Signs You’re Dealing With Hormonal Acneand How To Treat It
Ah, hormonal acnethose pesky, painful, and unpleasant pimples that show up at the worst times imaginable . Werent you supposed to shake off acne in your teen years?
Sadly, notespecially if youre battling bouts of hormonal acne, which most commonly appears in adult women ages 20 to 40. And even the post-40 crowd is not in the clear, New York City-based dermatologist Cherise M. Levi, M.D., tells SELF. There can be a resurgence of breakouts around menopause due to hormonal fluctuations in the body.
How can you tell if youre dealing with hormonal acne versus run-of-the-mill acne? Dermatologists use a few key characteristics to pinpoint if a pimple is hormonal. Keep reading to learn how to spot hormonal breakouts, plus six expert-approved hormonal acne treatments.
My Skin Consultation With Amanda
When I called Amanda for a follow-up skin consultation, I asked her these ten questions to see if we could discover more about the root cause of her breakouts. During our conversation, I learned that Amanda had started the Keto diet in December 2018. Because of the diets guidelines, Amanda was eating a lot more dairy than usual. When clients come to me with cystic acne, I often advise that they try cutting out dairy for at least three weeks to see if this could be a contributing factor. If dairy is the root cause of your acne, youll typically start breaking out within twenty-four to forty-eight hours of consuming it. Amandas acne started to appear a few weeks after she started her diet, so while the increase in dairy consumption could definitely have exacerbated her breakouts, it probably wasnt the root cause. Amanda stopped following the Keto diet in mid-January.
Learn more about why dairy can cause cystic acne.
Learn more about how to fade acne scars.
Changing Hormones Influence Your Skin Throughout The Years
Similarly, your doctor may grow suspicious that other hormonal factors are at play if your skin is not responding to tried-and-true treatments, says Hollmig. For instance, acne largely caused by a hormonal imbalance would not likely improve significantly with a topical antibacterial wash, he says. If your skin is not responding to treatment, your doctor may request lab testing.
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Eliminate Sources Of Chronic Stress And Reduce Cortisol Output
Hormone imbalances are strongly connected to stress. Chronic cortisol, a stress hormone produced by the adrenals, can disrupt the entire endocrine system.
Common sources of chronic cortisol output include lack of sleep, over-exercising and undereating, constant anxiety and worry, unresolved trauma or mental and emotional stress, and even chronic inflammation from a poor diet.
For hormones to be in balanceand hormonal acne to go awayyou must prioritize eliminating sources of chronic stress in your life , improving mental and emotional health , and getting at least 7 hours of sleep each night. Get to bed before 11pm to make sure your cortisol rhythms are properly balanced.
Common Signs Of Hormonal Imbalance
Knowing the signs of a hormonal imbalance in women can help you address the underlying cause and help get your hormones in balance again. Sometimes, all you need is to make some lifestyle changes to help your body produce enough hormones. Other times, you can use some natural remedies to help manage the symptoms of a hormonal imbalance.
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The Role Of Hormones In Acne Formation
Acne may be known as hormonal acne because one major causative factor is the hormone testosterone.
Testosterone levels go up in the teenage years as part of puberty. This causes male development in boys and gives muscle and bone strength in girls.
The hormone also has the effect of increasing sebum production at the base of hairs. This is because the glands that secrete the oil are sensitive to testosterone.
Other hormones play a part in acne, too. For women, hormonal changes relating to pregnancy or the menstrual cycle can also trigger acne. Falling estrogen levels may increase the risk of acne around menopause.
The role of progesteroneremains unclear.
Conditions that affect hormone levels, for example polycystic ovary syndrome
Drugs Acting On Adrenal Androgen Production
Oral corticosteroids if used in high doses might help patients with inflammatory signs of acne despite any hormonal causes, while oral low-dose steroids suppress adrenal activity in patients with proven adrenal hyperactivity. Elevated levels of DHEA, 17 hydroxyprogesterone, and androstenedione are positive tests and indicative of the diagnosis. Deficiency of 21 hydroxylase and less often eleven hydroxylase enzymes shifts the hormonal production of the adrenals toward androgens instead of steroids. In such a case, a low-dose prednisone or a low-dose dexamethasone once at bedtime is thought to counteract the unopposed ACTH production of androgens. This nighttime dose is thought to suppress the early morning peak of ACTH and meanwhile inhibit androgen formation.
Monitoring long-term side effects of steroids such as osteoporosis and blood sugar levels is mandatory, and long-term use of > 6 months is not preferred. The risk of adrenal suppression should be tested every 2 months using the ACTH stimulation test.
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Hormonal Acne: The Root Cause And How To Treat It Naturally
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The big red bumps start on your jawline. They spread all around your mouth and on the lower half of your face. Then they start appearing on your forehead, cheeks, and back.
Its embarrassing, its painful, and long after the bumps are gone, the scars stick around.
Hormonal acne is different from the breakouts you had as a teenager or when you dont wash your face before bed. First, treating hormonal acne is really hard to do with conventional topical skincare treatment. Hormonal acne is more complicated than a special cream .
And then, when a blemish finally goes away it doesnt feel like its truly goneit just recedes a bit. You know it will be back .
