Hormonal Acne Guide - Types, Causes, Treatment & more

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What is hormonal acne?

Hormonal acne is simply a type of acne that happens due to fluctuations in your hormones. It is mostly associated with puberty but can affect women of any age.

Scientifically known as acne vulgaris, hormonal acne is an inflammatory skin condition that happens due to the overproduction of sebum (an oily substance in skin glands).

This results in whiteheads, blackheads, pimples, and cysts under the skin which can make it difficult for common skin medications to work.

Which hormone causes hormonal acne?

Androgens are the main hormone that is responsible for hormonal acne. Androgen is the most important hormone that regulates and produces the oily substance in your skin glands (sebum). Testosterone is a type of androgen that can cause hormonal acne if there's too much of it.

Why do androgens cause hormonal acne?

High levels of androgens cause sebum levels to rise which results in the skin breaking out from too much oil. The overproduction of oil causes blocked pores which causes acne.

What is the main cause of hormonal acne?

The core cause behind hormonal acne is clogged pores. Clogged pores are caused by the androgen hormone, dead cells, or bacteria.

Hormonal acne can also be caused by a hormonal imbalance resulting from pregnancy, menstruation, or the menstrual cycle. Menopause is also a cause of hormonal acne due to the rise in estrogen levels. Apart from this, there are other causes, some of which can be controlled and others you can’t.

Causes of hormonal acne that you can control.

Some of the causes of hormonal acne which you can control are:

Causes of hormonal acne that you can’t control.

Causes of hormonal acne that you can’t control are

  • your family has a history of hormonal acne
  • you live in a high-pollution area
  • you have an existing health condition that's causing acne

How can hormonal acne be caused by pregnancy?

During pregnancy, you go through a lot of hormonal changes. High levels of progesterone are produced which stimulates your skin glands to produce more oil.

This in turn clogs up the pores on your face, leading to an acne breakout.

How does birth control cause hormonal acne?

During the phase of the birth control pill taking its effect, the lack of estrogen in the pill may allow for higher levels of androgen hormone. This can easily lead to a hormonal acne breakout.

How does hormonal acne affect my skin?

Hormonal acne causes skin breakouts in the form of bumps on your skin that could become red, inflamed, painful, and sore if not treated. If left untreated, hormonal acne can cause scarring in the affected areas.

Types of hormonal acne

Types of hormonal acne based on looks

  • Comedonal Acne - This type of acne is characterized by the presence of blackheads and whiteheads.
  • Inflammatory Acne - The presence of red, inflamed pimples characterizes this type of acne.
  • Cystic Acne - The presence of deep, painful cysts characterizes this type of acne.

Types of hormonal acne based on the severity

Research shows that hormonal acne can be broken down into 3 types based on their severity

  • Mild hormonal acne: mostly blackheads and whiteheads, won't need help from doctors
  • Moderate hormonal acne: inflamed and non-inflamed lesions, some of which may leave scars.
  • Severe hormonal acne: widely spread inflamed lesions

How long does hormonal acne last?

Depending on the severity of the acne, it can last up to 4 to 6 weeks after you start treatment.

Who is more prone to hormonal acne?

Hormonal acne is more common in women than in men. A study done in 2019, showed that 76% of the patients were women with a mean age of 35.5 years. It is more common in puberty ages but can still occur during adulthood.

What age does hormonal acne peak?

The age of hormonal acne normally happens between ages 20 to 50 years old. At 20 to 40 years of age, pregnancy is more common which causes hormonal acne. Almost 25% of women in their 40s and 50% of women in their 20s face hormonal acne.

The start of menopause happens at older ages and can also cause hormonal acne. This is due to a change in the balance of hormones such as estrogen and androgens.

What are the signs and symptoms of hormonal acne?

Hormonal acne mostly causes damaged skin cells which would look inflamed and sore with a red color. Hormonal acne can come in the following ways:

  • Whiteheads - closed inside the skin surface and appear white on top
  • Blackheads -open at the surface and appears black on top
  • Cysts - lumps under the skin filled with puss, which can be painful and sore
  • Papules - Red bumps filled with puss
  • Nodules - a larger version of papules that can be dense and painful

How do I know if I have hormonal acne?

