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Is It Hormonal Acne? Causes and Treatments

June 07, 2021

all about hormonal acne
By Samantha

Hormonal acne isn’t just acne that pops up around someone's period – it also includes acne in teenagers and adults during hormonal shifts, women with  PCOS, as well as the skin’s general sensitivity to hormonal changes. 

Hormonal acne can range from mild (a few pimples around your period or when you’re stressed) to severe cystic acne.  One thing is for sure, hormonal acne can be very frustrating to live with and treat.  

What's Hormonal Acne? 

Hormonal acne is when the hormones we produce are imbalanced, causing increase of inflammation and sebum production in the skin leading to more acne breakouts.  Hormones such as estrogen, testosterone, and cortisol, to name a few, can directly impact acne.  Our Hormones are responsible for the amount of oil that our oil glands produce. 

The four biggest hormones which affect our skin health are estrogen, testosterone, cortisol, and thyroid hormones.

It is actually difficult to directly measure hormone imbalances since tests may read levels as normal and level are different during different times of the day. 

Signs Of Hormonal Acne

Hormonal acne can occur at any age - common triggers are puberty, during periods or right before your period starts, pregnancy, times of increased mental , physical, or emotional stress to changes in medication such as going off hormonal birth control. 

Hormonal acne usually happens in the lower half of the face and around the jawline. 

Hormonal acne tends to occur during:

  • Puberty
  • Menstruation
  • Pregnancy
  • Menopause
  • PCOS
  • High Stress

Hormonal acne can range from either small pustules and whiteheads to larger cystic acne.   

If you notice your breakouts seem to happen more with the above changes, chances are you're likely to have hormonal acne. 

Hormonal acne is usually used to describe acne in females, but males can also experience it. 

Causes Of Hormonal Acne

In many cases, hormonal acne is caused by too much testosterone to your estrogen ratio, and a prolonged increase in cortisol too seems to be linked to acne.  

A decrease in estrogen levels in women such as during menopause can cause hormonal acne.

Stress

Yep, stress causes acne. Stress releases the hormone cortisol, which creates inflammation in the body. This inflammation can then lead to impair skin function and an increase in hormonal acne.

Menstruation

Menstruation is a popular time for hormonal acne breakouts, for obvious reasons.

During the ovulatory phase, most people enjoy a brief period of healthy, glowing skin due to peak levels of estrogen (which, aided by progesterone, keeps testosterone at bay). After ovulation is over, estrogen and progesterone levels drop considerably, opening the door for testosterone to play.

Testosterone then causes your skin to pump out sebum which mixes with dead skin cells and inflammation to clog pores and result in  all types of hormonal acne.

How To Reduce Hormonal Acne

Reduce Sugar Intake

During a hormonal breakout, the sugars in processed foods are not. High glycemic foods result in insulin spikes which increases systemic inflammation and can result in more acne.

If you struggle with skin that is sensitive to sugars, you might consider taking a  glucose support supplement and following a  skin-friendly diet.

Limit Dairy

Like processed sugars, dairy is horrible for hormonal acne. For some people, hormonal acne coulddisappear completely by eliminating all dairy. 

You may think I never drink miik - but dairy is hidden is many food products and ingredient lists and easily found in everyday foods, from sandwiches, soups,  sauces like dressing, dips, and sandwich spreads, whey protein powder, most baked goods and many prepackaged foods.  

The fact is that dairy is both a sugar, causes decrease of estrogen, and is generally a pro inflammatory food which can lead acne to form, and if you have hormonal acne you’ll want to substitute it with plant based alternatives. 

Treatments for Hormonal Acne  

Diet

Diet is not always the miracle answer to acne, but for many people what they eat makes a huge difference in their hormonal acne.

While decreasing consumption of high glycemic foods (especially around your period) can help reduce breakouts, increasing healthy fat intake, eating more probiotics and fiber can also help.

Studies have also shown that increasing  spearmint tea consumption could also help to  reduce testosterone levels, and therefore improve hormonal acne, however this is nor recommended for men. Consult your physician before trying a herbal remedy for hormonal acne. 

Exfoliation

Exfoliation is a must for people with hormonal acne. Exfoliation helps to remove the extra sebum and dead skin that can build up and create acne.  Exfoliating can be done 1-3 times a week and we recommend a chemical exfoliator. 

The Banish Pumpkin Enzyme Masque  is great for exfoliation because of the natural pumpkin enzymes and AHA glycolic acid in the mask. 

