Can Stress Cause Pimples? Experts Explain the Mind-Skin Connection

Ever notice that your skin flares up during a tough week? You’re not imagining it. Stress, anxiety, and even depression can trigger pimples and acne — a real phenomenon known as the mind-skin connection. 

In this article, we’ll break down how stress affects your skin, why anxiety and depression can trigger pimples, and what you can do to protect both your mind and your complexion.

The mind-skin connection

The mind-skin connection is more than just a wellness buzzword. It’s the focus of a field of medicine called psychodermatology (or psychoneurocutaneous medicine). Research shows that physical and mental stress can fuel breakouts by disrupting your body’s inflammatory and hormonal balance. 

The mind-skin connection doesn’t just apply to acne. Any skin condition can affect mental health. In fact, people with chronic skin conditions, like psoriasis and atopic dermatitis (eczema), can also feel significant psychological and social distress. And this can lead to a worse quality of life. 

How stress worsens acne

Anxiety, depression, and stressful situations don’t actually cause acne, but they can worsen it. 

Acne develops when hair follicles (pores) become clogged with: 

• Sebum (excess oil)

• Dead skin cells

• Bacteria

Blocked pores lead to skin inflammation, which shows up as pimples, blackheads, or cysts. 

When you're under stress, a few different things happen to make breakouts worse or more frequent in people who have underlying acne.

Increased oil and hormone levels

When your brain experiences stress, it releases more cortisol, a hormone that can stimulate your skin’s oil glands to produce more sebum. This extra oil increases the chances of clogged pores and breakouts. 

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• Want clear skin without draining your wallet? From prescription options to over-the-counter staples, see our top picks for the best-value acne treatments.

• Living with adult acne: Read one woman’s story about how she managed adult breakouts with medication, lifestyle changes, and a dose of patience.

Inflammation and slowed skin healing

When you're stressed, your body ramps up the production of inflammatory chemicals, like cytokines, and reduces the effectiveness of the immune system. This creates a perfect storm for skin problems: Inflammation makes acne lesions redder, more swollen, and often more painful, while delayed healing means pimples take longer to resolve. Over time, chronic stress can also disrupt the skin barrier, making it harder for your skin to repair itself and defend against new breakouts. 

Stress-induced picking

It’s never a good idea to pop or pick at pimples. This can introduce new bacteria to the skin, slow healing, and lead to scarring. But people who experience physical or mental stress may be more likely to touch or pick at their acne. 

Neglecting your skincare routine

Treating acne requires time and patience. It can take 2 or 3 months before an acne treatment really starts working. 

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But, when you're stressed, basic self-care often takes a backseat — and that includes your skincare routine. You might skip washing your face at night, fall asleep with makeup on, or stop using acne treatments consistently. These slip-ups may seem minor in the moment, but they can quickly lead to clogged pores, excess oil buildup, and more breakouts.

On top of that, because stress makes acne worse, a skincare routine that worked before might not be effective during high-stress periods. And, stress can also make skin more sensitive, too. So, it’s common for people to give up their usual acne skincare routine when they’re stressed. 

The key is to stick with a simple, consistent skincare routine, even when you're overwhelmed. Choose gentle, non-irritating products that support your skin through the ups and downs.

Stress-induced lifestyle changes

Stress can make it harder to maintain routines that support skin health — and easier to fall back on behaviors that quietly sabotage your skin health. Here are some examples of how this may play out:

• Eating more processed or sugary foods: This can spike insulin levels and increase inflammation. Both are linked to acne breakouts.

• Skipping sleep or getting poor-quality rest: This can affect hormone regulation, immune function, and skin cell turnover — all critical for clear skin.

• Getting less exercise: Physical activity plays a meaningful role in supporting clearer, healthier skin. It improves blood flow to the skin and regulates cortisol levels. And, not getting enough exercise has knock-on effects on stress, sleep quality, inflammation, and the immune system. 

Can antidepressants and other medications worsen acne?

Some medications prescribed for depression, anxiety, and mood disorders can trigger or worsen acne and other skin conditions. This is often due to the way these drugs affect hormone levels, inflammation, or oil production in the skin.

Examples of medications linked to acne or skin changes include:

• Lithium (Lithobid) 

• Lamotrigine (Lamictal) 

• Escitalopram (Lexapro)

• Citalopram (Celexa)

• Sertraline (Zoloft)

If you’re taking a mental health medication and notice a sudden change in your skin — such as more frequent or severe breakouts — it’s worth talking with your dermatologist or other healthcare professional. They may adjust the dose, recommend a different medication, or suggest skincare strategies to help manage the side effects without compromising your mental health treatment.

