Why Is Hormonal Acne Important
Hormonal acne does not always respond fully to treatment with acne creams, such as topical retinoids, and antibiotics. In some cases hormonal acne does not even respond well to treatment with Isotretinoin . Hormonal acne is more likely to come back after a course of Roaccutane has successfully cleared it.
Besides being stubborn to treat, hormonal acne causes redness for prolonged periods, scarring and pigmentation. Some types of hormonal acne cause a large number of comedones to develop especially on the sides of the face temples, cheeks and jaw line.
Enlarged pores on the nose and cheeks are commonly seen with hormonal acne. Hormonal acne can be really frustrating and cause a reduced quality of life for sufferers.
Hormonal acne can be distinguished from fungal acne on the type of spots and their location. Fungal acne causes smaller spots that are more evenly sized and itchy.
Adult Acne Is Often A Symptom Of Hormonal Imbalance
The teenage years are notorious for causing breakouts and acne, and most women are happy to know theyve left those problems behindor have they? Adult acne is a common problem in women of all ages. A better understanding of the causes of acne will help you understand why and what you can do about it.
I feel better, and my complexion has improved, too. I used to joke about having a worse complexion now than when I was a teen.
Lynnea, customer
Like adolescent acne, adult acne is often caused by hormonal imbalance. Many women break out every month at the onset of their period, and acne is a common symptom of PMS. Acne is also associated with polycystic ovarian syndrome , a hormonal condition that causes irregular or absent menstrual periods due to ovulation irregularities.
In women over 35, the hormonal fluctuations that orchestrate our periods tend to become more dramatic and unpredictable as you enter perimenopause and approach menopause which can exacerbate hormonal acne. Many women who havent had a breakout since their teens or early twenties suddenly find themselves battling acne in their 40s.
Root Cause Of Hormonal Acne #: Excess Androgens
Any kind of hormone imbalance can potentially cause hormonal acne to flare up, but by far the most common imbalance that causes hormonal acne is excess androgens. In fact, excess androgens are the most common hormonal dysfunction in women of reproductive age.
Androgens are hormones that produce male traits and include testosterone and DHEA . Healthy women should have androgens in their body, but excess levels cause a lot of problems such as acne, unwanted hair growth, and thinning hair on the head.
Excess androgens are almost always present in PCOSPolycystic Ovarian Syndrome but there are other causes, including medications, genetic conditions, and tumors on the ovaries or adrenal glands.
Those causes of excess androgens are rare, but more common causes of excess androgens include excessive high-intensity exercise , prolonged stress, and undereating. Stress disrupts the hypothalamic-pituitary-adrenal axis, causing it to produce higher quantities of the androgens DHEA and DHEA-S, which are then converted to testosterone.
Even in women without PCOS, excess androgens can be the root cause behind hormonal acne. Left untreated, excess androgens can cause long-term problems like infertility, heart disease, and diabetes. Excess androgens can also cause insulin resistance.
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When Should You See A Dermatologist
Visit a doctor when the acne is severe, reoccurring, itchy or painful. It is also wise to see a dermatologist before you try any DIY products or over the counter items. A doctor can evaluate your acne and tell you what treatments are best for you and your skin. If you notice any allergic reactions or worsening acne cases, contact your doctor immediately.
Hormonal acne does not have to take over your life. Keep your face clear and stay confident by visiting your dermatologist. For more information, contact us today.
Acne In Women Can Signal Hormone Problems
ByRachael Rettnerpublished 27 November 12
Acne in adult women is common, but in some cases, it can signal an underlying hormonal disorder, experts say.
Identifying such cases is important, not only to better treat women’s acne, but to correct hormone imbalances that can lead to other health problems, said Dr. Kanade Shinkai, a dermatologist at the University of California, San Francisco School of Medicine, who specializes in acne treatments.
However, doctors often simply give women prescriptions for acne treatments, such as antibiotics, which typically don’t work for acne caused by hormone imbalances, Shinkai said
Women who visit the dermatologist for acne and who experience signs of a hormonal disorder, such as irregular periods, should discuss their symptoms with their doctors, Shinkai said.
In addition, it’s important for dermatologists to conduct a thorough medical history of their patients so that they can identify hormonal disorders that manifest as acne, she said.
Symptoms
Acne in adult women is often hard to treat. One study showed that 80 percent of women prescribed antibiotics for acne receive no benefits from the drugs, Shinkai said.
In these cases, the acne may stem from normal hormonal changes, such as those that occur around the menstrual cycle, or from a true hormonal disorder. For many of these women, medications that target hormones, rather than skin bacteria, would provide the most help, Shinkai said.
