It’s a common experience: You’re feeling stressed out about work, family issues, relationships or something else. Then to add insult to injury, a giant pimple appears.
Anyone who’s been there knows that the link between the skin and stress is undeniable. But what exactly is going on with the skin — the body’s largest organ — when we feel this way? HuffPost asked dermatologists to break it down.
Stress elevates cortisol levels.
“Stress can have a profound effect on the body, including our skin,” said Dr. Nkem Ugonabo, a dermatologist and assistant professor at Albert Einstein College of Medicine. “It leads to the release of hormones such as cortisol, which leads to a cascade resulting in increased inflammation in the skin.”
Widely known as the body’s “stress hormone,” cortisol wreaks havoc on the skin barrier ― the part of your skin that keeps in good things like water, and keeps out bad things like irritants and allergens ― so that it can’t function as well.
“Hormonal changes like elevated cortisol can worsen existing skin conditions like acne, eczema, psoriasis or rosacea by increasing oil production and inflammation,” said Dr. Joyce Park, a dermatologist at Skin Refinery and the creator of Tea with MD.
If you’ve ever experienced “stress acne,” you know the connection between the skin’s appearance and inner feelings of pressure or anxiety. This is particularly common among those who are already prone to breakouts, as stress hormones lead to the overproduction of an oily substance known as sebum.
“Elevated cortisol in particular is associated with pimple formation and acne because steroids like cortisol stimulate sebum production,” said Dr. Karan Lal, a dermatologist with Affiliated Dermatology. “It also weakens your skin microbiome, allowing acne-causing bacteria to grow. Cortisol also leads to clogging of pores, also known as comedone formation.”
The brain-skin axis may set off a vicious cycle.
“The brain-skin axis is a bidirectional pathway that can explain how stress can manifest on the skin,” said Dr. Gloria Lin of Schweiger Dermatology Group. “It is important to note that this is a two-way street. Psychological stressors can have effects on the skin, but the skin can also be exposed to stressors from the outside world and cause feedback to the brain that can then worsen the psychological stress.”
This can start a vicious cycle of stress from both ends of the brain-skin axis, which may ultimately worsen the negative effects on the skin. Lin noted that chronic stress tends to have serious, long-term effects, though small doses of acute stress can lead to issues too.
“Stress can cause the activation of the hypothalamic-pituitary-adrenal (HPA) axis, which is an important mediator of the body’s stress response,” Lin explained. “It can cause the downstream release of cortisol, the primary stress hormone, from the adrenal glands. In addition, catecholamines like epinephrine, which is part of the ‘fight or flight’ response of the body, are also released. These can stimulate the release of pro-inflammatory cytokines, which are signaling proteins that are responsible for cell-to-cell communication, leading to downstream inflammation.”
This pathway can launch the activation of mast cells, for example, and these can cause your skin to feel itchy. Dryness and redness are other potential effects.

Ekaterina Goncharova via Getty Images
Stress can accelerate skin aging.
“Stress can negatively impact how the skin ages,” said dermatologist Dr. Mina Amin. “Stress hormones can lead to a breakdown of collagen and elastin in the skin, resulting in premature fine lines and wrinkles. As a dermatologist, I also commonly see hair loss due to stress.”
Indeed, prolonged periods of high cortisol levels can accelerate signs of aging like a loss of skin elasticity and the appearance of new wrinkles.
“Catecholamines and cortisol can lead to DNA damage and inhibition of DNA repair that will also lead to premature aging,” Lin said. “Stress can also increase reactive oxygen species that are free radicals that can damage the skin. Lack of sleep, which causes increased stress, has been shown to increase the rate of skin aging.”
There are other health implications.
“Stress can slow wound healing due to increased circulation of cortisol,” said Dr. Courtney Rubin, a dermatologist and co-founder of Fig.1 Beauty.
Researchers have found that it often takes longer for injuries or surgical wounds to heal in patients who are stressed out, compared with those who have lower stress levels.
“The HPA axis is important for skin barrier repair, so when this is disrupted, then it can lead to delayed wound healing,” Lin explained. “The epinephrine pathway can also constrict the blood vessels and limit the oxygen and nutrient supply to the skin. There can also be an increased risk of infection due to impairment of the immune system from stress.”
Stress generally makes the skin more sensitive and vulnerable to infections. It’s not uncommon for acute stress to reactivate the virus that causes shingles. And chronic inflammatory skin diseases are more likely to get out of control.
“Some people may experience a variety of rashes such as eczema, hives and psoriasis,” Ugonabo said.
“As a dermatologist, I commonly see skin conditions such as rosacea, seborrheic dermatitis, eczema, psoriasis and alopecia areata worsen with stress, mainly due to the increase in inflammation,” Amin echoed.
You can help your skin get through stress.
There are steps you can take to deal with the effects of stress on your skin.
“I often tell patients that if they are stressed and their skin is suffering the consequences, try to simplify their skin care routine instead of using more products,” Park said. “Oftentimes more products only irritate the damaged skin barrier more. Focus on gentle cleansing, hydrating and repairing the skin barrier to minimize inflammation and maintain skin health.”
Dallas-based dermatologist Dr. DiAnne Davis recommended maintaining a skin care routine that not only protects your skin but also allows you to slow down, relax and practice self care.
“Eat a well balanced diet and drink plenty of water,” she added. “Exercise daily to boost your energy and mood. Get plenty of sleep ― which most of us don’t do.”
Tackling the stress at the root of the problem can be even more helpful in this situation.
“Believe it or not, managing stress is a key part of your skin care routine,” Amin said. “My favorite methods of relieving stress include meditation, yoga and breathing techniques, which can all contribute to decreasing stress and ultimately helping your skin.”
