Acne & Stress: How to Stop Cystic Breakouts for Good (2022)

Experts Dr. Joshua Zeichner and Dr. Whitney Bowe weigh in.

Stress is, unfortunately, simply a part of life. With work, school, kids, partners, and friendships to maintain, it often seems like there aren’t enough hours in the day to accomplish everything we wish we could. And since your skin has such a great sense of humor, consistently high levels of stress and anxiety can lead to breakouts (because that’s exactly what you want to deal with on top of everything else).

So what’s the science behind this cycle of stress and breakouts? And how do we break it so that our skin remains calm even after a long, hard day at the office? To learn more about the connection between our mental health and acne, we spoke with two leading experts in the skin-care industry: Dr. Joshua Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York, and Dr. Whitney Bowe, a leading dermatologist based in New York City and the author of Dirty Looks. Here’s everything they had to say about stress and acne.

How Stress Affects Acne

If you’ve read anything about how stress affects the body, you’ve likely heard about cortisol, the primary stress hormone. Says Dr. Zeichner, “During stressful periods, our body revs up the production of cortisol. Cortisol is stimulated by a hormone in the brain known as CRH—CRH binds to oil glands in the skin, stimulating oil production, which then blocks the pores and promotes inflammation.” Think of this as one part of the alarm system going off in your body in response to stressful stimuli, like a presentation that doesn’t go well or a looming deadline. It’s part of your hereditary fight-or-flight response. Normally, your hormone levels return to normal after the perceived threat has passed, but it is possible to experience long-term activation of this response.

The Impact of Chronic Stress

While it’s normal to feel stressed out about certain aspects of your life, if you’re constantly feeling this way, it’s likely to negatively impact both your skin and overall health. Says Dr. Bowe, “Chronic stress is the type that has a substantial impact on the health of our skin. Prolonged stress of any kind impacts your endocrine system, [including] skin conditions like acne, eczema, rosacea, and psoriasis.”

(Video) How I Cured My Adult Hormonal Cystic Acne Naturally (no accutane)

She explains that your body’s counterattack to stress doesn’t just include surges in cortisol, but also involves the breakdown of tissues such as collagen (the fibrous protein that lends structure and support to your skin) and increasing inflammation, which is the body’s protective mechanism against harmful stimuli. “Over time, inflammation can cause everything from skin problems such as acne and rosacea to autoimmune disorders.” In other words, there’s a lot going on below the surface of your skin when you’re having a tough day.

Acne & Stress: How to Stop Cystic Breakouts for Good (1)

Identifying Stress Acne

As we learned with hormonal breakouts, there is a way to identify the root cause of your acne by how it presents on your skin. Says Dr. Bowe of her clinical experience, “I have noticed that stress acne is often more cystic, meaning it is beneath the skin as compared to blackheads or whiteheads. The cysts are deep and often tender or even painful, and they tend to be very persistent. When the cysts resolve, they leave marks that can sometimes last for weeks or even months.”

Dr. Bowe also explains that if she sees a new patient for acne and the legions are “picked or attacked,” that may also be an indication that the acne is due to stress. It’s understandable that you would want to try to squeeze these types of large, angry breakouts to make them disappear faster, but it will be better for you in the long run to leave them alone until you can start a course of treatment and/or see a professional.

“My patients suffering from stress-related acne often come in with post-inflammatory hyperpigmentation and are even more likely to scar because the stress can also aggravate that picking response,” Dr. Bowe says. If you feel like you can’t control this urge to pick, it’s helpful to talk with your doctor, as it might be a condition known as Excoriation Disorder.”

Treatment of Acne Caused by Stress

There are numerous treatment methods for keeping stress-related breakouts at bay and getting rid of them once they decide to rear their ugly heads. If you’re currently experiencing a breakout, Dr. Zeichner recommends using topical medications that contain ingredients like salicylic acid to keep your pores clear. “Salicylic-acid-based cleansers are useful especially during stressful periods because they can more effectively remove oil from the skin as compared to traditional cleansers. Clean & Clear’s Acne Triple Clear Facial Cleanser contains 2 percent salicylic acid to help remove excess oil and added cells from the surface of the skin.”

If you’re experiencing large, red, angry pimples (or “bombs,” as Dr. Zeichner calls them), he recommends using a product that contains benzoyl peroxide. “Benzoyl peroxide helps lower the levels of acne-causing bacteria on the skin and reduces inflammation to clear pimples. [Try] Neutrogena’s Rapid Clear Stubborn Acne Daily Leave-On Mask, which contains 2.5 percent benzoyl peroxide. It is important to treat the whole face because you want to clear your [visible and underlying] pimples, and you cannot predict where the next one will come in.”