Treatment
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What Is A Hormonal Imbalance
Hormones are chemicals produced by different glands and tissues, forming a part of the endocrine system.
Hormones travel to all of the bodys tissues and organs through the bloodstream. They give messages to these organs, letting them know what function to perform and when to do it.
Hormones help regulate a lot of processes in the body. Hormones manage appetite and metabolism, sleep cycles, heart rate, sexual function, general mood and stress levels, and body temperature. Because they affect so many functions, imbalances in certain hormones can lead to uncomfortable symptoms.
A hormonal imbalance occurs when a person has too much or too little of a certain hormone, such as insulin, cortisol, thyroxine, androgens, estrogen, or progesterone. Even slight changes can have a significant effect on your body.
Root Cause Of Hormonal Acne #: Pcos
Polycystic Ovarian Syndrome is an endocrine disorder that occurs in women. Most people assume the tell-tale sign of PCOS is cysts on the ovaries, but there are actually 3 criteria for diagnosis :
- Confirmed androgen excess on labs or androgen excess symptoms
- Ovulatory dysfunction
- Multiple cysts on ovaries
PCOS, like other syndromes such as IBS, isnt a disease, its a collection of related symptoms without a clear cause or cure. Many practitioners now understand that there are likely multiple causes or types of PCOS, including insulin resistance leading to ovarian overproduction of testosterone and stress, overexercising, and undereating leading to adrenal-driven androgen excess.
Theres also a strong link between the gut and PCOS. Women with PCOS have less diversity in their microbiome than women without the condition.
Researchers have found that women who had some symptoms of PCOS but werent at a diagnosable level had less gut diversity than healthy women, but more microbiome diversity than those who met all the criteria for PCOS. This suggests that PCOS is the end result of hormone and gut issues left untreated too long.
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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.
Why Do Androgens Cause Hormonal Acne
For the majority of women, hormonal acne occurs because their skin is sensitive to the normal levels of androgens like Testosterone.
Although considered to be a male hormone, it is normal for women to produce small amounts of Testosterone. Testosterone is an important hormone for women as it helps strengthen bones and muscles, provides a healthy libido and regulates the menstrual cycle. Androgens are the name for male hormones. Women produce other androgens as well as Testosterone. These are dehydroepiandrosterone sulphate , dehydroepiandrosterone , androstenedione. These three androgens are not very active by themselves and have to be converted to Testosterone or Dihydrotestosterone first.
Testosterone is produced by the ovaries and the adrenal glands. However, cells in the skin also make Testosterone from DHEAS. Skin cells, especially the cells in the sebaceous glands, also make DHT from Testosterone.
Hormonal acne also occurs when there are conditions in which too many androgens are produced such as Polycystic Ovarian Syndrome.
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Amandas Skincare Routinewhat Worked
When Amanda first started getting cystic acne on her chin, she cleared her active blemishes by applying Rapid Response Detox Masque all over her chin twice a week at night. She would also apply Anti Bump Solution as a spot treatment on her chin both day and night. My conversation with Amanda inspired me to send her a few more products to help fade her hyperpigmentation and get her across the finish line . I also advised her to start using Rapid Response Detox Masque three times a week instead of two.
Heres what Amandas complete skincare routine looked like:
A.M.
Serum Renée Rouleau Pore + Wrinkle Perfecting Serum* and Skin Correcting Serum* Moisturizer Renée Rouleau Skin Recovery Lotion* Spot Treatment Renée Rouleau Anti Bump Solution
Masks
Renée Rouleau Rapid Response Detox Masque Renée Rouleau Triple Berry Smoothing Peel*
*Gifted products
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Traditional Treatments For Hormonal Acne
Unless your hormonal acne is mild, over-the-counter products usually arent successful.
This is because hormonal acne typically takes the form of cystic bumps. These bumps form deep under the skin, out of reach of most topical medications.
Oral medications can work from the inside out to balance your hormones and clear up the skin. Common options include oral contraceptives and anti-androgen drugs.
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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.
When Should I See My Healthcare Provider About A Hormonal Imbalance
If youre experiencing new, persistent symptoms, its important to talk to your healthcare provider. They can order tests to help determine the cause of your symptoms.
A note from Cleveland Clinic
Hormones are complex and powerful chemicals. If one or more of them goes out of whack, it can cause certain symptoms that make you feel like youre not in control of your body. If you have new and persistent symptoms, its important to talk to your healthcare provider. They can order some tests to see if a hormonal imbalance or another condition is the cause. The sooner you reach out for help and treatment, the sooner youll be able to feel like yourself again.
Last reviewed by a Cleveland Clinic medical professional on 04/04/2022.
References
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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 .
