Abstract: Objective To investigate the relationship of lesion counts, severity and dermatology life quality with chronic stress and adrenal androgen level in postadolescent women with acne. Methods One hundred females, including 50 patients with acne and 50 normal controls, aged 26-45 years were recruited. Serum dehydroepiandrosterone sulfate （DHEAS） and glucocorticoid （GC） levels were determined by radioimmunoassay with a single serum sampling. Meanwhile, the chronic stress of each subject was evaluated by life events scale（LES）, the impact of acne on patients life was measured by dermatology life quality index （DLQI）, the lesions were counted, and severity was evaluated by global acne grading system （GAGS）. Results The life event score, serum levels of DHEAS and GC were significantly higher in the patients than those in the controls （189.7 ± 36.5 vs. 104.3 ± 13.3, 140 ± 30 μg/L vs. 110 ± 17 μg/L, 348 ± 88 μg/L vs. 142 ± 85 μg/L, respectively, all P < 0.01）. The life event score positively correlated with the serum levels of DHEAS and GC （r = 0.34, P < 0.05; r = 0.44, P < 0.01） as well as the lesion counts （r = 0.29, P < 0.05) in patients, and DHEAS level was also positively correlated with lesion counts （r = 0.54, P < 0.01). In addition, DLQI appeared to significantly correlate with lesion counts and severity （both P < 0.01）. Conclusions The occurrence and lesion number of acne are correlated with chronic stress and chronic stress-induced increase of adrenal androgen level in postadolescent women. Hence, antiandrogen and mental therapy should be given to these patients besides routine treatment.