How To Treat Hormonal Acne According To Dermatologists
Even celebs have to deal with it.
Design by Tiana Crispino
In This Article
This is how the hormonal acne story unfolds: Just when we think puberty’s passing took unsightly teenage acne with it, we’re introduced to a new wave of pimples in our 20s. Right around the time of our periods, acne flares up along our jawline, cheeks, forehead, and between the eyebrows , adding insult to injury. Looking on the bright side, though, you have options when it comes to helping quell hormonal acne. But let’s first dive into how to identify them.
Can Hormonal Imbalance Cause Acne
Acne is a skin condition when oil and dead skin cells clog your hair follicles. It causes whiteheads, blackheads, and pimples on the skin. Acne is most common in teenagers, but it can affect anyone at any age. In this article, we will explore if hormonal imbalance is the cause of acne and how we can manage this issue.
Best Products For Acne
The dermatologists we spoke to recommended looking for products with salicylic acid, benzoyl peroxide, adapalene and azelaic acid for acne-prone skin. Below, we highlighted a mix of face washes, moisturizers, sunscreens, spot treatments and face masks that feature these ingredients as well as other expert-recommended acne-fighting ingredients like niacinamide and zinc oxide. Experts recommended each of the following brands and products.
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Are Levels Of Testosterone And Of Other Androgens Raised In Hormonal Acne
There is conflicting evidence on this though the majority of studies show that elevated androgen levels are are frequent.
A large study from 2013 showed that of 835 women with hormonal acne, 55% had elevated levels of androgens DHEA being the one most frequently elevated. A Turkish study from 2017 of 207 women showed 55% of women with acne had elevations in one androgen. Smaller studies from Brazil and Japan have also showed elevated levels of androgens in adult women with acne.
A Czech study from 2000 of 90 women with acne showed that 81% had an elevated level of at least one androgen. The severity of acne did not vary with the degree of elevation however. However a British study from 1989 showed no elevations in androgens in women with acne.
Our clinical impression is that some women do have elevated androgen levels and hormonal acne may be the only sign of this. Other signs include excessive facial and body hair, irregular periods and hair loss. However, a large number of women have normal levels of androgens and it is believed that these women may just be more sensitive to these androgens. This is the reason they get acne.
The bottom line is routine hormone blood tests may be normal in hormonal acne. Hypersensitivity of the skin means that anti-androgen treatment is still important. Also Testosterone and DHT can be produced in the skin and blood tests would not show if too much of these hormones is being produced in the skin in some people.
Is Hormonal Acne Caused By Pregnancy
When you are pregnant, hormonal fluctuations can cause acne. Often, acne gets better as your pregnancy progresses. There are several treatments that you should avoid during pregnancy, including topical retinoids, salicylic acid and isotretinoin. Ask your healthcare provider about the safest acne treatment for you to reduce and eliminate breakouts during pregnancy.
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How To Treat Hormonal Acne With Tretinoin
While tretinoin can not help rebalance your hormones, itâs still a great acne treatment option. Letâs get into the details of tretinoin for hormonal acne.
Tretinoin is a proven effective acne treatment. Some researchers consider it the foundation of effective acne therapy.
In most cases, acne lesions are significantly reduced over 2-3 months of consistent use. But does tretinoin treat all types of acne?
Hormonal acne is a tricky one because the cause is an internal imbalance. A hormonal imbalance can cause issues such as acne, hair loss, anxiety, depression, and sometimes physical pain.
When it comes to hormonal acne, the driving force is often androgenic hormones. Other hormones, such as estrogen or progesterone can play a role as well.
While tretinoin can not help rebalance your hormones, itâs still a great acne treatment option. Letâs get into the details of tretinoin for hormonal acne.
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How Do I Get Rid Of Hormonal Acne
Listen, as someone who has been through almost all of the options for hormonal acne, Ill be honest with you: Youre going to have to see a dermatologist if youre dealing with cystic acne or inflammatory acne . No, dont freakits a good thing, because it means getting a treatment plan faster, which means less scarring and ~emotional damage~ for you.
