Hormonal acne is very common, and it's well documented that hormones have a connection with the development of acne. But how do you know if you have hormonal acne? And how do you defeat it?
Hormonal acne occurs when hormones like androgens act as a catalyst for increased sebum production, which then leads to clogged pores, bacterial overgrowth, and inflammation, the three main causes of acne.
If breakouts happen at specific times such as puberty, the start of menstrual cycle, menopause, pregnancy, or when experiencing a hormonal or endocrine disorder such as polycystic ovary syndrome, or after starting a new hormonal medication or birth control method - then it's most likely hormonal acne!
The solution for treating hormonal acne? A consistent skin care routine with a complete acne treatment system like Exposed. It's the safest, most effective, and most affordable approach.
Also read: How to choose the best acne treatment
Hormonal Acne: What is it?
Hormonal acne is often referred to as adult acne or adult female acne because this is often when individuals, notably women going through menstruation or menopause, experience hormonal fluctuations that can lead to acne.
Nonetheless, anyone can experience a breakout instigated by hormonal fluctuations. In fact, according to the American Academy of Dermatology, this is the leading trigger for teenage acne as well.
How to Identify Hormonal Acne
If you notice an increase in acne breakouts at these times, your breakouts may be due to hormones:
The start of your menstrual cycle
If you experience a hormonal or endocrine disorder such as polycystic ovary syndrome
After starting a new hormonal medication such as hormonal therapy or a birth control method like oral contraceptives
Even though you experience breakouts during periods of hormonal fluctuation, what we call "hormonal acne" is not much different than other kinds of acne. Let's look at why.
How Can Hormones Lead to Acne?
Acne has three main causes:
You may notice that hormones are not on this list; however, this doesn't mean that your hormone levels don't have an impact. Hormones are instead a trigger that can influence the root causes of acne in a few ways.
Hormones called androgens have a huge impact on sebum production and thus the development of acne. This is because sebaceous glands provide the location where certain enzymes turn androgen into testosterone.
When androgen levels become unbalanced during periods of fluctuation like puberty or menstruation, this can increase the amount of sebum produced, which can then build up and block pores. Once pores are clogged, skin is likely to become irritated and inflamed, which is then considered acne vulgaris.
How to Tell if Acne is Hormonal or Bacterial
You may have heard of the term "bacterial acne" before. This is because bacteria also have a huge impact on the development of acne vulgaris. It may seem like bacterial acne is different than hormonal acne, but bacteria plays a role in all acne formation.
Once pores are blocked from excess sebum, bacteria that thrive in sebaceous sites multiply and overgrow. While the P. Acnes bacteria that cause acne occur naturally on the skin and are healthy in lower amounts, the overgrowth can cause irritation leading to acne.
Because both "hormonal acne" and "bacterial acne" are caused by an increase in sebum and bacterial overgrowth, they are not different from one another, and a distinction between the terms should not be necessary when looking at treatments.
Treatment: A Holistic Approach
Treating hormonal acne begins with a consistent and balanced skincare routine. While one may be able to treat the hormonal fluctuations themselves through medication or birth control, this can often lead to negative side effects or unwanted lifestyle changes. Similarly, beware of topical retinoids that are known to increase photosensitivity, causing an increased susceptibility to skin cancer, photo-aging, and sun damage.
Instead, we recommend Exposed Skincare, which targets acne at a skin-deep level with ingredients chosen from science and nature combined.
A Balanced Skincare Routine
A balanced skincare routine that targets hormonal acne will primarily work to clear away excess sebum and clogged pores, but will also reduce bacteria and inflammation.
Hormonal Acne FAQ
Q: Is menopausal acne a form of hormonal acne?
Yes, menopausal acne is a form of hormonal acne. Hormonal acne can be caused by fluctuations in estrogen and testosterone during the menstrual cycle, pregnancy, childbirth, menopause, or due to other changes in hormone levels. Menopausal women are particularly prone to developing hormonal acne as their hormones fluctuate drastically during this time.
Q: Should you consider oral contraceptives for hormonal acne?
Oral contraceptives are sometimes prescribed for women suffering from severe cases of acne due to hormonal fluctuations. However, side effects from birth control pills are common.
Wolski 2014 found that the most common side effects of oral contraception include elevated risk for venous thromboembolism (VTE), changes in the carbohydrate and lipid economy, and subjective side symptoms such as headache, mood changes, nausea, back pain, breast pain and swelling, and decreased libido. Although serious side effects are rare, why run the risk?
