Edit What about more indirect effects?

<p><strong>What about more indirect effects? </strong></p> <div>Stress is associated with poor sleep quality, which in turn worsens acne, probably by reducing the effectiveness of our immune system. </div> <div> </div> <div>Stress also has an effect on our gut bacteria, upsetting a healthy balance, and this effect on the microbiome can exacerbate acne. Stress can also induce less healthy eating patterns, notably cravings for refined carbohydrates (such as white bread, cakes, pastries, biscuits and fast food) which in turn has been shown to make acne worse. </div> <div> </div> <div><strong>So, if there is good evidence that stress can worsen acne by various means, what can be done to interrupt these vicious cycles? </strong></div> <div>Perhaps obviously, anything that reduces stress may well also reduce the severity of acne. How to manage stress may often relate to its causes, and it may be that a change in life circumstances could be needed. More generally, things that help stress levels include exercise, relaxation techniques, yoga and meditation. </div> <div> </div> <div>If stress is exerting its effects on your skin through diet and your gut bacteria, then this can be remedied by looking after your microbiome. </div> <div> </div> <div>If poor sleep is contributing, then this too can be improved through various techniques collectively known as “sleep hygiene”.</div> <div> </div> <div>Having an effective skincare regime for managing your acne should run alongside your stress management strategies – developing a quick, easy routine using clinically effective skincare should be part of your day and can become part of your winding down,</div>

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