A study conducted by dermatologists at Stanford University recruited students who came into the university clinic for acne treatment for skin exams. They performed one during a relatively stress-free time, and one during exam week. The skin science researchers also gave the students questionnaires designed to measure stress. The results showed a strong correlation of acne severity with increasing stress.
A similar study carried out in Singapore, showed that students were 23 percent more likely to experience breakouts. At the same time, their sebum production did not vary much whether they were experiencing high or low stress, indicating that levels of the substance had little or no role. Instead, the results may have more to do with inflammation. Other studies have shown that stress can provoke inflammation, and acne is an inflammatory disease.
Yes, it is a catch: acne causes stress, and stress itself causes acne too.
Stress is the general biological response to a potential danger. It is a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances. The body gets hormonal stimulation that prepares it for the so-called flight or fight reaction. It starts in your brain. The hypothalamus releases corticotrophin releasing hormone, which triggers the hypophysis or pituitary gland to produce adrenocorticotrophin hormone, which in turn stimulates the adrenal glands to release cortisol, the major stress hormone. When not necessary to fight or fly away from danger, these hormones are just harmful for the body. They cause inflammation, suppress the immune system, which makes the body more prone to infections, including the infection by the bacteria Propionibacterium acnes, which is responsible for many symptoms of acne. They also cause an increase in the oil production by the sebaceous glands in the skin. This sebum clogs the pores, traps bacteria which thrive in that environment and trigger an inflammatory reaction. Together with some neuropeptides released by the nervous system when you are stresses, that explains the formation of the pimples. This is magnified by the presence of testosterone, which also increases the production of oil by the skin, contributing to the problem.
Due to the complexity of the causes of acne, even though there is a clear link between acne and stress, doctors do not think that you can really treat acne by taking anti-anxiety medication. That said, people with acne can also take advantage of seeing a psychologist or taking steps to reduce or manage high levels of stress overall. One example of professionals who take this possibility seriously is Dr Ted Grossbart, a clinical psychologist based in Boston, MA, who treats patients with skin problems through therapy sessions. His opinion is, although acne is 50 per cent due to hereditary factors, 30 per cent due to lifestyle and only 20 per cent is due to psychological factors, taking control of the emotional stuff might just be enough to push balance back in favor of health. Dr Grossbart sees a pattern: ‘It’s possible that your skin is acting as a protector, trying to tell you things that you won’t admit to yourself’ – he says.
Dr. Nicholas Perricone, a dermatologist in New York and the author of “The Clear Skin Prescription,” also argues that lifting weights (what I’ve been doing more of lately) causes the body to release more testosterone, which can also contribute to breakouts. He advocates yoga and other forms of moderate exercise to help reduce stress, which is linked to acne, and an anti-inflammatory diet heavy on cold-water, fish, beans and low-glycemic fruits and vegetables. Unlike many other doctors, Dr. Perricone believes acne is caused when stress, poor diet and other factors spur the release of hormone-like pro-inflammatory chemicals called cytokines, which can make the cells inside a pore “sticky” and more prone to getting clogged. “Acne is a chronic, systemic inflammatory disease” Dr. Perricone said.
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