Stress and Hormones: What You Can and Can’t Control

Acne doesn’t just come from clogged pores - your body plays a major role too.
For many people, breakouts seem to appear during times of high stress, lack of sleep, or hormonal shifts. That’s not just coincidence. Your skin responds to internal changes, especially stress and hormones, which can influence oil production, inflammation, and even how well your skin heals.

Understanding these triggers won’t make acne disappear overnight, but it can help you take back some control.

How stress affects your skin
When you're under pressure from school, work, relationships, or just everyday life, your body produces more cortisol, the stress hormone. Higher cortisol levels increase sebum (oil) production in your skin. This makes it more likely that your pores will become clogged, especially if your skin is already acne-prone.

Stress also increases inflammation in the body and can weaken the skin barrier, making it more sensitive and slower to heal. And let’s be honest, during stressful periods, it’s easy to skip your routine, sleep less, touch your face more, and pick at breakouts. All of that adds up.

The hormonal connection
Hormones, especially androgens, play a major role in acne. These hormones signal your skin to produce more oil, which can clog pores and lead to breakouts. Hormonal fluctuations can happen during:

• Puberty
• Menstrual cycles
• Starting or stopping birth control
• Polycystic ovary syndrome (PCOS)
• High physical or emotional stress
• Changes in medication

Hormonal acne tends to show up along the jawline, chin, or lower cheeks and often involves deep, painful bumps that don’t come to a head. It may flare at the same time each month or during specific phases of your cycle.

What you can actually do about it
You can’t eliminate hormones or prevent stress entirely, but small changes can make a big difference. Start with these:

• Stick to your skincare routine, even when life feels overwhelming
• Get enough sleep (7–9 hours is ideal) so your skin can repair overnight
• Eat consistent, balanced meals that keep your blood sugar stable
• Move your body in a way that feels good - gentle exercise can reduce stress
• Track your cycle if your acne flares monthly, and prep your skin ahead of time
• Try stress-reducing habits, like breathwork, short walks, or even journaling

These strategies won’t stop hormonal shifts, but they can reduce the severity and help your skin stay more balanced.

When to talk to a provider
If you’re dealing with regular breakouts around your cycle or experiencing deep, painful acne along the jawline or chin, it might be time to speak with your provider. Treatments like topical retinoids, oral antibiotics, or hormonal medications (like spironolactone or birth control pills) can be helpful in managing hormone-related acne.

Your skin reflects more than just your skincare products.
Stress and hormones are real, biological triggers, but with support, strategy, and sometimes prescription help, you can keep your skin calm through the ups and downs.

Sources to learn more:
Mayo Clinic | National Institute of Health | Johns Hopkins