Hot Flashes And Night Sweats
One of the most common symptoms of perimenopause is hot flashes, which often coexists with night sweats. Almost 80 percent of people who are in perimenopause or transitioning into menopause have hot flashes. Also, most women who receive chemotherapy or undergo surgery to remove their ovaries will experience hot flashes.
Scientists know that hot flashes occur as a result of low estrogen levels. Each hot flash involves a sensation of heat that starts in the chest area and travels to the neck and the head. It can last for a few minutes and may cause sweating. Some women also develop a faster heart rate during hot flashes.
If a hot flash happens during sleep, they are called night sweats. Women who have night sweats often wake up in the morning feeling tired.
Some people experience redness along their neck and face during a hot flash. This is called a hot flush.
On average, each hot flash lasts for about three to four minutes. Hot flashes can occur for a few months to several years. In a few rare cases, some people had hot flashes for 10 years.
Other signs of hormonal imbalance include:
- Constipation
- Heavy or irregular periods, missed periods, frequent periods, or stopped periods
- Vaginal dryness and itching
- Weakened muscles
- Pain in the muscles, tenderness, and stiffness
- Pain and swelling in the joints
- Depression
- Cancer treatments
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Under Eye Dark Circle
If under-eye dark circles are your constant companion, you probably have hormone issues. No matter what you do, it stays with you. It happens due to adrenal fatigue.
When your stress levels rise, the production of cortisol increases. It leads to lack of sleep at night and makes you feel restless. Constant tiredness and lack of sleep cause dark circles around your eyes.
Menopause And Hormonal Acne
Entering menopause causes a normal, natural reduction in your bodys production of female reproductive hormones such as estrogen. For some women, this can lead to an increase in hormonal acne outbreaks.
Like hormonal acne for non-menopausal women, menopause-related hormonal acne is the result of fluctuations in your bodys hormone levels.
As your estrogen levels decrease, your balance of androgens to estrogenic hormones can cause your body to create more sebum.
If youre acne prone, this can lead to everything from a few occasional pimples to severe and regular acne outbreaks.
Menopausal hormonal acne can even occur if you use HRT to deal with the symptoms of aging.
HRTs use an artificial hormone, progestin, to replace estrogen and progesterone, which can cause your skin to go awry.
As always, if youre experiencing menopause-related hormonal acne, the best approach is to talk to your healthcare provider about retinoids, antibiotics and hormonal medications to limit outbreaks and control your bodys sebum production.
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What Causes Acne Anyway
Acne caused by hormones is still acne, and acne has three primary causes: inflammation, bacteria, and oil production. Doctors used to believe that bacteria were the main culprits, but more recent research has revealed that inflammation could be the real problem. They learned that bacteria and oil can actually benefit the skin in appropriate amounts, and usually only became a problem when the skin became inflamed.
The way this works is relatively simple. P. acnes, the primary acne-causing bacteria, always live on your skin in reasonable numbers. They consume the oil your skin produces , which can prevent an unhealthy oil buildup. Similarly, your skin is always producing sebum to protect itself from every day irritants like dust, pollen, or even your own fingertips, picking or scratching at your skin. If you could prevent any inflammation, sebum and bacteria might live in harmony without any acne.
Unfortunately, your skin is often slightly inflamed because its very sensitive to stress and potential infection. Your skin becomes inflamed when it wants to protect itself by closing off the pores. If an irritant has gotten through your skins layer of sebum, your pores will detect it as a threat, and your skin will release its own stress hormones to induce inflammation. This will close the pores and prevent the irritant from spreading. Unfortunately it can also trap bacteria and sebum when it closes, and this is when acne almost always forms.
Risks And Side Effects
While you can begin by tackling hormonal acne on your own at home, you may want to visit a dermatologist if your condition is reoccurring or worsening. Your doctor/dermatologist can help pinpoint any underlying conditions that might be contributing to our breakouts, such as PCOS, high testosterone or cortisol levels, a thyroid condition, or another hormone issue.
If the treatments above dont seem to be doing enough to reduce your breakouts, speak with your dermatologist about other options such as antiandrogen drugs, which block androgen receptors to decrease the actions and effects of testosterone, or stronger topical prescriptions to fight acne-causing bacteria.
When treating hormonal acne yourself, theres potential to experience some side effects depending on the specific products and treatments you use. Some topical products might cause dry, red, flaky, painful skin at first, so make sure to follow directions, and remember that less may be more when it comes to improving your skins appearance.
If you have sensitive skin, such as eczema, dermatitis or rosacea, some products, such as retinoids and certain cleaners, may be too harsh. Certain products are also not safe when youre pregnant, so get your doctors advice if this applies to you.
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