It used to be considered an old wives’ tale that excessive stress could cause acne breakouts, but two different acne studies have now shown that the old wives may not have been far off the mark.

A 2003 study by Stanford researchers published in the Archives of Dermatology found that, at least among college students, there seemed to be a relationship between high levels of stress and high levels of acne. The authors of the study followed college students throughout the course of a semester and tracked levels of acne. As exams approached and stress levels rose, so did the number of pimples.

The study even attempted to look at other things that may have caused the outbreaks, such as bad dietary or sleep habits, but it found that those reasons did not adequately explain the higher acne levels. The researchers concluded, to put it simply, that stress causes harmful hormones to course through the body. These are the same bad hormones that can lead to hypertension, heart disease and other stress-related ailments, and it appears they can cause clogged pores and acne as well.

The Stanford findings confirmed the results of a similar 2002 study performed in Germany. In their study, German researchers found that when an individual is under stress, a common stress hormone called corticotropin-releasing hormone is released in the sebaceous glands, which leads to more oil production in the hair follicles. This leads to oily skin and oily skin means clogged pores and acne.

Researchers acknowledge that it is impossible to keep stress completely out of your life, but there are things that can be done to control it. Try taking deep breaths when stress levels escalate or consider starting an exercise regimen, which can also reduce stress. And, in situations that are bound to be stressful, such as preparing for college exams, do not participate in activities that can aggravate acne flare-ups. Make sure you avoid touching your face, which many commonly do when they are under stress, continue to follow good hygiene practices and use preventive measures, such as cleaning regularly with high-quality soap. Also consider applying benzoyl peroxide at the first sign of flare-ups as a treatment and preventive practice.