Acne Worsens at Exam Time
It's a small study, with just 22 acne sufferers, but it shows the
condition gets worse for college students facing the stress of
examinations, says a report in the July issue of the Archives of
"We were interested in exploring whether the association people
commonly thought existed was true or not," says study author Dr. Alexa
B. Kimball, associate professor of dermatology at Stanford University
School of Medicine. "This is the first look at that relationship. And
although the numbers are small, the findings are clinically and
Kimball enlisted 22 Stanford students, 15 women and 7 men, with
varying degrees of acne. Dermatologists rated each person for severity
about a month before an examination period and again just before and
after they took their exams. The students also filled out
questionnaires about their stress levels.
Their acne was assessed on the standard Leeds scale, and the results
are reported in strict scientific form, taking possible confusing
factors into consideration.
"By using logical regression and adjusting for change in sleep
hours, change in perceived sleep quality, change in meals per day, and
change in perceived diet quality, an increase in stress strongly
correlated with a progressive increase in acne severity," the report
Each assessment of acne severity by a dermatologist was backed up by
that of a separate investigator, who looked at pictures of the
students. The assessments agreed in 16 of the 19 cases that were
There are several possible explanations for the effect of stress on
the skin, Kimball says. "Most likely it is due to hormonal changes
caused by stress, especially the glucocorticoids," she says.
"Speaking for myself, I've noticed this for years, but there has not
been good literature to support it," says Dr. Marsha L. Gordon,
associate clinical professor of dermatology at Mount Sinai School of
Medicine in New York City. "This does provide some support."
The two dermatologists agree on the best way to handle the problem:
don't pile on medication, but try ways of making stress more manageable.
"There have been studies showing that relaxation and imaging techniques are helpful for people with acne," Kimball says.
"Learning stress-reduction techniques is really a good idea," Gordon says.
And the benefits are more than skin-deep, she says: "Later in life
those techniques can help manage hypertension, migraines and so on."