While most people only deal with acne on their face, hormonal acne often spreads to the shoulders, back, and butt. This makes most people painfully aware of its presence, especially when its summer and youre excited to wear that cute sundress or tank top.
Thats the reality of hormonal acne, and having many clients deal with it personally, I can tell you: it really sucks.
Going Deeper On Estrogen: How It Affects Skin Health
Even though it is still unclear how much estrogen affects sebaceous glands, estrogen plays a prominent role in overall skin health. Estrogen is associated with increased collagen production, skin thickness, skin hydration, wound healing, and improved barrier function . One study found that 2 out 5 women self-report more sensitive skin around the time of menstruation, which researchers suspect could be due to low levels of estrogen during this phase .
Many of the ways that researchers study the impact of estrogen on skin is by comparing premenopausal women to post-menopausal women . In the study referenced above, a third of postmenopausal and perimenopausal women also noted that increased skin sensitivity after menopause â the time when estrogen levels decrease .
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When Hormonal Acne Could Strike
Hormonal fluctuations are a pretty normal part of daily life, but there are times or situations when they could spike or drop in significant ways that lead to more acne. Puberty, menstruation, pregnancy, menopause, stress, testosterone therapy, and polycystic ovarian syndrome can all produce hormones that cause acne. Lets take a look at how all of these hormonal fluctuations contribute to acne.
Hormonal Acne Isnt Normal
Everyone has occasional acne and blemishes. Breaking out when youre going through stressor even a few zits around your menstrual cyclecan all be 100% normal. But painful, chronic cystic acne as an adult is a result of hormonal imbalances, and its not normal or something you should have to live with.
But theres one big problem: the #1 prescribed solution for hormonal acne doesnt actually solve the problem.
Thats right, treating hormonal acne with the birth control pill doesnt actually solve the problem. There is a root cause of hormonal acne, and you can treat hormonal acne naturally. Once you know what is REALLY behind your hormonal acne, you can take steps toward healing it.
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What Can I Do To Help Keep My Hormones And Acne Under Control
- Get professional advice. If you experience acne consult your doctor who will advise you on the best treatment options for your skin. They may recommend that you talk to an endocrinologist or to a gynecologist . Some women find that the contraceptive pill can help with menstrual acne. It does so by producing a protein called Sex-Hormone Binding Globulin which sponges up the testosterone thereby raising oestrogen levels in the blood.
If you are pregnant, or planning to get pregnant, you should avoid all acne medication and ask your doctor or gynecologist for alternative recommendations. Acne medication contains chemicals that are dangerous for a developing baby.For men, there are medical options available that help to keep testosterone levels, and acne, under control and your doctor will be able to advice on which are most suitable for you.
- Look after yourself. Exercise and a healthy, balanced diet will help you to keep your body in good shape . A diet rich in phytoestrogens may also help you to keep you hormones in balance. Find out more in what changes can I make to my diet to help my blemish prone skin?
- Take care of your skin. A regular skincare routine, using non-comedogenic products specially formulated for blemish-prone skin, will help you to keep your skin healthy and complement any medication you may choose to take. Find out more in the ideal skincare products and routine for blemish-prone skin.
What Are The Symptoms Of Hormonal Acne
Hormonal acne is caused by hormonal fluctuations or hormonal imbalances.
Because females go through pretty significant hormonal changes on a monthly basis , it’s more common for adult women* to deal with acne breakouts than men.
*Editor’s note: Researchers surveyed women and men, ages 20 and older, in a 2007 study to find how many continued to be “plagued by acne well beyond the teenage years.” They found that after the teenage years, women were significantly more likely to experience acne in all age groups.
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What Is Hormonal Acne Anyway
First, its important to understand the difference between hormonal acne and good old-fashioned pimples. Hormonal acne is intrinsically linked to your hormones, resulting in cyclical breakouts that usually coincide with a persons menstrual cycle, Joshua Zeichner, M.D.2, board-certified dermatologist and director of cosmetic and clinical research at the Icahn School of Medicine at Mount Sinai in New York, tells SELF. It can also match up with other hormonal shifts in your life, meaning your menopausal acne or postpartum pimples could be hormonal.
One important thing to note: Hormonal acne is technically not a medical term, board-certified dermatologist Ife J. Rodney, M.D.3, founding director of Eternal Dermatology + Aesthetics and professor of dermatology at Howard University and George Washington University, tells SELF. However, when a person tends to get very specific types of breakouts around the time of their period or when their body is experiencing vast hormonal shifts for other reasons , dermatologists generally describe it as hormonal acne.
Hormonal Acne = Hormone Imbalance
Hormonal acne is different than other kinds of acne in that its always caused by a hormone imbalance.
Different hormone imbalances can cause acne. It can be the result of too much or too little of any of your main sex hormones , but other hormones like DHEA and cortisol can play into it too.
And thats why the Pill doesnt always work for hormonal acne.
At best, the Pill can put a band-aid over imbalances, and mask the symptoms temporarily . Depending on what kind of hormone imbalance youre dealing with, the Pill can sometimes intensify your hormone imbalance symptoms and even make acne worse.
