Teenagers who were under high levels of stress are 23 percent more likely to have increased acne severity, according to researchers from Wake Forest University School of Medicine and colleagues.

"Acne significantly affects physical and psychosocial well-being, so it is important to understand the interplay between the factors that exacerbate acne," said Gil Yosipovitch, M.D., lead author and a professor of dermatology. "Our study suggests a significant association between stress and severity of acne."

The largest study ever conducted on acne and stress reveals that levels of sebum, the oily substance that coats the skin and protects the hair, increase in times of stress and are related to acne severity. Hormone levels, sebum production and bacteria are all known to play major roles in acne.

While psychological stress had always been identified among many factors that can worsen acne, there has been little research to understand the mechanisms behind this relationship.

Acne is an inflammatory disease of the skin caused by changes in the hair follicle and the sebaceous glands of the skin that produce sebum. The oily substance plugs the pores, resulting in whiteheads or blackheads (acne comedonica) and pimples (acne papulopustulosa).

The researchers suspected that stress increases the quantity of sebum, which leads to increased acne severity. However, the results showed that sebum production didn’t differ significantly between the high-stress and low-stress conditions.

"Common stressors like anxiety, fear, low self-esteem, depression and a variety of other internalized emotions, can trigger various chemical reactions inside your body that can result in acne flare-ups and other skin irritations," says Julie Gabriel, R.N.S., author of "Clear Skin: Organic Action Plan for Acne" available at Amazon.com and Barnes and Noble, "Stress can set your adrenal glands to work creating more cortisol, the substance that in turn causes your sebaceous glands to produce increased amounts of sebum oil, excessive amounts of which can be blocked in pores."

To combat stress and keep skin acne-free, Gabriel suggests the following:

1) Get plenty of rest and sleep a recommended average of eight hours per night. Try to maintain regular hours each day, regardless of which shift your work.

2) Journal a little each day mentioning any stress, worry, anxiety and tension you’ve felt.

3) Establish and follow a regular well-balanced diet with minimal sugar, white breads, dairy and soft drinks to keep your body healthy on the inside and outside. Eat at least five servings of vegetables and fruits every day.

4) Enjoy daily stress-relieving activities such as meditation, yoga, reading, hobbies or just a plain walk in a park.

5) Increase your daily intake of essential fatty acids, both in natural form and as dietary supplements. 

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