This week was a very stressful week for me. I had a lot of papers and projects due, and had to work nonstop with very little sleep.
The weird thing is, I got no acne all week long. Near the end of the week, my skin got a little bit itchy, and when I pressed certain spots, dry sebum would come out. It was as if I had gotten clogged pores, but there was no inflammatory response, so the sebum just stayed there and eventually reached the outside of my skin.
This got me thinking. Stress makes your body release cortisol, which suppresses the immune system and reduces inflammation. It's a very simple and direct explanation of what I observed this week.
Obviously I'm not saying that people should stress themselves out to help treat acne symptoms, because stress has many other detrimental effects on your health. But I have to wonder: why do people say that stress contributes to acne?
It's more like if you're stressed out and obsessed over acne, you'll see more pimples than are actually there. Worse, if you start excessively pick at or scrub your skin, it can highlight existing pimples or create the illusion of more being there. So if you aren't focused on acne, you probably won't see as many pimples as if you were. Kind of like chronic ear ringing -- you ignore it and you don't hear it, but if you focus on it it'll be louder.
Very high levels of cortisol over a long period of time can cause acne, or at least an acne-like rash like in
Cushing syndrome. But Cushing syndrome has cortisol levels far beyond the
normal range and causes a bunch of other symptoms. Cushing syndrome is caused by tumors (especially on the adrenal gland) and taking too much steroid medications, not typical emotional stress.
People say stress causes acne because they often think correlation is causation. This partial truth has been perpetuated on the Internet for a long time to the point it has become accepted as fact.