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Elevated Cortisol Could Be The Reason to Your Acne, Eczema and Inflammatory Skin Conditions

Home   The Journal   Elevated Cortisol Could Be The Reason to Your Acne, Eczema and Inflammatory Skin Conditions

February 25, 2025

Skin issues such as acne, redness, sensitivity, itchiness, inflammation, and more can have various causes——if the issues stem from a damaged barrier, imbalanced skin microbiome, bacteria, contact and environmental factors, etc., various skincare products can be effective solutions; if the issues originate from poor liver function, acidic body pH, diet, etc., improvement can be achieved through dietary changes and taking certain nutritional supplements. However, while all these are common factors, it could also be related to an excessive level of cortisol in the body!

How does excess cortisol affect the skin and appearance? How does cortisol become elevated? Let's break it down!







Cortisol is a hormone produced by the outer layer of the adrenal glands, and the daily production of cortisol is controlled by higher central mechanisms in the brain such as the pituitary gland and hypothalamus. Normal levels of cortisol help control blood sugar levels, regulate metabolism, resist disease, reduce inflammation in the body, enhance memory, and assist the body in regulating daily circadian rhythms for waking and sleeping.

However, just as one must drink enough water but consuming too much water can lead to water intoxication, while we need cortisol for body functions, elevated cortisol levels can cause various health issues, including impaired immune function, various skin conditions, weight gain, muscle loss, decreased bone density, blood sugar imbalances, digestive problems, cardiovascular issues, mood changes, sleep disturbances, and even impaired cognitive function.







When the brain senses stress or anxiety, and the hypothalamic-pituitary-adrenal (HPA) axis gets triggered, the body enters into a "fight-or-flight" response, leading to a significant increase in cortisol production at local sites. As the brain and skin are interconnected pathways, these excess cortisol can direct immune cells to enter the skin through the bloodstream or stimulate inflammatory mast cells, resulting in various reactions on the skin, including itchiness, redness, acne, eczema, psoriasis, rosacea, and even hair loss.

Here is the catch. This pathway between the brain and the skin is not one-way but bidirectional!

Research has found that the skin and hair follicles have complex mechanisms that can generate their own stress-inducing signals, which can travel to the brain and perpetuate the stress response.

Since the skin is constantly exposed to the external environment, it is more susceptible to environmental factors that can induce stress hormones. For example, the skin produces stress hormones when exposed to UV rays and temperature stimuli, and then sends these signals back to the brain, which can in turn contribute to psychological stress and further elevate cortisol levels that can affect skin health.







Some common signs that are telling you your cortisol level is high include:

  • Muscle weakness
  • High blood pressure
  • Weight gain (especially around the abdomen)
  • Increased stress or anxiety
  • Headaches
  • Fatigue and poor sleep
  • Menstrual irregularities
  • Mood swings or irritability
  • Memory problems or brain fog
  • Weakened immune system
  • Digestive issues
  • Increased hunger and cravings for unhealthy foods, such as sweet and fried foods
  • Thinning skin and easy bruising
  • Skin problems






Long-term stress or elevated cortisol levels due to underlying issues can have several negative effects on the skin and appearance, including:


  • Oily Skin・Acne・Enlarged Pores

    When cortisol levels increase, the body also produces higher levels of insulin, which stimulates the skin to produce excess sebum, leading to oily skin. When this excess sebum clogs the pores, issues such as acne, pimples, whiteheads, and blackheads will worsen, and the pores will become visibly enlarged.

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  • Inflammation

    While normal levels of cortisol are believed to have anti-inflammatory effects, being at high levels for an extended period can suppress the immune system, promote inflammation, and make the skin more susceptible to infections, leading to facial redness, sensitivity, inflammation, as well as triggering or exacerbating issues such as eczema, rosacea, psoriasis, and more.

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  • Redness

    Why does our face turn red when we're nervous? This is because a person's blood flow increases with anxiety and agitation, leading to a temporary dilation of the blood vessels in the face. In severe cases, it can even cause swelling! Now, occasional occurrence of this condition is not a major concern, but when the blood vessels remain dilated for a prolonged period of time, redness can persist and won't fade away. If you have rosacea, it is even more important to maintain healthy levels of stress and cortisol to avoid further aggravating the blood vessels and worsening the issue.

