STRESS, GUT HEALTH AND ACNE: EXPLORING PSYCHO-INTESTINAL LINKS IN ACNE PATHOGENESIS

Abstract

Acne vulgaris is a commonly occurring inflammatory skin disorder that affects both adults and teenagers and often causes considerable psychological distress. By emphasising the psycho-intestinal pathways that link stress, gut microbiota, and skin inflammation, this narrative review aimed to evaluate the role of psychological stress and gut health on the development of acne. In order to investigate the relationships between stress, dietary impacts, microbial imbalances, and the beginning of acne, evidence from international studies published over the past 20 years is examined. These studies include clinical, epidemiological, and mechanistic investigations. Based on the findings, a complicated interplay between follicular hyper keratinization, increased sebum production, microbial presence, and localized inflammation causes acne. The hypothalamic-pituitary-adrenal axis becomes active by psychological stress, resulting in elevated cortisol and neuropeptide levels that stimulate inflammatory responses and improve sebaceous gland activity. The gut–brain–skin axis plays an important role in the development of disease because dysbiosis of the gut microbiota simultaneously causes oxidative stress, impaired skin barrier integrity, and systemic immunological dysfunction. While nutrients including antioxidants, polyphenols, omega-3 fatty acids, and probiotics demonstrate protective effects by reducing inflammation and improving microbial balance, eating habits characterized by high glycaemic load and excessive dairy consumption may exacerbate hormonal and metabolic problems. Clinical outcomes and patient quality of life may be improved by combining standard dermatological treatments with stress management strategies, dietary modifications, and microbiome-focused therapy. To improve acne treatment and efficacy, future research should focus on customised approaches that consider microbial, nutritional, and psychological factors