Thats why if youre struggling with hormonal acne, I dont recommend turning to the birth control pill. for more information).
Instead, you need to find the root cause of your hormonal acne and work on balancing hormones naturally.
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What Are Treatment Options For Hormonal Acne
Over-the-counter cleansers
Over-the-counter skin cleansers and face washes may be able to help with mild to moderate acne. Common ingredients to look for include:
- Salicylic acid: Works by targeting the top layer of skin and dissolving dead skin cells, which helps prevent clogged pores.
- Benzoyl peroxide: Helps remove bacteria from the surface of the skin, making it less likely for bacteria to enter clogged pores and cause inflammation.
- Antibiotics: May include clindamycin and erythromycin, which are typically combined with benzoyl peroxide to help keep bacteria on the skin’s surface under control.
Prescription creams
Your dermatologist may recommend the following to bring hormonal acne under control:
Stick To Your Routine And Prescribed Medication
If you have some medication or a set routine that was recommended by your dermatologist, stick to it. Youre not doing yourself, your body, or your skin any favors if you dont finish your medication or go against what your doctor said.
Were creatures of habit, after all, so make your skin care routine a habit, and see if your skin responds. If it doesnt, make sure to let your doctor know.
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Treating Hormonal Acne Naturally
In addition to getting enough sleep and lowering your stress levels, there are some other things that can promote good skin.
DietDiets rich in fruit and vegetables are really good for your skin. Its also important to make sure youre getting enough omega-3 fats reduce inflammation and help keep your skin clearer.
SupplementsSome people find that omega-3 supplements or zinc supplements help reduce acne.
ExerciseExercise helps to regulate your hormones and also reduces stress. Aim for 30 minutes of exercise five times a week.
Tea tree oilTea tree oil can help reduce inflammation and kill bacteria. You can find tea tree oil in skincare products or you can use tea tree essential oil make sure to dilute this before using.
Alpha hydroxy acidsAlpha hydroxy acids helps remove dead skin cells which stops your pores from clogging. Make sure to wear a broad-spectrum sunscreen if using AHAs as they make your skin more sensitive to the sun.
What Causes Hormonal Acne
Aaand were back to hormones. The hormones that cause this type of acne are fluctuations of estrogen and progesterone, which both vary widely throughout the menstrual cycle, S. Manjula Jegasothy, M.D.4, board-certified dermatologist and founder of Miami Skin Institute, tells SELF. In addition, the ratio of each of these hormones to each other can also affect womens testosterone levels, and can also be causative in hormonal acne. Cortisol, the stress hormone, can affect all of these hormones too.
It is believed that hormonal fluctuations, which can be menstrual or cyclical in women, do cause increased oil production in the pore, says Dr. Jegasothy. This is how skin-care experts believe hormonal acne starts5, although the actual cause has yet to be determined.
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Insulin And Insulin Growth Factor 1
Insulin stimulates the growth and maturation of sebaceous glands. This action is mediated through upregulation of GH receptors on the sebocytes by insulin. Moreover, insulin inhibits SHBG production from the liver and further plays a positive feedback effect on adrenal and ovarian androgenesis. The controversial link between diet and acne can be explained by the fact that highly glycemic index foods result in insulin release and in turn excess androgen and sebum production.
How Menopause Affects Your Skin
As you transition into menopause your hormone levels drop leading to changes in your skin. You might start to experience:
- dry or itchy skin due to dropping oestrogen levels
- acne due to dropping oestrogen levels and increasing testosterone levels
- sagging and wrinkling due to dropping oestrogen and collagen levels
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Natural Remedies And Supplements
There are many nutritional supplements on the market that claim to treat menopause and hormone imbalance. However, few of them are backed up by scientific evidence.
Many of these supplements contain plant-derived hormones. These are sometimes called bioidentical hormones because they chemically resemble the bodys natural hormones. Theres no evidence to suggest that they work better than regular hormone therapy, though.
Some people find that yoga helps treat symptoms of hormonal imbalance. Yoga is excellent for your strength, flexibility, and balance. It may also aid in weight loss, which can help regulate your hormones.
You can also make the following lifestyle changes:
- Lose weight. A
The primary cause of acne is excess oil production, which leads to clogged pores. Acne is most common in areas with many oil glands, including the:
- face
- upper back
- shoulders
Acne is often associated with pubescent hormonal changes, but theres actually a lifelong relationship between acne and hormones.
Cystic Acne And Hormones: Is Your Acne Caused By Hormone Imbalance
These factors may indicate a hormone imbalance:
- The cysts are located around the mouth, chin, and jaw. This is where most, or at least the worst of, hormone-imbalance acne occurs because its where the skin has the most hormone receptors.
- The shoulder blades, buttocks, and thighs contain hormone receptors, so this is another place to look for cystic, hormonal acne.
- Oily skin is the result of hormone imbalance, too. If you have a lot of oil on your skin this may point to hormone imbalance, probably excess testosterone or DHEA-S levels.
Other symptoms of this kind of hormone imbalance include:
- male-pattern hair growth like facial hair
- male-pattern hair loss like balding
- increased irritability
- and maybe even irregular menstrual cycles.
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