Emotional stress ‘exacerbates acne’
The tiresome skin complaint of acne is aggravated by stress, US scientists have found.
They monitored the skin condition of 22 university students before and during their exams, and found those judging themselves the most stressed suffered the greatest increase in acne severity.
It is estimated that 85% of the population suffers from acne at some point in their lives, and the impact can be tremendous. Physical scarring can occur and is sometimes accompanied by long term psychosocial effects, as sufferers can become embarrassed and self-conscious by the condition of their skin.
This is why dermatologists have previously focused their efforts on treatments to reduce the severity of acne and avoid flare-ups, the research team explains in their paper in the journal Archives of Dermatology.
Previous evidence of a link between stress and acne has been entirely anecdotal, but patients, their families and doctors have strongly suspected a correlation. Outbreaks of acne often occur during or just after difficult life events, and adult acne sufferers are often high flyers with demanding jobs.
There is also the increasing scientific evidence that stress worsens existing conditions, by slowing wound healing and increasing pain sensitivity.
Dr Alexa Kimball and her colleagues from Stanford University recorded the severity of the acne and the perceived stress experienced by the groups of students, who were broadly representative of the student body as a whole – representing both sexes and a variety of ethnic backgrounds.
The acuteness of the acne was marked between zero and ten on a commonly used scale, first at least one month before any exams, and then within a period stretching from three days before an exam to seven days after.
Stress was also recorded during these two assessments, on the Perceived Stress Scale questionnaire, which determines how uncontrollable, unpredictable, and overwhelming the subject perceives their life to be. The students were also asked to comment on their quality of sleep and diet in the preceding month.
Even when the researchers adjusted their results for changes in quality of sleep and eating habits – which are likely to deteriorate around exam time and may inflame acne – there was a strong correlation between acne and stress.
Worsening perceived quality of diet also had an effect, but this was not as important as stress, whereas poor sleep did not cause a significant decline in the state of the students’ skin.
The scientists concede that the correlation does not necessarily point to a causal link between stress and acne, as the stress may have been heightened by a worsening of the skin condition, rather than the other way round.
But the team does point out high achieving populations, such as university students, tend to become less concerned with physical appearance around exam time.
The mechanism of the suspected link is not yet known but Dr Kimball and her team think it is possible that a release of a hormone or neuroactive substance which takes place when the body is under stress could cause the flare up, and healing is slowed by psychological stress.
The team calls for more research in this area to determine the scale of the correlation, and whether the stress relationship holds for those with more severe acne.