Adaptogens

Adaptogens are best if you are experience stress related acne.  An  adaptogen is a plant or plant extract used in herbal medicine which is believed to stabilize the body and create a state of homeostasis or balance.

Ashwagandha and Holy Basil are both popular adaptogens said to help acne. It can reduce stress to help reduce hormonal acne.  

Adaptogens like Maca and Vitex are touted to help with  hormonal side effects and alleviate PMS symptoms, but it isn’t clear whether or not they are effective for acne.

Retinoids

For hormonal acne that just doesn't want to back down, retinoids may be a more suitable treatment option. Retinoids are great for increasing skin turnover, increasing collagen, and it has anti-inflammatory effects too. 

When starting retinoids, your skin may be more sensitive and inflamed at first before since it can be irritating to the skin. If this happens, you can try applying every other day or layer it over moisturizer, and you may want to exfoliate less often if you're also using a retinoid.  

Tea Tree Oil

Studies have shown that tea tree oil at 5% concentration is as effective as benzoyl peroxide in reducing mild to moderate acne.  Make sure that your product that contains tea tree oil isn't mixed in a formula with highly comedogenic oils as that could worsen acne. 

Recommended product:  Vitamin C Beauty Elixir which contains tea tree oil that may help mild to moderate acne.

Benzoyl Peroxide

Benzoyl peroxide is an and effective treatment for all kinds of hormonal acne.  Benzoyl peroxide can reduce the amount of inflammation on the skin by eliminating acne causing bacteria on the skin surface.  It can be drying, so pair with a moisturizer. 

Antibiotics  should not be used for hormonal acne.

If you're using topical treatments for hormonal acne, more is not always better. Using multiple treatments can increase irritation and impair the skin barrier, so if you notice more burning, redness, or peeling itching skin, take it back and stick to one treatment only for a while until your skin adjusts. 

Oral Hormone Therapies

Of course, hormone therapy is an option for hormonal acne that is resistant to other treatments and if diet changes make no effect.

Birth Control Pill

IUDs and implants which only release progestin may make acne worse, whereas certain  birth control pills increase estrogen levels to combat hormonal acne if your cause is a lower ratio of estrogen.  Birth control pills come with their own slurry of side effects too. 

Spironolactone

For many women with hormonal acne, spironolactone is a very effective treatment option and it works because it is an anti androgen which will block androgen receptors.

Sprionolactone is recognized by the FDA only to treat high blood pressure and fluid retention, but doctors may prescribe it off label for hormonal acne. 

Isotretinoin

Of course, for the very severe cases of hormonal acne, treatment of isotretinoin may be required. Although  relapse rates for hormonal acne tend to be higher, it will still decrease the severity. 

With consistent therapy (lifestyle, topical, and sometimes oral), hormonal acne can effectively be controlled so you can have your skin – and your life – back!

Types Of Hormonal Imbalances That Cause Acne

Estrogen

Estrogen is important for determining how our skin looks and feels. As we age our estrogen levels change; our skin becomes dry, fragile, saggy, and has a general decrease in elasticity.  However, an overproduction of estrogen can be harmful as well. This can cause a worsened menstrual cycle, PMS, and hyperpigmentation or discoloration of the skin.

Testosterone

Testosterone controls sebum production, which is important for skin health and nourishing your skin with natural oils. However, when an overproduction of oil occurs, the pore becomes clogged and acne is born! Increase in testosterone, could make skin more oily and prone to breakouts.

Cortisol

Cortisol, also known as the stress hormone, has a massive impact on our skin. A surge in cortisol causes an increase in sebum production and spikes inflammation, one of the biggest triggers for acne. Chronic stress and high levels of cortisol can lead to unhealthy habits of coping like consuming excess alcohol, refined carbs, and sugar, which in turn can all make acne worse. 

Thyroid Hormones 

 Thyroid hormones are one more way your skins appearance can be affected. According to Dr. Trevor Cates,

  “An overactive thyroid can cause warm, sweaty, and flushed skin, while an active thyroid can lead to dry, coarse skin with a reduced ability to perspire.If you suffer from skin problems and have weight, digestion (constipation or diarrhea), or energy issues (fatigue or feeling overly stimulated),you should talk with your doctor about thyroid testing.” 

It's best to get your thyroid levels tested along with all your other hormones too so you know exactly what sort of imbalance you are dealing with, or you may not have a hormone imbalance which can help you rule out certain causes.

How long have you had hormonal acne, and which remedies gave you results?

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