Volume 30, Issue 168, February 2026

The influence of sleep quality and psychological stress on the severity of acne vulgaris

Wiktoria Ciszewska^1♦, Julia Brodziak¹, Anna Mazur¹, Katarzyna Fojcik¹, Marta Kowalska¹, Zofia Kosztyła-Czech¹, Michał Dworak¹, Tomasz Wiśniewski¹, Mateusz Matyja²

¹Medical University of Silesia, Poniatowskiego 15, 40-055 Katowice, Poland
²Specialist Voivodeship Hospital of Saint Barbara No. 5 in Sosnowiec - Trauma Center, Plac Medyków 1, 41-214 Sosnowiec, Poland

^♦Corresponding author
Wiktoria Ciszewska, Medical University of Silesia, Poniatowskiego 15, 40-055 Katowice, Poland

ABSTRACT

Acne vulgaris is known as one of the most common inflammatory skin diseases. A chronic course and complex etiology characterize it. In recent years, an increasing number of publications have highlighted the role of psychosocial factors, including stress and sleep quality, as potential modulators of sebaceous gland activity, the inflammatory response, and the clinical course of acne. This review summarize the current scientific literature on the association between sleep disorders, psychological stress, and the clinical severity of acne vulgaris. Through searches of PubMed, PubMed Central, and Google Scholar, we identified 29 relevant articles published in the last decade. The research findings primarily support the notion that poor quality of sleep is connected to more severe acne, increased sebum production, and signs of a weakened skin barrier. In adolescents and young adults, increased levels of psychological stress are also associated with more frequent and more severe acne. Many mechanisms are responsible for this condition. The activation of the hypothalamic–pituitary–adrenal axis, elevated cortisol and corticotropin-releasing hormone levels, pro-inflammatory cytokine production, and substance P expression are some examples. Overall, available evidence indicates that assessing and addressing stress and sleep problems may be a valuable adjunct to standard pharmacological treatment of acne vulgaris.

Keywords: Acne vulgaris, sleep quality, psychological stress, psychodermatology, acne severity

Medical Science, 2026, 30, e42ms3780

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DOI: https://doi.org/10.54905/disssi.v30i168.e42ms3780

Published: 23 February 2026