ObjectiveThe aim of the study was to evaluate the relationship between stress and serum concentration of substance P (SP) in acne-vulgaris patients.BackgroundAcne vulgaris is a multifactorial disorder of the pilosebaceous unit. The clinical picture can vary significantly, from mild comedonal acne to fulminant systemic disease. Although all age groups may be affected by its many variants, the peak incidence is during adolescence. Various studies have proved that neuropeptides affect the activity of the pilosebaceous unit by stimulating proliferation and differentiation of sebaceous glands, lipid synthesis, and induction of neutral endopeptidase expression in sebaceous cells, especially SP.Patients and methodsA case–control study included 40 patients with acne vulgaris and 40 age-matched and sex-matched controls. Emotional stress was analyzed with the use of Social Readjustment Rating Scale, whereas the methods of coping with stress were assessed with the Coping Inventory for Stressful Situation questionnaire, followed by taking blood samples to assess SP serum levels using the enzyme-linked immunosorbent-assay method.ResultsSP was significantly higher in the acne-patient group versus the control group (P < 0.05). A statistically significant difference was observed between acne patients and control groups regarding the Social Readjustment Rating Scale (P < 0.05).ConclusionThere was a statistically significant relation between stress scale and serum SP level in acne vulgaris.