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For cystic breakouts, which are some of the long-lasting and toughest to treat, Dr. Bowe recommends a multimodal approach. “I like to tackle cystic acne using minimally invasive procedures in my office, like cortisone injections, chemical peels, and light-based therapies. Additionally, some of my patients have found that the new influx of CBD products are helping to dial down some of the internal stress that is contributing to stress acne.”

Similar to hormonal acne, stress-related breakouts can be addressed by taking certain forms of birth control, but Dr. Bowe explains that daily pills should contain both estrogen and progesterone. “Progesterone-only forms of contraception, such as the ‘mini pill,’ implantable devices, and even some IUDs can make cystic acne much worse.” Be sure to talk with your dermatologist and OB/GYN to determine which form of birth control is right for you.

Acne & Stress: How to Stop Cystic Breakouts for Good (2)

Meditation & Skin Health

Obviously one of the most important ways to control your stress acne is to identify and treat whatever is causing you to feel stressed in the first place. Dr. Bowe has identified the “gut-brain-skin axis,” which essentially is the corollary relationship between these three systems and how they impact one another. The second prong of the axis focuses on mindfulness. “Meditation is a very powerful tool in this context. It has the goal of triggering what’s called the relaxation response, a term popularized by Dr. Herbert Benson at Harvard Medical School. During the relaxation response, the body releases chemicals and brain signals that relieve tension in your muscles, slow down your organs, and increase blood flow to your brain.”

She explains that this response can reduce the pain, discomfort, and anxiety that often manifest themselves in skin conditions like acne, and that scientists now theorize that the biological events taking place during the relaxation response essentially prevent the body from translating psychological worry into physical inflammation. “The experience of the relaxation response appears to change cellular connections in areas of the brain associated with reactions to stress. And the good news is that nurturing a daily practice that turns on your relaxation response can help you more easily cope with stressors in your life that persist or even worsen.”

So not only will incorporating a meditation practice into your daily routine help calm your mind, but you’ll also be able to see tangible results within the body that help prevent and reduce stress-related breakouts. It may help you and your skin feel healthier than ever before.

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How do you get rid of stress cystic acne? ›

How to Handle Stress-Related Acne Breakouts
  1. Salicylic Acid – unclogs pores and reduces oil buildup.
  2. Benzoyl Peroxide – anti-inflammatory and antimicrobial to combat increased inflammation and bacterial infection.
  3. Retinols – accelerates cellular turnover.
11 May 2020

How do you calm cystic acne fast? ›

Cleansing the area: Wash the face with a gentle, pH-balanced cleanser to remove any makeup, oil, or dirt. Applying ice: Wrap an ice cube or cool pack in a cloth and apply to the pimple for 5–10 minutes. Take a 10 minute break and repeat. Applying a topical treatment: Use a product that contains 2% benzoyl peroxide.

Why do I get cystic acne when stressed? ›

When your fight-or-flight response is activated, the body releases stress hormones, such as cortisol and androgens,” Dr. Minni explained. “These hormones increase your skin's oil production, which can exacerbate acne.”

Why am I getting so many acne cysts? ›

This can result from a combination of bacteria, oil, and dry skin cells that get trapped in your pores. Although anyone can develop acne, cystic acne tends to occur in people with oily skin. It's also more common in teens, women, and older adults with hormonal imbalances. Usually, cystic acne can improve with age.

How do you calm hormonal cystic acne? ›

Home Remedies for Cystic Acne
  1. Try topical creams like Retinoid A (adapalene). ...
  2. Use warm compresses to soothe inflammation. ...
  3. Remove makeup every single night before going to bed. ...
  4. Use a gentle facial cleanser. ...
  5. Avoid picking at your skin to lessen irritation and prevent infection from spreading. ...
  6. Consider your diet.
17 Nov 2020

How can I stop my cystic acne from getting worse? ›

You can take some steps to help prevent acne or keep it from getting worse:
  1. Wash your skin twice a day and after you sweat. ...
  2. Don't scrub your skin or use irritating products like exfoliants.
  3. Don't touch cysts or pick at blemishes. ...
  4. Stay out of the sun and away from tanning beds, which can damage your skin.
  5. Try to relax.
8 Apr 2022

What foods cause cystic acne? ›

You're more likely to have acne if your diet is full of foods and drinks like soda, white bread, white rice, and cake. The sugar and carbohydrates in these foods tend to get into your blood really quickly. That means they are high on the glycemic index, a measure of how foods affect blood sugar.

