Sooo, Is Stress Acne *Really* a Thing? Here's the Breakdown

The last few years have been stressful as hell (a global pandemic, war, political divide, climate change…need I go on?), and if you’re like me, your skin probably shows it. Stress acne—i.e. breakouts brought on by stress, pressure, and feelings of anxiety—is a very real thing that most of us either deal with constantly (hi), or during moment when we’re feeling especially strained. And as anyone who has dealt with stress acne knows, the constant cycle of unexpected breakouts, followed by a billion spot treatments and acne products, followed by even more skin stress, just breaks you out all over again. Fun times.

It’s not all doom and gloom through. Because so many of us deal with stress acne, dermatologists and skin experts are exceptionally well-versed in treating it. So if you’re experiencing whiteheads and under-the-skin cysts because of stress, you’ve got options—and I’m here to break them down for you. Ahead, all the expert-approved ways to prevent and get rid of stress acne before it messes with your sanity once again.

Meet the experts:

Can acne be caused by stress?

Yes, acne can absolutely be caused by stress. Here’s the gist: When we experience stress and anxiety, a hormone called cortisol spikes within our bodies. The occasional spike in cortisol is totally normal, but elevated cortisol levels for days, weeks, and even months at time is what leads to acne. “In modern life, most people experience chronic stress, which means their bodies are constantly being flooded with high levels of cortisol—and it’s horrible for our skin,” Dr. Wechsler previously told Cosmo.

When we’re feeling stressed, our bodies also release more of something called substance P, or SP, which is a neurotransmitter found in nerve endings of the skin. Substance P can cause oil glands to overproduce sebum, leading to clogged pores and breakouts, and also increase inflammation in the body. And ICYMI, inflammation is the root of all skin evils: “Any inflammatory skin disease, including psoriasis, eczema, rosacea, can be worsened by stress,” says Dr. Harper.

What does stress acne look like?

Unfortunately, there’s no way to look at a patient’s skin and determine if their acne is caused specially by stress or something else, says Dr. Harper. Stress acne can often look the same as acne that’s caused by poor diet, hormone fluctuations, or a bad reaction to skincare. “There’s no specific location on the face or body that stress acne appears either,” says Dr. Harper.

That said, Dr. Harper told me that the majority of her patients who are experiencing acne along with stress have more nodules or inflammatory papules (think: red bumps and cysts) as opposed to blackheads and whiteheads. So if you’re seeing angry, inflamed breakouts and you’ve been feeling more overwhelmed and anxious than usual, there’s a good chance your acne is stress related.

How do you get rid of stress acne?

The easiest, most effective way to get rid of stress acne is with a combo of skincare and stress-reduction techniques. Here, a quickie breakdown of the best options:

Prescription retinoids:

There’s no better topical prescription than a retinoid for treating stress acne, or any kind of acne for that matter. Retinoids work on a cellular level to kickstart your skin’s renewal process—a must for clear, healthy skin. There are a ton of different retinoids for acne to choose from, but Dr. Harper likes Aklief (a potentially gentler retinoid known as trifarotene) and Twyneo (a tretinoin and benzoyl perxoide combo) best.

I personally use Altreno (a lotion-based tretinoin) for my hormonal, stress-induced breakouts and have had great results. I recommend talking to your dermatologist to see which retinoid will work best for you and will be potentially covered by insurance. If you don’t have insurance or don’t have access to a derm, look into Curology or Apostrophe. Both companies offer virtual doctor’s appointments and prescription-strength retinoid creams (and even oral antibiotics), minus the insurance drama.

Over-the-counter skincare:

If you’re not ready to go the prescription route, try using over-the-counter skincare products (like my favorites below) that are formulated with salicylic acid, benzoyl peroxide, sulfur, and/or azelaic acid, all of which can help treat stress acne. When used in cleansers, serums, masks, and spot treatments, these ingredients can help unclog pores, kill acne-causing bacteria on the skin, and minimize inflammation over time.

4 top-rated acne treatments to try:

Stress-reduction techniques:

When it comes to treating stress acne (or any skin condition), it’s important to address the root of the problem—and in this case, that’s stress. Skincare can only do much on its own, so making it a point to commit to an activity or practice that helps alleviate stress and tension in your life is a must if you *really* want to get rid of your stress acne.

There’s emerging science that shows regular meditation can help keep cortisol levels stabile and acne in check, but any sort of stress-reduction technique—whether it’s walking a walk or listening to a soothing playlist—can honestly make a difference. “Stress-release techniques are anti-inflammatory, said Dr. Wechsler, who practices psychodermatology, a field of medicine that combined mental health treatments with skincare routines. “By minimizing your body’s inflammatory response to stress, you can improve the quality of your skin barrier, smooth and plump the skin, and reduce things like acne.”

The takeaway:

The world is a wild place right now and stress acne is a very normal thing to experience. “If you feel like you’re experiencing acne or any skin conditions because of stress, my best advice is to see a dermatologist for an evaluation and to discuss your treatment options or techniques to manage the connection,” says Dr. Harper.

Why trust Cosmopolitan?

Lauren Balsamo is deputy beauty director at Cosmopolitan with nine years of experience researching, writing, and editing skincare stories that range from the best retinol eye creams to the best pore minimizing treatments. She’s an authority in all skincare categories but an expert when it comes to acne. She regularly tests and analyzes acne products and treatments for efficacy, while working with the industry’s top dermatologists and estheticians to assess new formulas and brands.

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