School Stress, Hormones, and Acne

Dear Dr. Benabio,

OMG, my face is a disaster! My acne is worse than ever. PLZ help me!


Your Patient


Many of my patients email me; this is the most common email I am getting this week. Why is everyone’s acne flaring up all of a sudden? It’s because of this simple formula: [High School Stress + Hormones = Acne].

Acne results when your pores clog, trapping sebaceous oils and bacteria deep in the skin. When you’re under stress, your body releases cortisol, a hormone that helps you stay alive in life or death situations. High school, however stressful, is not usually life or death, but your body doesn’t know that, and it reacts as if it were.

Two side effects of increased cortisol are increased sebaceous oil production and increased inflammation in your skin. The result: big, red pimples in the middle of your face that make you now wish you were dead.

If you have painful, cystic acne bumps, then your dermatologist can inject the worst ones with steroids to reduce the inflammation and to flatten them out quickly — “Nurse! Give me a syringe with Kenalog. Stat!” (Who said I don’t do emergencies?) Steroid injections can, however, cause atrophy or dimpling in your skin, which can last for months — much longer than the original pimple.

  • Spot treating acne is difficult at home. Tretinoin products such as Retin-A, Differin, or Tazorac do not work if applied to acne spots.
  • You can pop a pimple; however, unless it has a white head, squeezing usually just makes a little pimple into a big pimple.
  • Apply a spot acne treatment such as Neutrogena Rapid Clear Fight and Fade Gel. The mild acids in it help dissolve a pimple when applied directly.
  • Use a spot cover-up or concealer that has salicylic acid in it. Yes, guys, it is OK for you to apply a dab of cover-up. Use your sister’s.
  • If you have a little extra cash lying around (humor intended), then acne zappers like Zeno can help. They apply heat directly to the pimple killing the bacteria and hastening recovery. Or just use your iPhone, (I’m sure they will have an app for that soon, right?).

Remember that school is stressful, so eat well, sleep well (preferably not in calculus class), and exercise regularly. These will decrease your stress hormones and help keep you acne free.

Disclaimer: I did not receive any free products or reimbursement from any products mentioned in this post; these are my unbiased suggestions.

Photo: John Steven Fernandez

12 thoughts on “School Stress, Hormones, and Acne”

  1. Dear Dr. Benabio,
    What is the best way of finding great a Dermatologist in my area (LA)? How do I know if they are good at what they do? is there a website w/ ratings?

  2. What is the best way of finding a great Dermatologist in my area (LA)? How do I know if they are good at what they do? is there a website w/ ratings?

  3. LOL! This entry is written with such great wry humour. I absolutely adore reading such wonderful entries — they make science so interesting.

  4. Dear Doc,,
    i’m quite interested on becoming a dermatologist myself in the near future,,
    I’m from Malaysia currently taking Cambridge Advanced Level in Science(Pre-U course),,
    can u tell me ur pathway of becoming a dermatologist??
    like numbers of years and fees=)
    thank youXD

  5. Hi Jeff -When you have a chance ..please see your plucking hairs myths post. thanks! 🙂

  6. Hi Doc! Just a quick message to let you know how much I enjoy and appreciate your blog. I love your style of writing, its so easy to read. I have my own skin care blog called and I just thought it might be a good read for some of your followers! Once again thanks for all of the fantastic informational articles and keep it coming! Take care.

  7. I’m not in high school. In fact, I’m 38 and still break out during stressful months. This past month was particulary trying and I had zits all over my nose and chin. I bought two things that really helped.

    First, the Neutrogena Rapid Clear Fight and Fade Gel (as recommended by Dr. B) worked surprisingly well. And second, even though I’ve been using Retin-A for 3 years, I bought a salicylic acne wash to use for a few days as well. Normally I would never use an acne was AND Retin-A, but Neutrogena’s Oil Free Acne Stress Control worked well without drying my skin too much. They add green tea and cucumber as “soothers”, and I guess it works.

    Just thought I’d throw that out there for those of you standing in the acne aisle overwhelmed and unsure of what to buy. The new Neutrogena stuff is pretty good.

  8. Have you tried Nuox for Acne?

  9. This is a good source for finding a dermatologist in your area.


  10. Visiting your Blog today. Thanks for this information. Pleased to meet you.

  11. HighSchooler says:

    What is the best scrub for blackhead prone skin? I have been using Epiduo and Proactive at night, as well as fight and fade gel for mild flare ups with a 2% salicylic acid pad in the morning and Minocyclin every other day. I exfoliate once a week and use a clay mask every three days on my nose. My acne flareups seem to be caused by the clogged pores that I cannot get rid of, any suggestions for a scrub instead of Proactive?

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