You’re not alone! Of all the 2020 related complaints I have heard, skin issues have been by far the most frequent. As a Naturopath who primarily treats acne, this is not that surprising, though for many who have developed acne for the first time, it has come as quite a shock! For others, lockdown and mask wearing has contributed to an aggressive flaring of pre-existing acne.So why has our skin, as a collective, gone berserk?The skin is directly linked to the nervous system and so there is often an enormous stress element when it comes to acne. Not only does our skin respond to stress hormones like cortisol by producing more oil and sebum, but when the adrenal glands are in overdrive, the body can end up with an excess of androgens like testosterone. Testosterone acts on the skin resulting in increased sebum and keratin which forms a plug. When bacteria feed on this plug, infection and inflammation occurs, forming a pimple. Anyone who has experienced acne (fun fact: that’s over 80% of women) will tell you that it can be deeply distressing and have an immense impact emotionally and psychologically. Thus the stress-acne cycle continues.There is no denying that 2020 was a particularly stressful year on a global level. Even if you got away pretty scot-free or fared better than a lot of people you know, your body has been (and probably still is) under a huge excess of stress. Whether you are conscious of it or not, your nervous system and adrenal glands are working overtime to keep the cogs turning! Often the effect of stress on the skin can be delayed, with symptoms developing some 12-18 months after a stressful event.Oh, and masks.If you’ve noticed a smattering of more superficial pimples and whiteheads in the newly coined ‘mask zone’ then you have probably put two and two together already. Avoid wearing makeup under your mask and choose a clean cotton or silk mask daily. Resist the urge to over-cleanse your skin – once a day in the evening is enough. Exfoliate no more than once a week. Keep hydrated and use a moisturiser that contains hyaluronic acid or ceramides beneath your mask to nourish your skin barrier.What else can you do?Given that the effects of stress can really sneak up unawares, get out your journal and reflect on what the sources of stress are in your life. How have the last 12 months affected you? What did you struggle with? What strategies do you engage in to manage or minimise the effects of stress? Do you make time for activities that bring you joy? In which areas could you use some more support?Top tips for stress related acne:Avoid coffee – caffeine perpetuates over-productivity, disturbs sleep and triggers the release of stress hormones like cortisol and adrenaline. Replace with herbal tea or chai, or go decaf!Schedule in time for activities that make you feel alive and joyful. This could be playing with your dog, dancing, reading a good book, swimming in the sea, or doing something you loved to do as a child.Laughter is the best stress relief! Watch a stand-up comedy, try a laughing exercise of simply spend more time with people who make you giggle uncontrollably.Balance out the high intensity exercise. If you love CrossFit, make sure you also include something gentler like yin yoga, a slow stroll or light resistance exercise. Overdoing the cardio can add stress to the nervous system.While you’re at it, avoid exercising after dark and work on optimising your sleep by limiting screen time and getting to bed earlier.Take up a meditation or mindfulness practice.Ask for a mental health plan from your GP for subsidised psychological support, because everybody can benefit from therapy in my humble opinion!Be patient – your skin didn’t get here over night and can take time to heal.If you’re dabbling with adaptogens, magnesium or other anti-stress supplements, get qualified support from a naturopath or nutritionist to feel the real benefits of these natural medicines! There is always more at play when it comes to skin conditions like acne – your gut and hormones are likely also playing a role. Seek personalised support for best results.