Stress acne: How to break the cycle6 minute read

New to the series? Read part 1, part 2, part 3, part 4 and part 5 first.

Scientists have known for a long time that there’s a link between stress, acne and mood [1]. But it may surprise you to learn that they don’t understand the exact nature of that connection.

One theory is that self-consciousness about acne leads to poor self-image and a low mood. If you’ve suffered from acne, this is hardly ground-breaking news. But it can go the other way too. Stress (arising from poor self-image, low mood or otherwise) may also drive acne. This is because:

– Psychological stress leads to increased cortisol production. Increased cortisol (and its associated hormones) leads to more sebum production, which is one of the key ingredients for pimples [2].

– Increased cortisol can also disrupt the gut microbiome, which leads to inflammation (another precursor to acne) [3].

It’s likely that all of the above combine to form a vicious cycle—and it leaves you feeling horrible.

The worst part is that people who haven’t suffered from acne don’t get this. To the outside world, it may seem like you just have a few pimples. But to you, those pimples are overwhelming. They zap your confidence and they prevent you from doing everything you want to do.

It’s no wonder acne sufferers are found to have lower self-esteem. They’re even found to have less sex [4].

But don’t despair. With a few simple practices, you can bust out of that cycle. It starts with your thoughts.


The stress of perfection

The founder of psychotherapy, William James, said that you could change your thoughts and change your life.

The trouble with acne is that is can become all-consuming. Whether you’re searching for that next miracle product on wondering how you’re going to hide your most recent breakout, it can end up taking over your mind. And, as you learnt above, thoughts that make you stressed can wind up making your acne worse.

Please don’t mistake me: I’m not saying you’re thinking your way to bad skin. Far from it. You’ve been dealt a genetic hand you had no control over, and the way those genes are interacting with our environment means that you have a susceptibility to breakouts.

It’s our culture of endless filters and perfection that makes you feel extra self-conscious about your skin. When everyone is striving to be flawless, perceived flaws are understandably stressful.

You can’t change your skin overnight, and you certainly can’t change the circumstances of your life overnight. But you can change how you react to them—and that can make all the difference. In the short-term, you give yourself a much-needed mental break. In the long-term, you can help to reduce cortisol and balance your gut microbiome, which are important steps in creating a healthy complexion.


Calm mind, happy skin

There are two key steps to calming your mind.

– Being kind to yourself.

– Finding your joy.

Let’s look at how you can do both.


The Happy Skin Solution Cover


1) Be kind to yourself

Whatever you focus on, grows. And the opposite is true too: pay something less attention, and it will have less of a hold on you.

Your pimples don’t deserve so much of your headspace. Here’s how you can regain control:

a) First, focus on something you do like about your face. Perhaps you’ve been complimented on your eyes or your smile, or maybe you’re proud of your perfectly shaped eyebrows. Whatever it is, seek out that feature every time you look in the mirror. Do this enough, and you’ll come to see that your pimples aren’t the first thing people see about you.

b) Next up: say goodbye to the picking, squeezing and extracting. Let’s be realistic: you know you’re not supposed to squeeze spots, but neither are you willing to walk around with a whitehead on your face. I get it. But carefully extracting a spot with a sterilised needle, dabbing it with tea tree oil and moving on is one thing. Spending minutes (if not hours) scrutinising your face is another. Consider that it doesn’t make your complexion any better, and use that time for something more joyful.

c) Finally, tune into your self-talk. It can be shocking to hear what you’re saying to yourself. You’ve probably belittled your appearance, questioned your value and spitefully compared yourself to others. This has to stop. Any time you feel a thought rise up, ask yourself whether you’d say that to a friend. If you wouldn’t, why are you saying it to yourself? You can’t stop your thoughts, but you can choose not to believe them.

These steps won’t magically clear your skin. But with time and patience, you’ll find that a breakout no longer sends you into a spiral.


2) Find your joy

A key part of relaxation (and reducing your cortisol) is getting out of your head. We’ve all experienced that state of ‘flow’. It’s where you’re so focused that time passes without you realising it. You feel more alive, and maybe even elated.

This is more powerful when it’s an active rather than a passive activity. You may think that watching TV relaxes you, for example, but you may not have unlocked how a calligraphy session can make you feel. For clues about what can get you into flow, think back to what you used to like doing as a child. Maybe dancing is your thing, or perhaps you once had a passion for painting. The sweet spot for flow is where you feel simultaneously challenged and skilled.

To boost your relaxation and enhance your sense of joy, try and get into that state of flow every day. It needn’t be for long: even 15 minutes is valuable. Dedicate whatever time you can afford.

Remember: reduced stress means reduced cortisol. Reduced cortisol means calmer skin.

The options are endless but, if you need inspiration, here are a few suggestions to get you started:

– Pick up that instrument you once played

– Cook a new recipe

– Put on your favourite song and dance

– Read your favourite book

– Have a go at meditation

– Try journalling

– Book a class or workshop to learn something new

Another easy way to get into flow is to spend time with people you love. So, instead of scrutinising your pores, hang out with your family. Rather than scrolling through social media, arrange to meet up with a friend. You’ll soon see that your life is so much more than your skin.


The whole-person approach to acne

When you’re suffering from acne, you just want fast results. Flipping your mindset is probably low on your priority list. But by reducing your stress levels, you’re taking an important step towards creating long-term change in your skin.

To learn more about a whole-person approach to clear skin—including how to support your digestion and get smart about skincare—pick up your copy of The Happy Skin Solution.

Related Posts

Dr Thivi Maruthappu


Dr Thivi Maruthappu is the UK’s first and only dual-qualified Consultant Dermatologist and Nutritionist, and the pioneer of the (much-needed!) Nutritional Dermatology field. She runs busy NHS dermatology clinics, conducts academic research and delivers lectures worldwide. She’s also recently authored her first book, Skin Food, which aims to make holistic skincare accessible for everyone.



Porter magazine called her a ‘Global Skincare Expert’, and Caroline Hirons described her as ‘one of the best facialists in the world’. In the skincare industry, Marie Reynolds is in a league of her own. I had the privilege of experiencing one of Marie’s facials as a young journalist—and I can still remember every exquisite detail more than a decade later.

Cherries for Happy Skin From Within

Give your skin a treat

Want the jumpstart guide to eating for great skin (plus updates from me)? No spam, ever, I promise.