-image and poor self-esteem. Psychiatric symptoms are more common in more severe acne and in the later stages of puberty.