What does anxiety acne look like? ›

Given the increase in oil production, she says your skin will usually look greasier and slightly more inflamed. Zeichner adds that stress acne can also look like a combination of blackheads, whiteheads, red bumps, and pus pimples.

Which hormone is responsible for stress? ›

Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues.

Where is stress acne located? ›

Stress pimples will usually pop up in the oiliest areas of the face, like the forehead, nose and chin. Your T-zone might look greasier and more congested too. Doctors say that if you're getting clusters of pimples all at once, stress can be a factor—hormonal pimples happen one at a time.

Why do I get cysts so easily? ›

One of the most common reasons cysts form on the skin is due to clogged sebaceous glands. These glands lubricate your skin, and if they get blocked, this can cause fluid to pool in one area. Other reasons cysts can form include the following: Injury or irritation to a hair follicle.

What hormone is responsible for cystic acne? ›

Cystic acne can be caused by a variety of factors

Hormone imbalance – particularly fluctuations of estrogen and progesterone. Certain medical conditions, such as polycystic ovarian syndrome. Medications such as testosterone, lithium and steroids can aggravate acne.

What does it mean if I keep getting cysts? ›

They can be a result of infection, clogged sebaceous glands, or piercings. Some other causes of cysts include: tumors. genetic conditions.

What cures hormonal acne fast? ›

How do I treat hormonal acne?
  1. Blackheads and whiteheads: Topical cream (tretinoin).
  2. Inflammatory acne: Topical retinoid and/or topical antibiotic and/or benzoyl peroxide.
  3. Moderate to severe acne: Antibiotic and/or isotretinoin (retinoid).
  4. Cystic acne: Steroid injection (intralesional triamcinolone).
10 Sept 2021

What should I avoid if I have cystic acne? ›

Dairy products, refined foods, and high-sugar foods and beverages should be avoided: Milk and dairy products: milk, cheese, yogurt, etc. Highly processed foods: fast food, frozen meals, meal bars, sugary cereals, chips, microwave meals, white bread, etc.

What should I eat if I have cystic acne? ›

To lower the chance of infection and scarring, cystic acne should be treated by a dermatologist. Your skin can clean up with the use of antibiotics and topical (skin) treatments with prescription dosage.
10 Best superfoods for people with cystic acne:
  • Lemon. ...
  • Berries. ...
  • Nuts. ...
  • Yogurt. ...
  • Oranges. ...
  • Pumpkin seeds. ...
  • Quinoa. ...
  • Salmon.
7 Sept 2022

What to drink to get rid of pimples? ›

Best Acne Detox Beverages
  1. Green Tea. Green tea is one of the most popular morning drinks and one of the most effective beverages for fighting acne. ...
  2. Coffee. ...
  3. Coconut Water. ...
  4. Lemon Water And Honey. ...
  5. Kale Green Juice. ...
  6. Pomegranate Juice. ...
  7. Turmeric Milk. ...
  8. Aloe Vera Juice.

Is banana good for cystic acne? ›

Bananas contain a lot of natural quick release sugar that causes a spike resulting in your skin producing more oil that can exacerbate an already bad acne problem. In fact, bananas scored a whopping 62 (out of 100) on Harvard's glycemic index chart!

How can cysts be prevented? ›

There's no way to prevent most ovarian cysts. But, regular pelvic exams help ensure that changes in your ovaries are diagnosed as early as possible. Be alert to changes in your monthly cycle. Make a note of unusual menstrual symptoms, especially ones that go on for more than a few cycles.

What is good to get rid of cysts? ›

Options include:
  • Draining the cyst. The doctor cuts the cyst and pushes out the gunk inside. ...
  • Injecting medicine into the cyst to reduce swelling if it's tender, swollen or growing,
  • Removing it by minor surgery to take out the entire cyst wall. This usually keeps them from coming back.
  • Laser removal.

Can you get rid of cysts forever? ›

Our dermatologists can drain or remove the cyst for you. The procedure may leave a small scar, but the best excision is the conventional wide excision which will remove the cyst completely. It can leave a longer scar but with this method the cyst is not likely to ever return.

How do I overcome anxiety acne? ›

If you have depression or anxiety, your dermatologist may refer you to a mental health professional for therapy sessions or even medications. Lowering overall stress — like with meditation or exercise — can also be an important way to help keep your acne under control and improve mental health.