How does acne affect mental health?

Acne isn’t just a cosmetic concern — it can take a real toll on your emotional well-being. 

Research shows that people with moderate to severe acne are more likely to experience mental health symptoms, including:

• Depression: Depression is up to three times more common in people with acne compared to those who don’t have acne, especially in adults. 

• Suicide: Some studies report about 5% of people with acne and depression experience thoughts of suicide. That’s a small percentage, but it’s higher than the general population. 

• Anxiety: People with acne are almost three times more likely to have moderate to severe anxiety. And, similar to depression, anxiety affects both adolescents and adults with acne, but the link is stronger in adults.

• Poor self-esteem: Low self-esteem is a common consequence of acne in all age groups — but especially in women and people with severe acne. Other related effects on mental well-being include extreme embarrassment, frustration, anger, and self-consciousness.

• Social phobia: Some people with acne can develop social anxiety disorder and agoraphobia (the fear of leaving home or going into crowded places).

• Stress: Hard-to-treat acne also causes stress, which in turn triggers worsening acne. This creates a cycle that can be hard to break. 

Because acne often appears during adolescence and young adulthood — times when social connection and identity are forming — its emotional impact can be especially intense.

This creates a frustrating feedback loop: Stress about acne can make breakouts worse, and worsening breakouts can cause even more stress. You may find yourself constantly checking mirrors, avoiding social situations, or feeling ashamed of your skin — all of which can erode your confidence and quality of life.

Treating acne when you have anxiety or depression

In some cases, the psychological burden of acne may be as serious as the condition itself. That’s why skin and mental-health professionals focus on treating the mind-skin connection with a whole-person approach — one that considers both the physical and mental aspects of skin health.

It helps to be open and honest with your healthcare provider about how you’re feeling. There’s good evidence that successfully treating acne can help with feelings of depression.

There are many effective prescription and over-the-counter (OTC) treatments for acne. Here, we’ve rounded up the best-value acne medications. But the best treatment approach for your acne depends on which type of acne you have, how severe it is, and which treatments you’ve tried in the past. 

Some common treatments include medications that:

• Fight bacteria and lower inflammation (like benzoyl peroxide and antibiotics)

• Promote healthy skin growth (like tretinoin and other retinoids)

• Stabilize hormone levels (like oral contraceptive pills and spironolactone)

How to prevent stress-related pimples?

The best way to prevent stress-related acne is to focus both on managing your stress and developing good skincare habits proven to prevent breakouts. While you can’t eliminate all stress from your life, you can reduce its impact on your skin with a few targeted strategies:

• Stick to a simple, consistent skincare routine. During high-stress times, gentle cleansing and regular moisturizing can go a long way. Avoid harsh scrubs or over-washing, which can irritate skin and worsen acne.

• Re-commit to your acne treatment plan. If you already have an acne treatment plan, stick with it. Though it’s tempting to skip steps or abandon your routine altogether, consistency is key, especially during tough times.

• Prioritize stress management. Talk to supportive family and friends, spend time outside, or try techniques like mindfulness, meditation, deep breathing, or journaling. These can help regulate your nervous system and reduce cortisol spikes that trigger breakouts. 

• Move your body. Regular exercise supports circulation, lowers stress, and helps balance hormones — all of which benefit your skin.

• Get enough sleep. Aim for 7 to 9 hours of quality sleep to help your body regulate hormones, reduce inflammation, and repair the skin. 

• Watch for lifestyle triggers. Stress might lead you to eat more sugar, touch your face more often, or skip your usual self-care. Being aware of these habits can help you avoid them.

If you continue breaking out despite these changes, consider getting professional help from a therapist, a dermatologist, or both. They can help tailor a treatment plan that addresses both the root causes of your acne and your current stress levels.

When to seek help for anxiety and depression when you have acne

It’s very important to address any depression, anxiety, or other mental health issues you may be experiencing. If you have any of these, your dermatologist may refer you to a mental health professional for therapy sessions or even medication. Keep in mind that it can take a few months to find the best acne treatment plan for you. So, try not to get discouraged, and work with your healthcare professional to find the best approach for you.

If you have thoughts of suicide, seek help immediately. The National Suicide Prevention Lifeline is always there to help — just call 1-800-273-8255. 

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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