While stress doesn’t directly translate to acne, we’re much more prone to breakouts at high-stress times. When we get stressed, our body produces more cortisol, the “fight or flight” hormone, which causes a spike in your heart rate and blood pressure. This can lead to breakouts, according to Bertha Baum, DO, board-certified dermatologist, and cosmetic surgeon.

“Stress has been shown in numerous medical studies to contribute to flares of existing dermatologic conditions like eczema, psoriasis, and rosacea, and to interfere with the skin’s ability to heal and regenerate,” says Sara Hogan, MD, FAAD, and board-certified dermatologist. “In the case of acne, stress hormones like cortisol lead to an increase in inflammatory factors, oil production, and the synthesis of androgens (sex hormones, like testosterone), which in turn lead to further oil production in the skin.”