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  • Damaged Repair Ability

    Elevated cortisol levels can impair the skin's ability to repair itself, making it more prone to damages while slowing down the wound healing process. This essentially means that issues like acne, eczema, rosacea and psoriasis can become difficult to recover from.
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  • Dryness

    Excess cortisol increases the proliferation of keratinocytes and local inflammatory cytokines in tissues, severely weakening the skin's natural barrier function. When the barrier is compromised, the skin's ability to retain moisture decreases, leading to dryness, dehydration, and tightness, and in severe cases, itchiness can occur.
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  • Degradation of Collagen and Elastin

    Starting from the age of 25, collagen and elastin, which are essential for maintaining tight and elastic skin, naturally decrease by about 1.5% per year, and prolonged exposure to high levels of cortisol can accelerate their breakdown. When these two crucial substances are lost at an accelerated rate, the skin will prematurely age, leading to the worsening of issues such as wrinkles, fine lines, sagging skin, loss of elasticity, and enlarged pores.
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  • Uneven Skin Tone・Hypderpigmentation

    It's not just UV rays that stimulate melanin production! Elevated cortisol levels can also promote melanin production, leading to pigment deposition, uneven skin tone, and even the appearance of dark spots!
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  • Skin Problems Caused by Decreased Liver Function

    The liver's main functions include clearing toxins and waste from the blood and the entire body system, as well as regulating carbohydrate metabolism. Research has shown that elevated cortisol levels can directly and indirectly damage liver tissue, leading to liver inflammation, which impairs its proper functioning. When the liver is unhealthy, toxins accumulated in the liver can enter the bloodstream, causing various health issues. Skin problems such as eczema, rosacea, acne, psoriasis, overgrowth of candida, cellulite, etc., also become increasingly severe.

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  • Face Becoming Puffy, Rounder and Fatter

    When cortisol levels increase, sometimes a process called "Lipogenesis", which generates fat tissue particularly on the face, neck, and abdomen, may occur. Additionally, high levels of cortisol can lead to the retention of water and sodium in facial tissues, causing facial swelling.






There are many different factors that can lead to excessive cortisol levels in the body, such as:


  • Chronic Stress

    One of the main reasons for high cortisol levels is chronic stress. When a person is continuously under stress, whether due to work, relationships, love, financial issues, or other factors, the body's stress response system may become overly active, leading to sustained high levels of cortisol.
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  • Sleep Deprivation

    When sleep is insufficient or when sleep quality is poor, the body enters the "fight-or-flight" response. Not only does this disrupt the normal rhythm of cortisol production, to cope with sleep deprivation, it also stimulates a significant increase in cortisol in specific locations in the body.
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  • Unhealthy Lifestyle

    Factors such as prolonged sitting, poor diet (including processed foods and unhealthy fats), excessive sugar intake, caffeine, and alcohol consumption can all lead to an increase in cortisol levels.

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  • Excessive Excercises

    Intense or prolonged physical activity without adequate rest can trigger the body's stress response, leading to elevated cortisol levels.


  • Medications

    Some medications, such as corticosteroids used to treat skin inflammations like eczema and rosacea, asthma, or autoimmune conditions, can cause cortisol levels to rise.


  • Imbalanced hormones

    Imbalances in thyroid hormones, and sex hormones like estrogen, testosterone, and progesterone, can indirectly affect and increase cortisol levels.


  • Diseases

    Some diseases, such as Cushing's Syndrome, are characterized by abnormally high levels of cortisol in the body.






Skin issues caused by high cortisol levels can be improved by using the skincare products recommended above. However, to achieve true and lasting improvement, it is necessary to address the fundamental issue of reducing elevated cortisol levels. You may want to check the above list of factors that can lead to excessive cortisol levels in the body and see which apply to you, and consider meditation, breathing exercises, yoga, deep relaxation techniques to manage stress, adequate sleep, moderate exercise, balanced diet, relaxation activities, healthy social interactions, and maintaining a regular lifestyle, all of which help to normalize cortisol levels.

If you are using steroid creams for eczema and rosacea, it is advisable to refrain from prolonged use. While corticosteroid creams have potent anti-inflammatory effects, long-term use can keep cortisol levels high, which can suppress the immune system and promote inflammation, making the skin more susceptible to infections. Moreover, prolonged use can disrupt the skin's microbiome and defense system, leading to more bacterial or fungal infections. This is why eczema or rosacea symptoms may improve initially with the use of steroid creams but can worsen upon discontinuation, and sometimes becoming more severe than before.

On the other hand, if you suspect that your cortisol level is over the roof because of the medication you are taking, hormonal imbalances, or a medical condition, then it is best to consult healthcare professionals for personalized advice and treatment plans.

Finally, it is crucial to understand that feeling disheartened, helpless, sad, or avoiding social interactions due to skin issue not only adds no value to the situation, but could also inadvertently create psychological stress that result in even more cortisol being produced, ultimately worsening existing skin conditions. Therefore, try to remain calm, stop overlooking in the mirror and think positively. As your cortisol slowly lowers, your skin condition will also start to stabilize.




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