Researchers found teenagers who were under high levels of stress were 23% more likely to have increased acne severity.
Stress has long been thought to aggravate acne, but researchers say this is the first large-scale study to confirm the relationship and look at possible explanations.
"Acne significantly affects physical and psychosocial well-being, so it is important to understand the interplay between the factors that exacerbate acne," says researcher Gil Yosipovitch, MD, professor of dermatology at Wake Forest University School of Medicine, in a news release.
Yosipovitch says the results suggest stress-related inflammation may be to blame for the breakouts.
Stress Worsens Teen Acne
In the study, published in the Swedish journal Acta Dermato-Venereologica, researchers looked at the relationship between stress levels and acne severity in 94 teenagers in Singapore with an average age of 15. Most of the teenagers had mild to moderate acne.
Researchers measured the teens’ self-reported stress levels and acne severity at a time of high stress (just before midyear exams) and at a time of low stress (two months after the end of exams).
At the same time, they also measured levels of sebum, the oily substance that coats the skin and protects the hair and plays a major role in acne. Researchers say sebum production is known to fluctuate with variations in temperature and humidity, and Singapore was chosen for the study because its temperature and humidity are consistent throughout the year.
The results showed that sebum production did not vary significantly during low or high stress periods.
But acne severity was significantly related to the teens’ stress levels.
"Our research suggests that acne severity associated with stress may result from factors others than sebum quantity," says Yosipovitch. "It’s possible that inflammation may be involved."
Researchers say acne is an inflammatory disease, and previous studies have shown stress can trigger inflammation in the body.