Some of the signs that show that you are facing hormonal acne are:

  • Pimples stay longer: Hormonal acne looks similar to regular acne, however, the pimples are deeper in the skin with hormonal acne which makes them last longer.
  • Your pimple is found to be in your lower face: even though hormonal acne can occur in any part of your face if you find it in your jawline or chin, you can easily categorize it as hormonal acne.
    “This is because these excess hormones in your body stimulate the oil gland, many of which are around your chin area" -  Marina Peredo, M.D., a cosmetic and medical board-certified dermatologist
  • You notice breakouts on the same day every month: hormonal acne tends to follow a pattern every month almost similar to your menstrual cycle. If you see a pattern, then it's hormonal acne.
  • Highly stressed: If you are under high stress, your pimples can easily be hormonal acne caused by the cortisol hormone. To read more about it click here
  • If you are going through a hormonal change: Since hormonal acne is caused by hormonal changes, it is best to consider that acne during this phase can be hormonal acne. These phases include menopause, pregnancy, puberty..etc

Fungal/bacterial acne vs hormonal acne?

Fungal acne is the overproduction of yeast and hormonal acne is the overproduction of androgen which leads to more sebum production.

How to tell if acne is hormonal or bacterial

When you have acne around your period, it's most likely hormonal acne but if topical treatments aren’t helping the acne go away, it's bacterial acne.

What can make hormonal acne worse?

Some of the key factors that can make hormonal ance worse are:

Does hormonal acne go away on its own?

Hormonal acne can be treated but it can’t be stopped. At most, you can reduce its symptoms and control it more.

Do I need to see a dermatologist to treat my hormonal acne?

A dermatologist can advise you on what can help your stubborn acne, but it's not the only option.

There are many ways to treat hormonal acne without seeing a dermatologist.

You can reduce your risk of hormonal acne by

  1. Maintaining good hygiene - Keeping your skin clean and free from excess oil can help to prevent acne.
  2. Following a healthy diet - Eating a healthy diet rich in fruits and vegetables can help to promote healthy skin.
  3. Managing stress - Managing stress levels through relaxation techniques such as yoga and meditation can also help to reduce the risk of acne.
  4. Avoid harsh skincare products - Harsh skincare products can irritate the skin and make acne worse.

Tips to reduce hormonal acne

  • Wash your face gently no more than twice a day and after sweating
  • Use mild soaps or cleansers and warm water(not hot water)
  • Do not use harsh or exfoliating scrubs
  • Avoid scrubbing, picking, or scraping pimples - doing so can make them worse and can cause inflammation
  • Avoid makeup, or use water-based cosmetics that are marked as non-comedogenic sparingly
  • Avoid environments with high humidity that cause excessive sweating

Note: Too much washing or scrubbing or contact with water can remove oil from the skin and irritate it more. The skin can respond by producing more oil and so worsening the acne.

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Best vitamins for hormonal acne

Vitamin A, B, C, E. It's better to eat foods with these vitamins (meats, fish, vegetables, and dairy products) but if it’s not possible you should take supplements.

Treatment options for hormonal acne

There are several treatment options available for hormonal acne, including:

  • Topical Treatments - Topical treatments such as benzoyl peroxide and retinoids can help to unclog pores and reduce inflammation.
  • Oral Medications - Oral medications such as antibiotics and birth control pills can help to regulate hormone levels and reduce acne.
  • Lifestyle Changes - Making lifestyle changes such as reducing stress levels and following a healthy diet can also help to improve hormonal acne.
  • Natural Remedies - Natural remedies such as tea tree oil and aloe vera can help to reduce inflammation and promote healing.

How soon after treatment will hormonal acne go away?

After 4 to 6 weeks you should start to see a difference in your hormonal acne

Other common questions on hormonal acne

What can make hormonal acne worse?

  • Lack of sleep
  • Stress
  • Using skin care products that aren’t oil-free
  • Eating refined/sugary foods and dairy products
  • Drinking sugary beverages

What are the benefits of using anti-androgen treatments for hormonal acne?

They are more effective than traditional acne treatments because the anti-androgen treatments address the cause of the acne, the androgens.

The anti-androgen treatments don’t have any androgens which lowers the number of androgens within the skin which is the main cause of hormonal acne.

Conclusion

Hormonal acne is a common skin condition that can be frustrating to deal with, but there are several treatment options available.

By understanding the causes of hormonal acne and taking steps to prevent it, you can keep your skin looking healthy and clear.

References