Can Hormonal Acne Be Caused by Stress?

The short answer is yes. Stress is a major culprit when it comes to hormonal acne. You’ve probably heard of the stress hormone, cortisol, but what you may not understand is exactly how high cortisol, caused by stress, creates hormonal chaos inside the body and why it can lead to acne. We’re here to break it down.

We’ll start with progesterone. This hormone works (in combination with estrogen) to help regulate skin health. It does this by keeping the acne-causing form of testosterone, DHT, balanced. Ultimately, when progesterone is too low, it can’t properly do its job to keep DHT in check. DHT builds-up and causes excessive oil production, clogged pores, and eventually acne (typically around the chin, mouth, and jawline). Since progesterone works so closely with estrogen, these two hormones must maintain a certain ratio. When progesterone is low, it means estrogen is high. This common imbalance, known as estrogen dominance, results in several other symptoms like heavy or irregular periods.

So, can you guess what causes low progesterone? You got it – high cortisol. Both progesterone and cortisol are produced in the adrenal glands. When your body is stressed, the adrenal glands prioritize the production of the stress-fighting, anti-inflammatory hormone cortisol, over the production of progesterone. The more stressed you are, the more cortisol you produce, and the more progesterone decreases.

There are many other issues brought on by stress that increase the likelihood of hormonal acne. For example, stress causes an increase in androgens to protect the brain from the negative effects of cortisol. These androgens are precursors of DHT, the acne-causing hormone. Stress can also negatively reshape the composition of your gut bacteria. Since excess hormones are eliminated through your gut, an unhealthy GI tract means hormonal imbalances are exacerbated.

The goal isn’t to eliminate stress completely. Maintaining some degree of that fight or flight response is important in appropriately reacting to the demands of life. That said, unhealthy levels of cortisol brought on by chronic stress can clearly cause long-term hormonal imbalances, which almost always show up on the body’s largest organ, the skin.

Sleep about 8 hours each night. You’ve heard this one a million times, but its importance shouldn’t be ignored. Whether you’re aware of it or not, lack of sleep causes your body to react as if it’s in distress, releasing more cortisol. Sleep helps calm and restore the body so that you’re better able to cope with stressful situation. Sleep also gives your body and skin the chance to heal and repair itself.
• Beyond getting a full 7-9 hours, go to sleep and wake up at the same time each day. This will give your body a sense of regularity that anchors and improves the quality of your sleep.
• Your body needs to drop its temperature a few degrees to initiate sleep and to stay asleep, so sleep at a cool temperature (about 18 degrees Celsius) to make it easier on your body.
• If you’re struggling to fall asleep at night, try avoiding naps, alcohol, and caffeine during the day to improve your sleep cycle.

Exercise a few hours each week. The body and mind and very much connected. Physical activity produces endorphins and serotonin which elevate and stabilize your mood in a way that help reduce stress. With this in mind, it’s no surprise that sedentary lifestyles are linked to an increased risk of mental health conditions like anxiety. Physical activity can also help relieve physical stress caused by muscle tension.
• Aim for 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity each week for effective stress reduction.
• Focus on high frequency. It's better to walk every day for 15-20 minutes than to squeeze in a three-hour gym session once a week.
• Find forms of exercise that are enjoyable for you. Feeling intrinsically motivated to move your body will increase the likelihood that you continue to pursue your weekly workout routine, so experiment with everything from spinning, to dancing, to rock climbing.

Incorporate relaxation techniques into your day. The body responds to stress with muscle tension. At the same time, tense muscles tell the body that it’s stressed. Unless interrupted with a reminder or reason to relax, this positive feedback loop can continue indefinitely.
• Meditation is the quintessential practice to bring about that “relaxation reminder.” There are countless meditation apps, videos, and books available to teach you how to meditate, but if you dedicate just 10 minutes each day to slow, deep breathing, you’ll see benefits.
• Journaling can help process and reduce negative emotions like stress. Put your thoughts on paper to declutter your mind so you can think more clearly and solve stressful problems. Focus on gratitude to help positively reframe stressful situations.
• Spend time outdoors. It not only forces you to unplug from the psychological and physical stress brought on by your computer (and phone), but it also increases your exposure to natural hormone-regulating elements like sunlight and fresh oxygen.

Avoid inflammatory foods as much as possible. While triggers of psychological stress seem more perceptible (a presentation due next week or a fight you had with your partner), physical stress inside the body is often equally prevalent. Compounds that are unstable in the body, like processed foods, wreak havoc on your insides and cause inflammation. Your body sees this inflammation as “stress” and responds with increased cortisol.
• Processed foods are typically packaged and contain a long list of ingredients, many of which you probably won’t recognize. Avoid these foods along with highly processed cooking oils, like vegetable, canola, and soybean.
• Food intolerances have a similar effect – they cause inflammation in the gut, forcing the adrenal glands to prioritize cortisol over progesterone. Lay off any foods that cause a negative bodily reaction, like bloating or stomach pain (gluten is a common trigger).
• Environmental chemicals, whether consumed (ex. in the form of pesticides) or absorbed (ex. by using certain non-natural personal care products), can also impact your body in a way that causes physical internal stress. Do what you can to limit these toxins.

When it comes to stress-induced acne, there’s a lot more going on behind the scenes than you may have realized. Chronic stress causes a slew of hormonal fluctuations and imbalances that can trigger breakouts and other symptoms of estrogen dominance. In that sense, managing both psychological and physical stress is an effective and free form of hormonal acne treatment. Managing stress is a lot easier said than done, but sticking to small daily habits can, over time, have a major impact. So, if you haven’t moved your body today, this is your sign. Get up, go outside, and walk around the block. Your body and skin will thank you.

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