Want help dealing with inflamed skin? Here are 26 skin care products for issues you didn’t even know had solutions.
HuffPost and its publishing partners may receive a commission from some purchases made via links on this page. Every item is independently curated by the HuffPost Shopping team. Prices and availability are subject to change.
A cooling and hydrating eye stick
Promising review: “I have always had bags and dark circles under my eyes and have tried sooooo many things. I was skeptical that this would work, but oh. my. goodness. This little stick is amazing. The puffiness was gone. Dark circles, still there some but definitely not as bad. It also smells really nice and absorbs instantly. Plus, the container is cute. I highly recommend to anyone else who has tried all the things and been disappointed.” — HeartsUnfold
A brighting, firming and de-puffing eye cream
An oil-absorbing volcanic face roller
Promising review: “As I have oily skin that typically gets worse in the warm weather, I usually buy blotting papers to remove excess oil in my T-zone. Those work fine, but THIS product is absolutely ingenious! Not only does it work beautifully without disturbing my makeup, it’s reusable, easy to clean, and most importantly to me, it is so much more eco-friendly!I highly recommend this to all my oily-skinned beauties out there!” — GodivaRn
A scar-reducing skin care oil
Get it from Amazon for $9.95
A bump-erasing and skin-smoothing body scrub
A skin-brightening and scar-reducing kojic acid soap
Promising review:
“My wife and I recently started using this kojic acid soap, and it has truly worked wonders for our skin. The results have been impressive. Not only has it helped fade dark spots and blemishes, but it has also given our skin a brighter and more even complexion. I’ve noticed a significant improvement in the texture of my skin as well, and it feels smoother and softer. This soap lathers well and has a pleasant scent for us, making it a joy to use daily. We’re delighted with the results and highly recommend this for anyone looking to achieve more radiant skin.” — BATHUSI LOBAKAA gentle and hydrating cream cleanser
A delicious-smelling and skin-firming Bum Bum cream
Promising review: “Y’all. This stuff smells like heaven. Somehow this scent is appropriate for summer and winter at the same time. It absorbs quickly with no sticky feelings afterward. The one thing that might deter some people from buying it is that there is a shimmer to it. Once I’ve used it on my hands, I notice that in sunlight, my skin has a bit of a glimmer. I personally love this and can’t wait to use this lotion during the summer. I think it’s 100% worth the high price tag. When I can summon up the will to spend the money, I’ll be buying the body wash, spray, and full-sized lotion as well, as the current, the mini lotion stays in my purse.” — Elizabeth
A boob polish to firm and tighten
An octopus-shaped scrub stick to remove whiteheads and blackheads
A pack of 36 blemish-healing hydrocolloid patches
Promising review: “I do not claim to understand the science behind these tiny miracles, but they have changed my life. I spent my work day looking forward to going home and putting one of these bad boys on my newly erupted Mt. Zit and the overnight results were shocking. Not only is it grossly satisfying, but it saved me several days of walking around with a bloody crater in my face because my previous method of dealing with unsightly blemishes was to pick pick pick.” — Adg
Supergoop Unseen Sunscreen
“Every time I’ve worn makeup since I got it, I’ve been impressed by the way my matte foundation glides over it, looks with it, and lasts with it. You can see the texture and color in the photo above; it really does go on completely clear. And it’s water- and sweat-resistant for 40 minutes!” — Natalie Brown, BuzzFeed shopping
La Roche-Posay’s acne-friendly sunscreen with SPF60 protection
A prescription-strength retinoid gel for acne
An anti-bacterial pillow mist
Promising review: “I have really acne-prone skin and breakouts still happening in my thirties. I spray this each night on my silk pillow and my zits have minimized drastically!” — Alina Hepfler
A microdermabrasion exfoliation mitt
A callus-removing foot file
A professional callus-remover gel
Two pairs of skin-peeling foot masks
A nourishing acne-healing oil
Promising review: “Best oil for adult acne! My favorite acne treatment by far!! Everything else dried me out or would make my acne worse. Because my acne is hormonal, not teen acne, I reacted to all of the drying products that are so popular. This oil is super hydrating, doesn’t cause breakouts and actually helps heal my skin and improves clarity. I add a pump of it to my DIY clay face masks once a week too, and it works great in that combo. It also smells amaaaazing. Couldn’t believe my eyes!” — Sophia G.
A piercing-caused keloid scar-reducer
Talk to your doctor before attempting to treat your keloid on your own, and learn more about keloids from Cleveland Clinic.
Promising review: “This product is amazing! Truly a miracle product. I had an AWFUL keloid forming near my nose piercing about six weeks after getting it done and it was getting bigger and more irritated by the day, nothing was helping. I bought this and started using it and in less than two weeks my huge keloid was completely gone!I was definitely skeptical and a little nervous when it didn’t seem to be getting noticeably smaller after a week but then the second week, it started totally disappearing so give it some time to work if your bump is on the larger side. If you remain patient and apply it twice a day, it should do the trick!” — Jordan Caprigno
A heated gua sha stone
A shampoo scalp massager and exfoliator
A detoxifying butt mask
A relaxing and de-puffing ice roller
A nano facial steamer
Promising review: “After having seen my esthetician for a few months, I asked her for a facial steamer she’d recommend for home use. She suggested this one and I have been using it nightly since receiving it. It is VERY user-friendly and certainly is making my skin look healthy and therefore, makeup looks better when I go out for the evening, etc. I highly recommend this product and as I use it with a towel over my head in order to keep the steam more focused on my face, it’s a complete joy and immensely relaxing.” — Antonia O.