The Hormone Series Part I: Cortisol and Your Skin, From Acne to Aging

Acne Hormonal Health Inside Out Skin Health

Well the the rumors are true: stress does age us and cause breakouts! *sigh* It’s all thanks to the pesky stress hormone cortisol. Here’s how cortisol impacts your skin, and how to keep this stress hormone in balance for the sake of your skin and general wellbeing.


  • Part 1: Cortisol and Your Skin
  • Part 2: Insulin and Your Skin
  • Part 3: Estrogens and Your Skin
  • Part 4: Androgens and Your Skin
  • Part 5: Progesterone and Your Skin

It’s no big surprise that hormones impact our skin. Just ask any teenager, pregnant woman, lady who recently stopped hormonal birth control, or menopausal woman who’s breaking out.

But which hormones impact the skin, how (hint: it extends far beyond just acne and breakouts!), and how can we keep them balanced?

This is exactly what we’ll uncover in the 5-Part Hormone Series, and in this post, we’re taking a closer look at the body’s primary stress hormone cortisol.

First things first: what is cortisol?

Cortisol is the body’s primary stress hormone — the body releases cortisol in response to stress.

Very important note: “stress” doesn’t just include mental stress and stressors like preparing for a big presentation at work or college midterms.

“Stress” also includes physical stressors like digestive issues, gum disease*, and other sources of chronic inflammation.

*Fun fact: Dr. Sara Gottfried is BIG on oral care for the sake of reducing inflammation and healthier skin. All the details are in her book Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

Our diets and lifestyle can also increase our cortisol levels:

  • High-carb / high-sugar foods
  • Pro-inflammatory foods
  • Caffeine
  • Lack of sleep
  • Fasting (whether purposeful or accidental like skipping breakfast while in a rush to get to work!)
  • Excessive exercise

Yes, I’m sorry to say that lack of sleep and caffeine both significantly increase cortisol levels! As a first-time mom of an almost 1-year-old, I agree that this hurts to hear. *sigh*

There’s no doubt about the fact that anxiety and stress significantly impact physical health and wellbeing, including skin health.

Your body sees all forms of stress (again, mental and physical) as a threat to survival and so prioritizes them over all other functions.

This is why chronic stress has been linked to:

  • Heart disease
  • Hormonal imbalances
  • Increased risk of diabetes
  • Increased risk of cancer
  • Leaky gut and digestive disorders
  • Increased inflammation and inflammatory diseases
  • Inflammatory skin conditions like acne and eczema

… and SO much more.

How does cortisol affect skin? Let’s take a closer look at how stress impacts skin health.

Where to begin!?

[Phsycolofical stress] impairs the permeability barrier homeostasis and stratum corneum (SC) integrity, and reduces both the innate and adaptive immunity of the epidermis.


What does this mean and why does it matter!?

Simply put: stress weakens the skin barrier.

This is a big deal considering the skin barrier traps moisture in and keeps allergens, irritants, and pollutants out. When the skin barrier is impaired, it can lead to inflammation in the skin.

Inflammation is the skin’s archenemy. It’s at the root of every and all skin condition from acne and eczema to premature aging.

But it doesn’t end there.

Stress also impacts skin by:

  • Raising blood sugar levels, which provokes breakouts and acne
  • Stimulating the production of DHEA-S, an androgen hormone that’s directly related to breakouts and acne
  • Contributing to estrogen, progesterone, and androgen imbalances since the body will always prioritize the production of stress hormones over sex hormones
  • Increasing oil and sebum production, and so increasing the risk of breakouts and acne
  • Depleting vital vitamins and minerals like B Vitamins, and the antioxidant Vitamins C and E — these are all key for healthy, clear skin
  • Suppressing the immune system, and so the rate at which skin will heal and the body’s ability to fight off infection (including a zit!)
  • Negatively impacting the health of the liver, which plays such a vital role in managing healthy hormone levels and maintaining healthy, clear skin
  • Contributing to “leaky gut” or increased intestinal permeability — this is a major source of chronic physical stress and is at the root of most digestive issues

*whew, I need to take a breather*

The bottom line: stress and cortisol have a major influence on the health of the skin both directly (as with weakening the skin barrier and altering the skin’s pH) and indirectly (as with causing other hormonal imbalances and raising blood sugar levels).

In fact, stress and skin are so connected that researchers have coined the term “brain-skin axis.”

The brain-skin axis is an interconnected, bidirectional pathway that can translate psychological stress from the brain to the skin…

Stress triggers the hypothalamus-pituitary-adrenal (HPA) axis, a trio of glands that play key roles in the body’s response to stress. This can cause production of local pro-inflammatory factors, such as cortisol and key hormones in the fight-or-flight stress response called catecholamines, which can direct immune cells from the bloodstream into the skin or stimulate pro-inflammatory skin cells.


And again, the brain-skin axis definitely doesn’t end with inflammation.

Cortisol and stress can drive acne and provoke breakouts.

Yes, “stress acne” is very real!

Which is very frustrating since acne is also a big source of stress… it’s a vicious cycle for so many women, and one we need to actively break!

No matter whether someone’s acne has root causes that are primarily topical (the result of impaired skin barrier function typically stemming from an improper skincare routine that causes irritation and inflammation, alters the skin pH and microbiome, and impairs the skin’s natural exfoliation process), or internal (as with hormonal imbalance or chronic digestive issues), stress is only going to make things worse.

