It's a fact stress makes teens spotty!

A large study had found that stress exacerbates teenage acne.

Researcher Dr. Gil Yosipovitch, a professor of dermatology at Wake Forest University School of Medicine, along with researchers in Singapore conducted a study with 94 high school students in Singapore.

Singapore has a stable climate where weather factors remain constant and they set up a test to see if stress is a contributing factor in teenage acne.

The students had an average age of just under 15 and were undergoing an annual exam that determines who will go on to university and who will follow some other pathway.

The study looked at whether levels of sebum, the oily substance that coats the skin and protects the hair, increase in times of stress and are related to acne severity.

Acne is an inflammatory disease of the skin caused by changes in the hair follicle and the sebaceous glands of the skin that produce sebum.

The oily substance plugs the pores, resulting in whiteheads or blackheads (acne comedonica) and pimples (acne papulopustulosa).

The researchers suspected that stress increases the quantity of sebum, which leads to increased acne severity, however, the results showed that sebum production didn't differ significantly between the high-stress and low-stress conditions.

The students were asked to complete a questionnaire widely used in stress research, once just before mid-year exams and again during the summer break; dermatologists assessed whether the students' acne worsened.

The researchers found that teens who claim that stress makes them break out in spots have a point and are telling the truth as the stress of taking an exam can make pimples worse.

There has been little research to understand the mechanisms behind this relationship but Dr. Yosipovitch believes inflammation may be to blame rather than greasy skin, and stress makes the skin condition worse.

Blackheads, whiteheads and pustules are all caused by a waxy substance called sebum that can be overproduced and clog pores of which adolescents are especially prone to, but studies have shown cleanliness and diet are not important factors.

Yosipovitch believes the findings may apply to other skin conditions as many skin diseases are associated with stress such as eczema, psoriasis, and chronic itch.

Yosipovitch believes the skin is a mirror to what is going in a person's mind.

The research was funded by the National Medical Research Council of Singapore and is published in Acta Derm Venereol, a Swedish medical journal.