Any acne google search will reveal links between acne breakouts and a variety of factors including cosmetics, spicy food, sunlight, chocolate, and even sweat. However, one less tangible factor that is often included but rarely explained is stress.
Stress is truly a significant factor in acne. While it is unlikely to cause acne alone, it can trigger flares and aggravate the condition by causing excessive oil production and delaying the wound recovery time of acne.
Stress induces excessive oil production
During periods of high stress, the hypothalamic-pituitary-adrenal (HPA) axis is activated and produces hormones. The HPA axis is the interaction between our body’s central nervous system (brain) and the endocrine system (hormonal-related).
The HPA releases androgens and corticotropin-releasing hormones (CRHs) in response to stress. CRHs bind to the receptors on our oil glands and accelerate lipid synthesis. CRHs also activates the testosterone in our body, which further enhances lipid production.
When the body experiences stress, neuropeptides are also released. Neuropeptides are small proteins found in the brain that are engaged in the functions of signalling and communication. Neuropeptides can also influence hormones. In particular, a neuropeptide called Substance P can stimulate the growth in the number and size of oil glands, which contributes to acne.
Stress delays wound recovery
Individuals with high levels of perceived psychological stress have shown significantly delayed recovery rates of the skin barrier. In other words, stress slows down the body’s ability to heal wounds, which can be a factor in slowing the repair of acne injuries.
Stress also triggers the increased level of the hormones glucocorticoids and catecholamines, which can adversely influence the healing process.
Glucocorticoids reduce the number of cytokines at the site of injury. Cytokines are essential in the early stage of wound healing as they protect against infection and prepare the injured site for repair by sending signals for phagocytes. Phagocytes kill and digest unwanted microorganisms. The later stages of wound repair are thus delayed with lower level of cytokines, meaning more time is required for acne to heal.
Further, catecholamines regulate a range of immune functions such as cell proliferation, production of cytokines (essential in wound-healing process) and antibodies. Elevated catecholamine levels during times of stress can inhibit the production of cytokines or suppress the body’s natural immune response to attacks.
Stress promotes habits that aggravate acne
The stresses of daily life may encourage individuals to pick at or scratch their skin. Such habits cause further inflammation, scarring and hyperpigmentation.
Stressed individuals are also more likely to have unhealthy habits, such as poor sleep patterns, imbalanced nutrition, and excessive consumption of alcohol. Stressed-out individuals can, at times, overeat in the face of chronic stress or increase their intake of calorie-rich food to calm the nerves. Comfort foods such as ice cream or cake can help to tone down the body’s stress responses but trigger acne or inflammation.
Finally, stress can cause people to neglect good self-care, including maintaining a usual skincare routine.
How to lessen the impact stress has on your skin?
Physical exercise can alleviate stress and regulate the production of stress-related hormones. Patients suffering from acne may be tempted to steer from exercise due to the discomfort from sweat, but exercising can provide important benefits to your skin. Just shower immediately after exercising and use a gentle moisturizer to keep your skin hydrated.
Experiment with other stress-reduction techniques as well such as meditation, yoga or reading a good book. If a stressful event is around the corner, be sure to get sufficient sleep and consume proper meals to eliminate other potential triggers that can aggravate your acne.
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