We recommend starting with a topical treatment system such as Exposed Skin Care before considering oral contraceptives. Exposed Skin Care is a scientific, balanced and natural approach to treat hormonal acne. It contains five gentle yet effective active ingredients that work together to reduce inflammation, kill bacteria, remove excess oil and clear pores–all without harsh chemicals or irritating fragrances. So if you're looking for a safe and effective way to tackle your hormonal acne, Exposed Skin Care is definitely worth a try.
Q: Should you consider anti-androgen drugs for hormonal acne?
Anti-androgen drugs, such as spironolactone and flutamide, are sometimes prescribed to treat hormonal acne. These medications work by blocking the receptors that bind testosterone in the skin, reducing inflammation and preventing future breakouts.
Studies suggest that spironolactone is an effective treatment for acne vulgaris in women of different ages. The most common side effects from spironolactone are increased potassium levels and the risk for hyperkalemia. There is also a potential for increased risk of cancer, although the evidence is not definitive. These potential side effects should be weighed against the benefits of spironolactone in treating acne.
Flutamide should never be considered in the treatment of acne in our opinion as it liver toxic and can cause severe liver damage. Not even for cases of severe acne.
We recommend you use a safe, topical acne treatment system like Exposed. If you do decide to consider taking medications for your acne, please discuss it very carefully with your doctor first. Talk to them about the risks and benefits of these drugs, as well as other treatment options that may be more appropriate for you.
Q: Should you consider lifestyle changes to treat hormonal acne?
According to Yang et al (2020), acne can be caused by many things, from heredity to lifestyle choices. Smoking and the improper use of cosmetics may lead to breakouts, as well as eating too much sugary or greasy food and consuming dairy products. Poor sleep quality is a risk factor - along with intense stress levels – not just for skin flare ups but in general health terms too! Pollution exacerbates problems, especially when combined with sun exposure or high temperatures; mineral oils, halogenated hydrocarbons (and other ingredients) should also all be avoided where possible if you want healthy skin that glows without irritation. It stands to reason then that not doing any of the above should improve hormonal acne.
However, other studies suggest that lifestyle changes may or may not be effective at improving acne. Magin 2004 found that there is little evidence to support the idea that diet, hygiene, and sunlight exposure are associated with acne causation or exacerbation, suggesting that lifestyle changes are not effective. Smith 2011 found that there is some evidence, though, that a low glycemic index diet can lower acne severity.
Overall, more research is needed to determine whether lifestyle changes are effective at improving acne.
Q: Should you consider retinoids for hormonal acne?
Well, no, we really don't think you should. Why would you when Exposed is safer, more affordable and more effective? But a lot of you are still going to think that seeing a doctor for your acne is the best approach and that's why we need to talk about what you can expect from retinoids.
Retinoids are a type of vitamin A that can be used to treat hormonal acne. Topical retinoids work by unclogging pores, reducing inflammation and preventing future breakouts. However, they can also be irritating to the skin so it’s important to use them with caution.
If you decide to try topical retinoids, start with a low potency retinoid such as adapalene and work your way up to more potent products if necessary. Additionally, you should always use a moisturizer in conjunction with retinoids to help reduce irritation and flakiness.
Common side effects from treating hormonal acne with oral retinoids include dry eye syndrome and blepharoconjunctivitis. Blepharoconjunctivitis can be thought of as the perfect storm of eye irritation and distress, with symptoms like redness, swelling, itching and discharge all resulting from inflammation of both eyelids and conjunctiva. In some cases it can even cause an uncomfortable crusting or scaling effect on the lids themselves - a reminder that our bodies are vulnerable to more than we may realize!
Pregnant women can not under any circumstance use oral retinoids as they cause developmental abnormalities or birth defects in a developing fetus.
Talk to your doctor or dermatologist about which retinoid is right for you.
Q: What are the best ways to treat hormonal acne naturally?
There are several natural treatments that may help reduce the severity and frequency of hormonal acne. These include topical products such as tea tree oil and green tea which are both included in our treatment system. Additionally, taking zinc or probiotic supplements may also help reduce inflammation and bacteria on the skin.
Q: How does diet affect hormonal acne?
Your diet can have a significant impact on the severity of your hormonal acne. Eating a balanced diet with plenty of fruits, vegetables, whole grains and lean proteins is important to maintain healthy skin. Additionally, reducing your intake of processed foods, dairy products, sugar and caffeine may help reduce flare-ups. Finally, make sure you are drinking enough water on a daily basis.
Q: What medications can cause hormonal acne in addition to birth control pills?
Certain medications, such as corticosteroids, lithium and anticonvulsants, can increase the risk of hormonal acne. Additionally, certain testosterone supplements or treatments for prostate cancer may also lead to breakouts. If you are taking any of these medications, talk to your doctor about possible alternatives or ways to reduce their side effects.