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Can a Lack of Sleep Cause Acne?

It Is Likely, Because Good Sleep Is Important for Overall Skin Health

Last updated: January 24, 2019

Article Summary

Although lack of sleep is not a direct cause of acne, research shows that proper sleep encourages stress reduction, hormone balance, healthy skin oil production, and strong immune responses -- all of which could theoretically help prevent acne.

Acne is an inflammatory disease, and proper sleep may also lead to less inflammation in the body. This could potentially help reduce acne and help with the healing of acne lesions, which could help reduce scarring

Try to get eight hours a night or more when you can. 

Common sense tells us that getting enough sleep will help keep us healthy, and might even help reduce acne. This is reflected in the following survey results from a 2007 study published in the International Journal of Dermatology

International Journal of Dermatology

Among people who were surveyed about their acne, 75% believed that acne was triggered by poor sleep. Only stress was believed to be a greater factor, which was reported by 82% of people.

Influence of poor sleep on acne

Although many people believe that lack of sleep causes acne according to the survey, this is not yet proven with direct scientific evidence.

However, we do know that sleep is important for maintaining a healthy balance in the body. Since the skin is the largest organ of the body, imbalances caused by insufficient sleep are likely to affect the skin. We can see this echoed by researchers in the following 2007 study published in the Indian Journal of Dermatology, Venereology and Leprology:

Indian Journal of Dermatology, Venereology and Leprology

"Sleep performs protective and restorative functions for the skin." They added, "Studies have suggested that acute sleep deprivation and poor sleep quality may impair the integrity of the skin."2

So if in fact getting enough sleep were to help reduce acne, how exactly would this happen? We can find some clues in other studies that show us that getting adequate rest helps with some of the following underlying factors that are important when it comes to acne:3

  1. Skin oil 
  2. Stress
  3. Wound healing (acne lesions are small wounds)


1. Sleep Promotes Healthy Skin Oil Production

Skin oil forms a protective layer on the skin that acts as a barrier against damaging substances and the sun's rays. Generally speaking, overproduction of skin oil contributes to acne. So what happens to skin oil when we sleep? Researchers in 2007 put this question to the test. Somewhat surprisingly, they found that skin oil production increased during sleep. However, the chemical make-up of skin oil also matters. In other words, people with acne tend to have "bad" skin oil, whereas people without acne tend to have "good" skin oil. So theoretically, even if skin oil production goes up while we sleep, it might be "good" skin oil, or more precisely, skin oil with the right chemical components. This area of research remains something of a mystery, but the researchers argued that the skin oil produced during sleep positively affected the skin in a manner that might reduce acne. They also noted that the other beneficial occurrences during sleep most likely led to an improvement in acne.2 

Indian Journal of Dermatology, Venereology and Leprology

A 2007 Indian Journal of Dermatology and Venereology study that included 85 women with acne between the ages of 18 and 40 found that women who slept more showed higher levels of skin oil. This indicates that skin oil production increases during sleep.2 

2. Sleep Reduces Stress

Most dermatologists and acne researchers agree that stress and acne are linked. Sleep is an important means by which the body copes with stress. Broadly speaking, the more stressed a person is, the more likely it is that he/she will develop acne. This happens because of how stress affects hormones, skin oil production, and wound healing.

How stress is linked to acne

So it makes sense that getting enough sleep will help reduce stress and thus reduce acne. However, when it comes to proving a link between sleep, stress, and acne, things get a bit difficult because we have a chicken or egg scenario, as outlined in the illustration below. Does poor sleep cause stress and thus cause acne? Or does acne cause stress, which can then lead to poor sleep? It's an interesting thing to consider, but before we get too deep into the weeds with this, it is safe to assume that getting proper sleep should help reduce stress, and this is ultimately a good thing when it comes to acne.

How sleep stress and acne are related

Since sleep and acne are so interconnected, let's look more specifically at the ways poor sleep might lead to more stress and, in turn, more acne.

Hormones

Poor sleep can disrupt hormonal cycles.4 Some researchers believe that stress increases hormones that cause acne, such as androgens, by increasing skin oil production.5

Skin oil production

There is also evidence that stress can activate skin oil production. When we delve deeply into this we see that when we get stressed, the brain releases a hormone called corticotropin-releasing hormone, which is believed to increase the conversion of androgen precursors into the androgen, testosterone, in the skin-oil-producing glands. This causes the glands to increase in number, and produce more skin oil. As stated, increased skin oil normally equates to more acne.5

Wound healing

Acne lesions are small wounds, and stress can cause the body to release certain substances that block healing at the site of a wound.6

Archives of Dermatology

As researchers noted in a 2003 study published in Archives of Dermatology, "[P]sychological stress…can slow wound healing by up to 40%, which could be a factor in slowing the repair of acne lesions."5

3. Sleep Promotes Wound Healing, and Acne Lesions are Wounds

We have seen that improper sleep may lead to stress and impair the body's ability to heal acne lesions. On the flip side of the coin, sleep directly helps with wound healing through the activation of the immune system, the release of hormones, and encouraging tissue regeneration

Effects of good sleep on acne

Let's have a closer look at each of the ways in which sleep can help heal wounds. And remember, since acne lesions are wounds, it's safe to assume that sleep could also help heal acne lesions through the same mechanisms.

Immune system

Quick healing of acne depends on a fully functioning immune system. The immune response peaks during sleep and then drops when awake.4 In other words, a healthy immune system requires sleep.

The release of hormones

During sleep, the body releases hormones, such as the growth hormone, that encourage immune cell activation and tissue growth, leading to skin healing at the site of a lesion.4,6,7

Tissue regeneration

Animal studies have shown that the regeneration of skin and other tissues occurs mostly during sleep. In fact, new tissue growth happens about twice as fast during sleep than it does when awake. This is part of another cycle that corresponds to our sleep patterns. Tissue breakdown mostly occurs during waking hours and is balanced by tissue growth and repair that mostly occurs during sleeping hours.7Since tissue regeneration is necessary for repairing skin damage caused by acne lesions, this is another reason why sleep is most likely very important for acne-prone people.


Conclusion

Insufficient sleep can impair the body's ability to heal tissues, and lead to unhealthy skin-oil-production, hormone imbalances, improper immune function, and stress. The combination of these factors may contribute to acne, and cause slower healing and repair of acne lesions.

Try to get eight hours or more sleep per day when you can. 

The Experts at Acne.org

Our team of medical doctors, biology & chemistry PhDs, and acne experts work hand-in-hand with Dan (Acne.org founder) to provide the most complete information on all things acne. If you find any errors in this article, kindly use this Feedback Form and let us know.

References:

  1. Suh, D. H. et al. Topical betamethasone for prevention of radiation dermatitis. Int J Dermatol 139, 68 (2007).
  2. Omidvari, S. et al. Topical betamethasone for prevention of radiation dermatitis. Indian J Dermatol Venereol Leprol 73, 209 (2007).
  3. Williams, H. C., Dellavalle, R. P. & Garner, S. Acne vulgaris. Lancet 379, 361 - 372 (2012).
  4. Besedovsky, L., Lange, T. & Born, J. Sleep and immune function. Eur J Physiol 463, 121 - 137 (2012).
  5. Chiu, A., Chon, S. Y. & Kimball, A. B. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch Dermatol 139, 897 - 900 (2003).
  6. Suh, D. H. & Kwon, H. H. What's new in the physiopathology of acne? Br J Dermatol 172, 13 - 19 (2015).
  7. Adam, K. & Oswald, I. Protein Synthesis, Bodily Renewal and the Sleep-Wake Cycle. Clin Sci 65, 561 - 567 (1983).

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