Breaking out when we're stressed is standard protocol for our skin. It's like our body's way of shaking off all that tension, like a knee-jerk (face-jerk?) response to those sleepless nights and not-so-nutritious midnight snack sessions. So while it's not exactly everyone's favorite automatic body response, it isn't the worst thing in the world either.
Thing is, stress acne comes and goes, and it can take its leave quickly and painlessly if you don't let it stress you further. So the next time your pores hit you with some zits you didn't ask for, here's a complete guide to help you get through it:
Does stress break you out?
Technically, stress isn't the direct culprit of breakouts, but it does trigger responses in your body that are. "The impact of stress is actually very complex because the body is complex, and everything is interconnected and a change in one leads to a chain reaction," says dermatologist Dr. Windie Hayano of The Skin Inc. Dermatology and Laser Center. "This is the reason why the skin is very interesting because you can really see signs of what is happening internally manifest externally."
When we're stressed out, it triggers secretion of certain hormones like cortisol, leading to an increase of our sebum production that makes our oil glands prone to bacteria and being clogged and inflamed.
Dr. Gaile Robredo-Vitas of BeautiqueMD adds that stress hormones' influence on sebaceous glands contribute to oilier skin (that can lead to acne) or cause acne to heal slower. It can also make existing skin conditions like eczema, psoriasis, and acne to worsen, and affect our wound healing response and mechanism and impair our skin barrier. Hormones like the corticotropin-releasing hormone (CRH) can even worsen inflammation on people who already have acne.
And turns out, even when we're not in a high-stress situation, our bodies read certain behavior as signs to get those sebum-causing hormones going. "A few studies correlate stress to behaviors that can indirectly cause acne exacerbation such as not getting enough sleep, eating unhealthily or picking at your skin," Dr. Gaile shares.
Dr. Windie also points out that studies have highlighted the connection between our gut, brain, and skin that could tell us a lot about acne severity. Stating an example, she explains, "Strong emotions of stress (anger, depression, anxiety) are thought to aggravate acne by changing the gut microflora and increasing intestinal permeability leading to skin inflammation."
What's the difference between regular acne and stress acne?
Sadly, stress acne is a sneaky one because it looks exactly like the zits we get normally. They could manifest as comedones, papules, pustules, and nodules (or cysts), so telling them apart from the breakouts you usually get can be tricky.
That said, Dr. Gaile does point out two telltale signs that you're having a stress-induced breakout:
- 1. If the breakouts come out all at once after a particularly stressful situation
- 2. If the breakouts develop on the oiliest areas of the face like the T-zone (your forehead, nose, and chin), since stress causes our oil glands to be more active
Stress acne can develop on the body, too, and Dr. Windie specifically pointed out the back and chest. She also agrees that it's difficult to tell regular acne and stress acne apart. If you're lucky, the derm says your bout with stress can only cause oilier skin and not acne. "You can just simply have oily skin and that’s it. Those two conditions are not mutually exclusive," she notes.
But when it comes to what type of acne to expect and where, the doctor says that in adults, inflammatory lesions or those red breakouts with pus and nodules are generally more prominent on the lower chin, jawline, and neck. Meanwhile, whiteheads are less predictable and could even be a struggle to treat. "So yes, the struggle is real," Dr. Windie quips.
How do you treat stress acne?
1. Avoid doing things that make it worse.
The worst thing you can do when struggling with stress acne is to panic. You're already breaking out from the pressure, so you don't need to add more! Here's a list of Dr. Gaile's tips that'll keep the zit outbreak from getting worse:
- -Avoid picking at your lesions: This can not only worsen the breakout but lead it to leave marks.
- -Avoid over-washing or over-exfoliating your face: Cleansing twice a day is enough, and don't forget to cleanse after sweating or exercising!
- -Stop experimenting with anti-acne products: Doing so can make your lesions worse and can cause other skin issues to develop, like allergies.
2. Make some adjustments to your skincare routine.
Instead of trying new acne-fighting products on your stressed skin, the dermatologist recommends using ingredients that are foolproof for treating breakouts, specifcally salicylic acid and benzoyl peroxide.
Dr. Gaile writes, "Salicylic acid aids in removing excess oil and de-clogs the pores, while benzoyl peroxide has anti-bacterial and anti-inflammatory properties and also is a keratolytic (regulates skin turnover and prevents piling up of dead skin cells leading to comedone formation and clogged pores)."
How you'll incorporate these ingredients to your regimen is up to you, whether it be through cleansers, toners, exfoliators, gels, or creams. But instead of using them as a spot treatment, the doctor suggests using them all over your face to prevent new breakouts aside from treating the existing ones.
Dr. Windie Hayano also recommends staying away from abrasive scrubs and amping up your cell turnover with retinols, BHAs, and AHAs—the three staples for managing breakouts. "It just has to be a part of your regimen because they address at least the basic four pillars of acne," she tells us.
"There are also calming ingredients like madecassoside, centella asiatica and algae extracts that are found to be anti-inflammatory in nature. The idea basically is to prevent inflammation or stay away from things that can lead to inflammatory states."
Madecassoside Cream, P725, A'PIEU, Lazada; Centella Blemish Ampoule, P1300, COSRX, Beautymnl
As these anti-acne treatments can be quite drying to the skin, Dr. Gaile also reminds us to always keep the skin hydrated all throughout. She explains, "Lightweight moisturizers intended to repair and reinforce your skin barrier is also a good addition, since most anti acne products are drying and can be irritating."
Aside from these, maintaining a consistent skincare routine that covers all the essentials should help you get through this trying time for your skin better. Cleanse, exfoliate, moisturize, and protect your skin from the sun daily and your complexion will recover much quicker and you'll avoid more skin trouble in the future!
All that said, if none of these tips work, you can always consult your dermatologist to have a treatment program tailor-made for you.
3. Get skin treatments as often as possible for prevention.
Getting a chemical peel every month from your dermatologist can do wonders for acne prevention. Lasers peels like the Q-Switched ND YAG laser is another one of her picks, as it can control oiliness and stimulate collagen synthesis. "When combined with good skin care, these procedures will help control any form of breakout," Dr. Windie assures.
4. Adjust your diet and consider taking supplements.
Since our gut, brain, and skin our connected, Dr. Windie advises to make a few changes in your diet to prevent stress breakouts from happening. Here's her checklist:
- -Add pro and prebiotic-rich food in your diet
- -Stay away from sugar and dairy
- -Boost intake of anti-oxidants: Vitamin A, C and B (in all forms) are best for acne
- -Consider taking skin-benefiting supplements with pantothenic acid, zinc and niacinamide
5. Address the other lifestyle changes you think your body needs.
Eliminating all stress from your life isn't that simple, but taking steps to cut down on how much of it you deal with could be all you need.
According to the derm, identifying what's causing your stress in the first place can help, especially once you acknowledge and deal with them before eventually avoiding them. Adopting healthier habits like eating a balanced diet, drinking enough fluids, staying active, and getting exra hours of sleep never hurts either.
If you have the time, Dr. Gaile also suggests engaging in relaxing activities like meditation, yoga, and massages to soothe your mind. Reaching out to a friend in a similar situation as you could be a great source of comfort, too.