How stress causes acne

Stress contributes to acne in a very specific way, with high cortisol levels (one of your stress hormones) redirecting other hormones.

Acne is often an insulin/hormone issue. There is this cascade of hormone triggers that ultimately stimulates excess sebum production in the skin, resulting in acne.

It works like this:

  1. Cortisol – your stress hormone – causes extra glucose to be released into your bloodstream. This is good for extra energy, but it has secondary effects, especially when cortisol remains high for a long period of time.
  2. High glucose in the blood stimulates insulin production.
  3. Insulin directly stimulates the ovaries to produce androgens, like testosterone, which is why people with a high sugar, high carb diet have more acne.
  4. Androgens directly stimulate your sebum-producing skin cells.
  5. More sebum means your skin cells get blocked, causing more acne.

Additionally, dairy contains insulin-like growth factor (IGF-1), but low-fat or no fat dairy products are particularly bad for the acne-prone.

When you have excess insulin in your blood for any reason, it stimulates the ovaries to produce androgens, which then directly stimulates your sebum-producing skin cells.

Your skin cells overproduce sebum, and then the bacteria gets into the skin cells, deactivates their natural innate protections, and essentially carves out a space underneath the skin by degrading the collagen and eating it, plus the sebum and dead skin cells. This results in inflammation and redness, along with the acne lesions. This space creation under the skin is what creates the pocks and divots that are so characteristic of acne scars.

The other thing to note is that when the high cortisol levels stimulate the release of glucose into your blood, this excess glucose also feeds yeasts and bad bacteria in your vagina, because lactobacilli can only eat glycogen that has been broken up by amylase – that is, broken up into little pieces by the same enzyme in saliva that breaks down carbs in your food so that the lactobacilli can use it.

Normally, the amount of amylase matches the amount of glycogen, but when the glucose is directly in your mucous membrane cells, the amylase level is walking to the beat of a different drum.

That is, not the same sort of system, so amylase isn’t working in the same way as it might normally be with other glucose sources, so lactobacilli remain at the same level, meanwhile, bad bacteria and yeast can overgrow, crowding out the lactobacilli resulting in vaginal infections and imbalances like bacterial vaginosis.

Yeast and some bad bacteria can use glucose and glycogen whole (as in, not broken up by amylase) as food. This is why diabetics get more vagina problems and yeast infections, and also why stress can result in vagina problems – for more reason than one. Stress really screws with your system in so many ways.

A one-off bad time is tolerable for our system, as it is designed to deal with that, but longer periods of stress can really throw you out big time, because cortisol has so many secondary effects – it just stops everything else from working properly, just so you can run away/fight/whatever. Stress is supposed to be resolved, not ongoing.

The hormonal cascade that continues after the stress is gone

Once the cascade of hormones starts, it can continue on for some time even after the stress has passed, because androgen production stimulates more androgen production. It then starts its own little cycle that needs to be interrupted.

How to get rid of high cortisol and the hormonal cascade that triggers acne

To interrupt it, first obviously is getting rid of the stress response and high cortisol. Normally the first thing is check your diet, to make sure you are keeping your blood sugar stable with low-glycaemic index foods (eating like a diabetic).

Make sure you are not adding insulin to your system unnecessarily with high fructose/glucose meals, like dried fruits and carbs like grains, rice, potatoes, pasta, bread, sweets, even wholegrains. They can unwittingly keep insulin higher than you might like.

Then focus on the stress response, not the food. It’s a good place to start. Obviously also you can do regular cortisol-reducing activities like meditation, light exercise, dancing, laughing and art, music or whatever floats your boat and distracts and relaxes your brain.

We can’t help stress, but herbal anxiolytics are also a useful way to – without a lot of effort – interrupt our stress response. They can soothe your system so you can get on with the rest of your day. And, get rid of acne.  



Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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