Can acne be stress related?

I love treating acne, and I often find that my patients are a bit confused as to how stress can affect their skin.

There is not only the fact that stress affects our gut and the microbiome of the gut (AKA the ecosystem of bacteria that live in the gut)...

There is also the fact that the microbiome of the gut affects the microbiome of the skin!

Yes, that's right... our skin has its own special microbiome as well!

And the bacteria that causes infection and inflammation of the hair follicle is what is responsible for the proliferation of acne.

But, it's usually more of an internal job than just skin treatment alone (although topical treatment is absolutely vital in my opinion to keep the skin healthy and encourage healing).

When it comes to HORMONES there's a hell of a lot more driving the presentation of acne than most people know about.

This is why going on the pill for your skin often works... because it masks the hormonal imbalances that are contributing to acne!

It also reduces our sebum (AKA skin oil) levels back to that of a prepubescent child, but more on that another day!

You see, androgens (AKA hormones that act like testosterone) are responsible for the increase in oil production that then causes a cascade of events, increasing the sebum production in the skin and proliferating the bacterial infection that is acne. (Read more about how this works in this blog).

But androgens aren't just as simple as testosterone alone.

Androgens can be produced from the OVARY, which is where we would see high levels of testosterone and work on the balancing of the ovarian function to reduce testosterone and therefore acne.

But androgens can also be produced from the ADRENAL GLANDS, which is where we'd see higher levels of different hormones (specifically androstenedione and DHEA-S for the nerds out there 😁).

Adrenal treatments are generally focused around helping the body cope with stress, as the adrenals go into overdrive and become imbalanced with increased stress.

The treatment of ADRENALLY PRODUCED ANDROGENS is totally different than the treatment of OVARIAN PRODUCED ANDROGENS.

Which is why it's SO important to get comprehensive functional testing done to understand what your body is doing to fuel the acne.

Because I see so many people with hormonal acne who all share the same story (acne, put on the pill, acne went away, went off the pill, acne returned with a vengeance) I sometimes start to wonder if mainstream medicine and GPs actually think about the adrenally produced androgens.

So, I go off and research on all the platforms that GPs use.

This is an excerpt from a great platform called Medscape, which shows that, YES, this information is out there...

I hope more doctors start to pay attention to the many different facets of acne rather than just complacently prescribing the pill, which masks the imbalances and leave them to be dealt with another day.

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"Yet another noteworthy aspect is that corticotrophin-releasing hormone levels change during stress, and corticotropin-releasing hormone regulates sebaceous gland function, thus explaining the relationship between stress and acne."

If you're on the rollercoaster ride of acne, don't give up hope.

There are probably many pieces of the puzzle that haven't even been looked at yet.

Remember, it is always in your uniqueness that you will find your answers!

Want to see what might be driving your acne?

Reach out so we can dive deper into all wat covers all aspects of stress, adrenal function, hormones and more.

Much love,

Emily Banks (Principal Consultant)