A number of clinical studies have confirmed what the acne sufferers and dermatologists alike have suspected about stress and acne: stress indeed does affect acne. Having established that, the next question is: how does stress affect acne? Before examining this, let us take a look at how stress affects skin in general.
How Does Stress Affect the Skin?
Skin and brain originates from the neuro-ectoderm during the embryonal stage. Skin, as the fifth sense organ is supplied by millions of nerve endings that are connected through the nervous system with the brain. In fact, it is only proper to state that skin indeed is an extension of the brain, the seat of our mental activities and the master controller of the body. Hence, any changes occurring in the nervous system and the brain can affect the skin in a number of complex psycho-neuro-immuno-hormonal pathways. Sebaceous gland, an important gland of the skin, naturally, is also affected by stress similarly.(See below)
How Does Stress Affect Acne?
It has been hypothesized that stress, the modern day nemesis, can affect acne in three ways:
- A period of continuous stress can induce a new eruption of acne
- Acne, which is already present, is sustained despite treatment and even become resistant to conventional therapies during an especially stressful period of time.
- A sudden crisis in life, exacerbates the acne lesions already on the face.
Hence, learning to relax is a very important aspect when you consider the best treatment for acne options.
The effects of stress on acne may be mediated through various pathways:
- Stress-acne: Hormonal Causes. Stress through the stimulation of neuro-chemical pathways in the brain, stimulates release of various hormones from the pituitary and other endocrine glands. The release of androgen hormones are controlled by these master glands. Androgen hormones are the main perpetrators of sebaceous hyperactivity which is the most important factor in the causation of acne.
- Stress-acne: Psychological Causes. Stress caused by anxiety due to acne eruptions and due to other causes induce teens to pick on the acne lesions leading to exacerbation of the lesions and scarring. This further increase the tension and the whole triggering cycle is repeated. In some acne sufferers the stress induces bulimia or overeating response leading to increase in the hormonal activities and new acne eruptions.
- Stress- acne: Psycho-Social Causes. The self imposed social alienation because of facial disfigurement and perceived social stigma further add to the depression and anxiety and aggravate acne and related problems.
- Stress- acne: Immunological Causes. Stress reduces immunity through its effect on the thymus gland which produces T cells that protects our body against invading germs. Reduced immune status leads to the multiplication of bacteria inside the sebaceous glands causing inflammation of the acne lesions.
- Stress- acne: Chemical Mediators: Stress, through its activity on the autonomic nervous system and hormones stimulate the release of neuropeptide P and certain other chemical mediators which induce inflammation in the skin and pilosebaceous units, thus leading to formation of new acne lesions.
- Stress- acne: Genetic Susceptibility: Some individuals are, through genetic predisposing characteristics, more stress prone than others and respond with increased sebaceous activity when under stress.
- Stress- acne: Target Organ Theory: Different individuals respond to stress in different manner. Due to genetic and hereditary predisposition, living style, dietary habits, relaxation responses etc, certain organs in the body are more prone to be affected by stress induced structural and pathological changes. The weak, target organs are affected first, when the body is kept under stress mode for long. In some, it may be the heart, in some the brain, in some the immune system, and, in others, the skin in general or the pilo-sebaceous unit in particular. Thus their skin may respond to a particular stressor by producing more acne lesions!
The above review is sufficient to visualize the extend of stress-acne relationship.
There are still certain issues to be addressed on the topic of stress acne relationship:
- It is still not clear up to what extend stress is responsible for acne in normal individuals
- There are conflicting reports as to whether stress does really increase sebum secretion. More clinical and laboratory studies are required to straighten this issue out.
- How much importance should be given for stress management in the management of acne?
All said and done, it is becoming increasingly evident that acne cannot be treated satisfactorily unless you combine anti acne therapy with an effective stress management program.