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The factors contributing to acne breakouts are many. Hormonal influences, environmental conditions, and stress can lead to the noticeable red inflammation that occupies our face, chest, and backs to various degrees.

from: It is estimated that 85% of the population in the United States will experience some form of acne at some point in their lives. Most commonly associated with teenagers who are undergoing severe hormonal changes, adults also suffer from acne flare-ups. For both groups, scientists are demonstrating a direct link between stress and acne.

While reported cases show that 80% of acne sufferers are teenagers, it is also documented that the remaining 20% of acne sufferers are adults. Adults are more likely to suffer from stress related acne than from environmental or hormonal causes, but teenagers dealing with academic demands, athletic rigors, and relationship issues are also susceptible to stress related acne.
It has been understood for some time now that acne is caused when oils secreted by the sebaceous gland beneath the skin combine with dead skin cells, dirt, and bacteria to clog skin pores and cause an infection to develop, providing evidence that environmental factors can contribute to acne. This, though, offers no explanation for stress acne.
It has also been understood that hormonal changes such as those experience by teens or women during their menstrual cycle contributed to acne, but again this offers no explanation for stress acne.
While there has clearly been a correlation between stress and acne breakouts, until recently scientist have had a difficult time supporting the claim with scientific findings.
Our bodies react to stressful situations by triggering the central nervous system, which in turn sends signals to the rest of the body to ready the body to take action. A significant part of this preparedness is the release of hormones from our adrenal glands, such as cortisol and androgen. These hormones help to prepare us for our instinctive fight or flight response.
Additionally, it is now understood that as our body reacts to stress, fatty secretions in the sebaceous glands are released. This combination of hormonal influences and fatty secretions-known contributors to acne outbreaks-is sent into action by our own central nervous system, creating stress acne.
It is also known that during stressful periods, our bodies immune system is significantly weakened, resulting in slower healing of acne breakouts. The prolonged visible signs of acne can lead to more acne. Called an acne cycle, the anxiety produced by being self conscious about an acne breakout can create more stress and more acne.
Greg Podsakoff is a former acne sufferer, and currently provides information on treating acne, pimples, and zits, via an objective informational skincare website, http://www.acne-treatments-guide.com