One of the primary reasons?

Excess cortisol also ramps up the activity of the sebaceous glands, causing the skin to produce more oil, which leads to blocked pores and breakouts. 

Vogue UK

And it certainly doesn’t end there!

As we’ve discussed, cortisol also drives blood sugar levels up, impairs the production and balance of our sex hormones, slows skin healing and regeneration, suppresses the immune system, causes inflammation, and eats up key skin-protective antioxidants (hello, pore-clogging sebum oxidation).

Not surprisingly, a study focusing on students with acne have found that acne severity significantly increased during a high-stress exam period (source).

Stress can also provoke inflammatory skin issues like eczema and psoriasis.

Studies have found that increased stress levels can cause inflammatory skin conditions like eczema and psoriasis to flare (source).

This is thanks to cortisol’s effect on skin barrier function, inflammation, and the immune system.

Stress can negatively affect skin’s permeability barrier function and homeostasis. In AD [atopic dermatitis/eczema] patients, barrier dysfunction could lead to increased sensitization to allergens and microbial organisms, increased transepidermal water loss, and lowered threshold for itch.

Stress also contributes to the immune and inflammation dysfunction in AD patients.

National Library of Medicine

Elevated cortisol levels also accelerate skin aging.

So are the rumors true? Does stress age us!?

Sadly, yes.

Cortisol is a catabolic hormone, which means it breaks down tissues. The skin is tissue.

Plus, cortisol also increases inflammation in the body and skin. The direct relationship between inflammation and aging is so well established that researchers have coined the term “inflammaging.”

(It’s sort of like a fun celebrity couple nickname, no?)

As well as serving as a signal for the rapid breakdown of collagen, the proteins in skin which give it its structure and firmness, too much cortisol can have a serious knock-on effect on other features associated with skin ageing – think increase in oxidation, inflammation and glycation.

Vogue UK

So now you may be wondering: “How can I keep cortisol levels balanced for healthy skin?”

And of course, clearer, healthier skin is only one of the many, MANY benefits of managing stress and working to keep cortisol levels balanced within a healthy range!

So let’s look at 6 ways you can start getting your cortisol levels under control ASAP.


Studies have found that regularly practicing gratitude can lower cortisol levels by up to 23%. Yes, 23%!

So consider staring a daily gratitude journal practice.

Here’s how to get started:

  • Consider when you can make a 5-10 minute gratitude journaling practice a practical part of your daily routine. In the morning before heading off to work? Before bed?
  • Set an alarm or reminder to help establish the routine.
  • When the time comes, set a 5-10 minutes timer.
  • Start a “brain dump” of everything you’re grateful for that day, big and small. Yes, delicious matcha lattes and snuggles with your dog definitely make the list!
  • Don’t worry about your handwriting, grammar, spelling, or using complete sentences. This is for your eyes only.
  • After the timer goes off, read over your list.


No, baths are not frivolous!

Yes, you can consider them a key part of your wellness routine!

Because not only are baths relaxing (healthy in and of itself!), but the right ingredients provide body and skin with a dose of essential minerals.

Be sure to include epsom salt in your weekly bath. Epsom salt IS magnesium, a mineral that not only promotes muscle relaxation and a better night’s sleep, but has been shown to decrease stress and anxiety levels.

Tip! Up your bathtime game with Body Unburdened Mineral-Rich Bath Soaks for wellness within and glowing skin.


Studies have found that lavender essential oil helps calm the central nervous system and easy anxiety — one found a 70% decrease in cortisol levels! (source)

Tip! To reap the benefits, diffuse lavender essential oil or treat your skin to Body Unburdened lavender & vetiver body oil.


Do you usually skip out on breakfast? Let’s break that habit! Because when we skip breakfast, levels of the stress hormone cortisol rise.

Plus, when blood sugar levels crash, we get “hangry” and irritable. No fun for anyone!

So for the sake of healthy, balanced blood sugar and cortisol levels, aim to eat a breakfast rich in protein and healthy fats within an hour of waking.

TIP! My Protein-Packed Piña Colada Chia Pudding is a great breakfast option to make ahead and grab on-the-go.

This Protein-Packed Pina Colada chia pudding recipe will keep you feeling full and your taste buds satisfied!


Yes, beauty sleep is real!

Numerous studies have shown that a lack of sleep leads to increased cortisol levels (source).

So one of the best and simplest ways to keep cortisol levels balanced and in a healthy range? Make sleep a priority.

TIP! Set a bedtime alarm in your phone and stick to it. To help you fall and stay asleep, do some deep belly breathing or the legs-up-the-wall yoga pose before bed, or enjoy a mineral-rich epsom salt soak (see above!).


… or cut it completely, if you dare…!

Now if you’re thinking I could NEVER get through the day without caffeine, you’d be surprised at just how much balancing your blood sugar levels helps to stabilize and increase your energy levels! Not to mention the effects of prioritizing quality sleep at night.

Again, caffeine increases cortisol levels. End of story.

Bonus: swap your coffee for matcha green tea, which provides a caffeine kick AND a healthy dose of l-theanine, an amino acid that actually promotes relaxation and so helps to balance and lower cortisol levels. This helps offset the cortisol-spike from caffeine. Win!

My matcha recommendation: Encha Latte Grade Matcha


Let’s keep the conversation going in the comments below!


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