How long does stress acne last? ›

Lamb said it might be more challenging to get the acne under control because of the frequent flare-ups that happen over time. But if the breakout is from more of an acute stressor, like the death or illness of a family member, Dr. Lamb estimated that the acne could take about four to six weeks to clear up.

Can acne be mental? ›

Increased acne severity was significantly associated with increased stress levels (P<0.01). A recent questionnaire-based survey among 1,560 adolescents in Greece found a positive correlation between acne and self-reported stress (P<0.0001).

What can I drink for stress? ›

7 Everyday Tonics that Help Your Body Adjust to Stress and Anxiety
  • Ginger.
  • Maca.
  • Matcha.
  • Reishi.
  • Apple cider vinegar.
  • Turmeric.
  • Ashwagandha.

How do I balance my hormones after stress? ›

How to Naturally Balance Your Hormones
  1. Get enough protein. Proteins provide amino acids that your body cannot make on its own and are needed to produce peptide hormones. ...
  2. Exercise regularly. ...
  3. Maintain a moderate weight. ...
  4. Watch your gut health. ...
  5. Lower sugar intake. ...
  6. Reduce stress. ...
  7. Get enough sleep. ...
  8. Eat healthy fats.

What is a symptom of too much stress over a long period of time? ›

•A consistent sense of feeling pressured and overwhelmed over a long period of time. •Symptoms include aches and pains, insomnia or weakness, less socialization, unfocused thinking.

What helps to destress? ›

10 Quick Ways to De-Stress
  • Practice breathing exercises. Focus on your breath, pushing all other thoughts aside. ...
  • Meditate. Meditation helps quiet your mind. ...
  • Mindfulness. ...
  • Practice gratitude. ...
  • Call a support person. ...
  • Do relaxation exercises. ...
  • Exercise. ...
  • Immerse yourself in a creative outlet.

What does hormonal acne look like? ›

What does hormonal acne look like? Whiteheads, blackheads, papules, pustules, cysts and nodules are all common hormonal acne symptoms. Normally, whiteheads and blackheads do not cause pain, inflammation or swelling, but if they do, then they are most likely forming into cysts and pustules.

What is it called when you get a lot of cysts? ›

Collapse Section. Steatocystoma multiplex is a skin disorder characterized by the development of multiple noncancerous (benign) cysts known as steatocystomas.

What is inside of cystic acne? ›

Cystic acne is characterized by sebaceous cysts that lie under the skin. These cysts are larger than normal papules and pimples, and they are sometimes painful.

How do dermatologists remove cystic acne? ›

Only a doctor should inject a corticosteroid. To remove a large pimple or painful acne cyst or nodule, your dermatologist may also use a procedure called incision and drainage. It involves using a sterile needle or surgical blade to open the blemish and then removing what's inside.

How do I know if my cystic acne is hormonal? ›

One of the telltale signs of a hormonal breakout is its location on the face. If you're noticing inflamed cystic acne on your chin or jawline area—anywhere around your lower face, really—you can bet your bottom dollar that it's probably hormonal acne.

How does stress acne go away? ›

As Health previously reported, this can include spending time in nature, doing light exercises, setting work-life boundaries, and cleaning up your space. Also important to keep in mind: Try not to stress even more over your stress acne—it may take a while, but it will go away eventually.

Can emotional stress cause cysts? ›

Stress causes many health problems—but ovarian cysts aren't one of them. [1] Ovarian cysts are a common occurrence often caused by the natural process of your menstrual cycle. While stress doesn't lead to ovarian cysts, it may impact your ability to conceive in other ways.

Why do I develop so many cysts? ›

They can be a result of infection, clogged sebaceous glands, or piercings. Some other causes of cysts include: tumors. genetic conditions.

Why does my body keep creating cysts? ›

Common cyst causes

One of the most common reasons cysts form on the skin is due to clogged sebaceous glands. These glands lubricate your skin, and if they get blocked, this can cause fluid to pool in one area. Other reasons cysts can form include the following: Injury or irritation to a hair follicle.

What hormones cause cysts? ›

Functional cysts

Follicles produce the hormones estrogen and progesterone and break open to release an egg when you ovulate. A monthly follicle that keeps growing is known as a functional cyst. There are two types of functional cysts: Follicular cyst.


1. How to treat EVERY type of acne (With Pictures )
2. Acne: Understanding the Types of Acne and Treatment Options
(Nucleus Medical Media)
3. Dealing With Severe Acne: Skin
(BBC Three)
(Dr Dray)
5. What Your Acne Says about Your Health
(The Doctors)
6. How I Get Rid of a Pimple in One Day

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