How To Tell the Difference Between Stress Acne and All Other Breakouts

In this world, nothing is certain but death and taxes… and breakouts. We’ve all dealt with a blemish at least once in our lives, and I would bet my life savings that the majority of adults reading this article will experience at least one more before the month is over. They can suck, but they’re just a normal part of having skin—which, you know, is something you generally want to have, particularly on your face. But, as an adult, there are times when acne breakouts can indicate a bigger issue, past the general explanation of clogged pores. 


Donna Hart, MD, is a medical, surgical, and cosmetic dermatologist. Hart is published in several medical journals, is board-certified by the American Board of Dermatology, and is a member of the American Academy of Dermatology, American Society for Dermatologic Surgery, and Women’s Dermatologic Society.

Hormones also play a similar role, but according to Hart, the difference is timing. If you find you mostly get breakouts around your period, it’s likely your acne is related to hormones rather than stress.2 "Hormonal changes, mainly increased androgen levels, have the same affects on oil glands,” Hart says. "The main way to tell the difference is to track acne triggers, for example, after a period of stress versus more regularly with monthly menstrual cycles."

What Causes Stress Acne

what causes stress acne

First things first: What causes stress acne? Stress, of course, but it's a little bit deeper than that. According to a 2017 research review in The Journal of Clinical and Aesthetic Dermatology titled Emerging Issues in Adult Female Acne, a self-administered, dermatologist-validated questionnaire of 3305 women ages 25 to 40 years in France, researchers found "adult onset acne was reported by 41 percent of women," and, "stress was listed as a precipitating factor for acne in half of the women surveyed."3


Dr. Michele S. Green is a board-certified dermatologist with an MD from Mount Sinai Medical School in NYC. Green worked for global skin care brands, L'Oréal, Johnson and Johnson, Bioré, and RoC on the research, development, and safety testing of worldwide product launches. She has published articles in professional journals including The Journal of American Academy of Dermatology and Cosmetic Dermatology.

Where Stress Acne Is Located

hormonal acne

This can vary. If you find you’re normally breaking out in the same place around the same time of month—i.e., your chin or jawline—you can bet that your acne is likely related to your menstrual cycle rather than your stress levels. This is especially true if the acne takes on the form of painful cysts: According to Dr. Green, these "usually appear in the same spot over and over again and become severely chronic because they’ve accumulated so much oil over a span of days or even weeks."

But stress acne, as opposed to other types of breakouts, will usually appear in the oiliest areas of your face. "[Stress] pimples or acne lesions typically appear on the T-zone," Dr. Vaidian shares. “When this is the case, the acne is usually accompanied by dilated pores, shininess, blackheads, whiteheads, and uneven or grainy skin.” Regular acne, on the other hand, will not appear with these accompanying symptoms. Similarly, Dr. Green says that stress acne is often accompanied by telltale signs like redness and itchiness."

What To Do About Stress Acne

stress and hormonal acne

“If you work with your skin, the results will be there one step at a time,” Dr. Green says. For treatment options, she recommends “a topical spot treatment, something like salicylic acid which can be found over-the-counter.” If it’s something deeper—a stress “cyst,” something under-the-skin, perhaps—"just hold a warm or cold compress over the affected area to decrease the pain and/or redness.” This should be done for a few minutes twice a day until the spot is minimized.

“If stress acne seems to happen often, then try switching your skincare routine. Find products that work with your skin, not against it,” Dr. Green recommends. Dr. Vaidian also suggests taking care to ensure your stress levels are managed as well. “Drink plenty of fluids, eat a healthy diet and do things to manage your stress such as get more sleep and do things to relax,” she says.

If you suspect that your acne may be due to stress or hormonal-related reasons, talk to your dermatologist about your immediate skincare options to help speed up your recovery.  

Original Article:

January 25, 2021 — The Wellery

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