Study of Psychological Stress, Sebum Production and Acne Vulgaris in Adolescents

Abstract

Sebum production is thought to play a major role in acne vulgaris in adolescents. Psychological stress may exacerbate acne; however, it is not known whether the perceived association between stress and acne exacerbation is due to increased sebum production. The aims of this study were to determine: (i) if psychological stress in adolescents is associated with increased sebum production; and (ii) if stress is associated with increased acne severity independent of, or in conjunction with, increased sebum production. Ninety-four secondary school students in Singapore (mean age 14.9 years) were enrolled in this prospective cohort study. During a high stress condition (prior to mid-year examinations) and a low stress condition (during the summer holidays), the following were evaluated: (i) self-reported stress level using the Perceived Stress Scale; (ii) sebum level at baseline and at 1 h; and (iii) acne severity. The prevalence of self-reported acne in this study population was high (95% in males and 92% in females). Most subjects had mild to moderate acne. Sebum measurements did not differ significantly between the high stress and low stress conditions. For the study population as a whole, we observed a statistically significant positive correlation (r=0.23, p=0.029) between stress levels and severity of acne papulopustulosa. In adolescents, psychological stress does not appear to affect the quantity of sebum production. The study suggests a significant association between stress and severity of acne papulopustulosa, especially in males. Increased acne severity associated with stress may result from factors other than sebum quantity.

Bacteriology of Acne

“…Increased acne severity associated with stress may result from factors other than sebum quantity. [8] Acne is not an infectious disease in the classical sense; however, inflammatory acne can be viewed as an infection of the blocked pilosebaceous ducts with Propionibacteria which are trapped by cornified plugs within the follicular ducts. The three major organisms isolated from the surface of the skin and the pilosebaceous ducts of patients with acne are Propionibacterium acnes, Staphylococcus epidermidis and Malassezia furfur.…”

Adolescent Female Acne: Etiology and Management

“…Acne patients often present with a variety of lesions in various stages along with post-inflammatory acne scars and hyperpigmentation. 4 Other potential factors that may contribute to acne development and severity include genetics, 5 stress, 6 and exogenous exposure to comedogenic substances including tars, polyvinyl chloride, and medications (corticosteroids, androgens, halogens). 7 Positive association with acne and milk intake (both whole and skim) in women has been recently noted as well.…”

Psikonöroimmünoloji ve Multifaktöryel Psikodermatolojik Hastalıklar

“…Periferik sinirlerden salg›lanan SP'nin sebase glandlar›n proliferasyonunu stimüle etti¤i ve sebase hücreler-de lipit sentezini artt›rd›¤› son zamanlarda gösterilmifltir. SP d›-fl›nda β-endorfin, VIP, NPY, CGRP'nin ve opioidlerden MSH α'n›n sebositlerdeki yang›sal sitokinleri, hücre ço¤almas›n›, farkl›laflmas›n›, lipogenez ve androjen metabolizmas›n› düzen-ledi¤i ileri sürülmüfltür [37][38][39] . 1960'l› y›llardan itibaren strese ba¤l› klinik alevlenmeler baz› otörler taraf›ndan gözlenmeye bafllanm›flt›r 40,41 .…”