Acne can be a cause of stress and anxiety, but it is also well known that stress can trigger or exacerbate it.
Several scientific studies have shown that the skin’s cells that secrete sebum are sensitive to nerve stimulation.
A clinical study has revealed the onset of acne flare-ups in students during exam periods. This study showed a strong correlation between degree of stress and severity of acne at exam time. In one French study, half of the women interviewed, aged over 25 years attributed their acne to stress.
Acne is an inflammation of the pilosebaceous follicle. It is the result of three events: blockage of the follicle by a plug of cells (comedone), the increased secretion of sebum by the sebaceous gland (seborrhoea) and the bacterial colonisation of the blocked follicle (spot).
The cells of the sebaceous gland have surface receptors which once activated and stimulated encourage the secretion of sebum. When we are stressed, we produce hormones (cortisol) and substances (neurotransmitters) capable of stimulating the sebaceous gland receptors. These receptors multiply and secrete more sebum and substances which cause inflammatory lesions. The skin is therefore more oily and acne lesions appear.
When acne breaks out or worsens in adult women, their stress factors should be looked into. It is not always easy to eliminate them, but doctors must factor them into their treatment. We must both reassure women about future changes in their acne and also try to reduce the aggravating factors.