If youre dealing with mild-to-moderate blackheads and whiteheads, you should see some success with at-home efforts, but if youre dealing with cystic acne, youll need to incorporate prescription medications . Think about it: Your entire genetic makeup is causing your hormonal acne, so its unrealistic to think some drugstore face wash or toner can have a huge impact, you know?
In fact, your risk of developing cystic acne only partially has to do with how you take care of your skin, says Dr. Gohara. But if youre here, youre probably desperatewhich, yup, I live thereso lets break down the at-home options and professional options :
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Best Retinol For Hormonal Acne
Differin Gel contains Adapalene, a retinoid that was formerly only available by prescription, but now can be purchased over the counter. Apply a thin layer over your face once daily not just on areas that are currently experiencing breakouts for the best way to prevent future hormonal acne flareups.
Retinols are vitamin A derivatives that are among the most studied and published ingredients in skin care, Dr. Hartman explains, adding that they help with everything from preventing acne to evening out discoloration to unclogging pores. are a mainstay of treatment for all types of acne but do the most for non-inflammatory acne by increasing cell turnover. Topical retinoids are also an important part of combatting inflammatory papules and pustules, he elaborates.
Kypris Clearing Balance & Calm Serum
A must-have for battling breakouts and redness, the Kypris Clearing Balance & Calm Serum works with oily and acne-prone skin types to restore balance, regulate oil production, prevent congestion and reduce the appearance of breakouts and hyperpigmentation. Rich in antioxidants, amino acids and vitamin E thanks to its zinc, lilac leaf stem cells, tea tree oil and lavender-fortifed formula, it also prevents breakouts from forming while creating a brighter, more even complexion.
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How Long Does Pregnancy Acne Last
Unfortunately, its not just something that crops up for a short period of time. Like everything else in pregnancy, its unpredictable, according to Holey. It tends to start around six weeks, and it might fade gradually, last well until after babys arrived or come and go in waveskind of like your appetite.
What Causes Cystic Acne
According to Kluk, hormones are a key player in sparking a bout of acne, which explains why you always seem to spot a cyst looming around the same time as your period. This is because hormonal fluctuations can stimulate oil production and thicken the lining of the pores.
Whats more, genetics, our diet and lifestyle can also play a role.
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Hormonal Acne: What You Should Know
Brandi Jones MSN-Ed, RN-BC is a board-certified registered nurse who owns Brandi Jones LLC, where she writes health and wellness blogs, articles, and education. She lives with her husband and springer spaniel and enjoys camping and tapping into her creativity in her downtime.
Acne is a skin condition that affects approximately 650 million people worldwide. Hormonal acne develops due to changing hormones. It occurs in males and females during puberty and is more common in males during adolescence. In adulthood, it is more common in women.
This article reviews hormonal acne causes, symptoms, and over-the-counter , natural, and prescription treatments.
Boy_Anupong / Getty Images
What Are The Causes Of Hormonal Acne
Hormonal acne is essentially caused by fluctuations in hormone levels. The hormones that influence hormonal acne are estrogen and progesterone , testosterone , and cortisol .
The causative hormonal changes typically occur around the time of your menstrual period, when you start or stop using hormonal birth control, during or after pregnancy, and during perimenopause and menopause. Less commonly, it can be triggered by certain medical conditions such as polycystic ovarian syndrome . Genetics also play a role in hormonal acne one study found that 67% of women in the study group with hormonal adult acne had an acne family history.
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How Do I Know I Have Hormonal Acne
But how do you know if your red spots are caused by hormones or something else altogether? And why is that important? Pegging down the root cause of your acne can help inform an effective treatment plan. For example, if a product is causing breakouts, the answer could be as simple as discontinuing usage. On the other hand, if you’re experiencing hormonal acne, treatment may be a little bit more complex.
Green says hormonal acne typically presents as cysts along the jawline and on the chin in adults and in the T-zone during puberty, but it can also present as whiteheads, blackheads, papules, and pustules, says Umarand that’s exactly why it’s important to consult a board-certified dermatologist who can help you correctly identify your condition.
In the meantime, you can also look for patterns. “It is common for hormonal acne to reappear in the same areas in a cyclic fashion,” she explains. “Many adult patients struggling with hormonal acne indicate that their breakouts are more pronounced for a certain period each month or when they have endured significantly more stress.”
