Acne’s Connection to Cortisol and Stress

If your skin tends to flare up during times of pressure, disrupted sleep, or emotional strain, there’s a physiological reason behind it. Chronic stress is a well-established driver of acne, and one of the central players in this relationship is a hormone called cortisol.

Cortisol is often referred to as the “stress hormone” because it’s released by your adrenal glands in response to any kind of stress, whether physical (like intense workouts or illness), emotional (relationship tension, burnout), or environmental (poor sleep, blood sugar swings, or even loud noise). While cortisol plays a vital role in helping us stay alert and respond to life’s challenges, prolonged elevations can create deeper imbalances, which may show up on your skin.

How Does Cortisol Affect The Skin?

Cortisol is not inherently bad—it’s necessary for survival. In small bursts, it helps us focus, mobilize energy, and get through tough moments. But when stress becomes chronic, and cortisol stays elevated for too long, the downstream effects can negatively impact multiple systems in the body, especially your skin, hormones, gut, and immune response. Over time, this can contribute to inflammation, breakouts, and impaired skin healing.

3 Ways Cortisol Contributes to Acne

1. Cortisol increases oil (sebum) production

When cortisol is elevated, it increases the activity of the sebaceous (oil) glands. More oil on the skin means a higher chance of clogged pores, especially when mixed with dead skin cells and acne-causing bacteria like Cutibacterium acnes. For people already prone to acne, this can lead to more frequent or severe breakouts, particularly on the face, chest, and back.

2. Cortisol drives systemic inflammation

Chronic stress promotes a state of low-grade, ongoing inflammation throughout the body. This systemic inflammation makes it harder for the skin to recover from breakouts, increases redness and swelling, and can worsen existing skin conditions like acne, eczema, or rosacea. Inflammatory acne lesions (like cysts or deep papules) often take longer to heal and are more likely to scar, especially when cortisol is elevated for long periods.

3. Cortisol disrupts hormonal balance and skin barrier function

Prolonged cortisol elevation affects more than just oil production. It also disrupts blood sugar regulation, which can contribute to insulin resistance over time. Elevated insulin is linked to increased androgen activity (such as testosterone), which further drives sebum production and hormonal acne patterns (e.g., along the jawline or chin).

Cortisol also compromises the skin barrier, which is your skin’s natural defense system. A weakened barrier can make your skin more reactive, irritated, and susceptible to environmental triggers. This is why stress acne often appears alongside dryness, sensitivity, or redness.

Signs Your Acne May Be Stress Related

If any of the following resonate, cortisol may be playing a key role in your breakouts:

Your acne worsens during periods of emotional stress or overwork
You notice flare-ups after poor sleep or long travel days
You’re feeling wired but tired, anxious, or burnt out
You also struggle with digestive symptoms, hormonal imbalance, or fatigue
Topical treatments alone haven’t been effective

How Naturopathic Support Can Help

As a Naturopathic Doctor, I approach acne from the inside out. When stress and cortisol imbalance are part of the picture, treatment isn’t just about products or spot treatments but rather about regulating your nervous system, supporting your adrenals, and restoring balance across the body.

My approach often includes:

Lifestyle and nervous system regulation
Targeted supplementation, including adaptogens like ashwagandha, rhodiola, or holy basil to support adrenal function
Acupuncture, which has been shown to reduce cortisol levels and promote parasympathetic (rest-and-digest) activity
Skincare recommendations that protect a stressed skin barrier
Nutrient repletion for stress-depleted vitamins and minerals like magnesium, B vitamins, zinc, and vitamin C.

Each plan is tailored to your skin, your stressors, and your goals.

Simple, Natural Ways to Lower Cortisol

Supporting your body’s stress response doesn’t have to be overwhelming. Here are a few simple, evidence-based ways to reduce cortisol and support skin healing:

Spend time in nature – Even 20 minutes in a green space can lower cortisol and promote a calmer mood.
Prioritize sleep – Aim for 7–9 hours per night. Poor sleep keeps cortisol high and makes the skin more inflamed and reactive.
Balance your blood sugar – Eating regular meals with protein, fibre, and healthy fats helps keep insulin and cortisol in check. Skipping meals or relying on caffeine and carbs can trigger spikes.
Practice breathwork or meditation – Just 5–10 minutes a day of diaphragmatic breathing or mindfulness can significantly reduce cortisol over time.
Take breaks – Even short moments of rest throughout your day help reset your nervous system and keep your skin (and mind) in a calmer state.

These may seem small, but over time, they build resilience

Final Thoughts

If your acne seems to be mirroring your internal stress, it might be time to take a more holistic look at what’s going on. Chronic cortisol elevation is often overlooked in conventional acne treatment, but addressing it can be the missing link in stubborn or recurring breakouts.

Curious to learn more? Book a free 15-minute discovery call to explore how naturopathic care and stress-focused support could fit into your acne healing journey.