How To Treat Hormonal Acne Naturally
In some cases, plant-based treatment options may be used to clear up mild hormonal acne.
Natural treatments are usually free of the side effects sometimes caused by prescription options. But they may not be as effective. Research on natural options is lacking, and at this time nothing has been proven to produce results. Talk with your doctor about potential risks and to ensure the treatment wont interact with any medications youre taking.
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Apply A Retinol Product Before Bed
Before you go to bed, theres one last important step to achieving clear skin: smoothing on a retinol product. What is retinol? Its the over-the-counter version of the vitamin A derivative Retin-A, which reduces wrinkles and key for acne control unclogs pores. Retinol is a great multi-tasking acne treatment for adults, says Dr. Sobel. It helps speed up cell turnover and regeneration and exfoliates keratinocytes, the cells on the outermost layer of the skin. It also works to unclog pores and keep skin looking youthful while minimizing and preventing fine lines and wrinkles. Three to try: Differin Adapalene Gel, La Roche-Posay Effaclar Adapalene Gel, and Sobel Skin 4.5% Retinol Complex Night Treatment. Dr. Sobel recommends starting off slowly with any retinol product. Try it one or two days a week to build up a tolerance and avoid irritation, he says. Gradually, move up to four time a week, and then daily if needed.
The bottom line:Be patient and consistent with your regimen and dont give up, Dr. Sobel adds. It takes time to clear and fade existing blemishes while preventing future breakouts. It wont happen overnight, but it will happen.
Best Toner: Dickinsons Enhanced Witch Hazel Hydrating Toner With Rosewater
Key Ingredients: witch hazel, hyaluronic acid, aloe vera and vitamin E | Certifications: NA
For those battling mainly non-inflammatory acne, such as blackheads and whiteheads, a toner with witch hazel can help. As an astringent, witch hazel works to remove excess oil and shrink pores while offering anti-inflammatory benefits too. Dr. Mariwalla recommends a formula like Dickinsons Enhanced Witch Hazel Hydrating Toner that is free from drying alcohol and has hydrating ingredients like hyaluronic acid and aloe vera. To avoid any irritation and over-drying your skin, try using this toner once a day after washing your face before bed and before applying any other skincare products. Use a reusable pad to be extra sustainable.
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Discover How You Can Get Clear Of Your Acne Schedule A Free 15 Minute Clear Skin Discovery Session
This is all important because research has shown there are androgen receptors in the base of the oil gland and also in the cells that line the pores! If there are high levels of testosterone floating in the body, they are highly capable of binding to these receptors.
To put it simply, when these hormones attach to the oil glands in the skin, they trigger the gland to produce more oil as well as feed the bacteria. Then, an inflamed acne lesion is well on its way to the surface of your skin.
The key takeaway is that by lowering androgen and testosterone levels in the body, the skin will not produce as much acne or not produce ANY at all.
So how does Estrogen play into all this?
Estrogen and testosterone frequently act like a teeter totter. As one goes up the other goes down.
Hormonal acne is an elevated androgen/testosterone and low estrogen issue. It is not an elevated estrogen problem. Therefore, taking herbal supplements that block estrogen, such as DIM, will make your acne worse and increase testosterone causing cystic breakouts. I do not recommend DIM for hormonal acne for these reasons.
So it makes sense that if you lower androgen levels, the skin will not produce as much oiland your acne will improve!
Viva Naturals Ultra Strength Omega
Best Natural Supplement for Hormonal Acne
Those who are looking to increase their omega-3 intake may want to check out these fish oil supplements from Viva Naturals. The brand offers bottles with 180 and 90 supplements, and the serving size is 2 soft gels. Each serving contains 2200mg of pure fish oil. The servings also have 1400mg of eicosapentaenoic acid and 480mg of docosahexaenoic acid , which are omega-3 fatty acids. The company uses an extraction method that strips away toxins, heavy metals, and other harmful components, so you are getting high-quality fish oil without any unnecessary elements.
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What Other Treatments You May Need Alongside Tretinoin To Treat Hormonal Acne
Drum roll, please. Introducing your next three acne-fighters:
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Oral Contraceptives
Each of these treatments can be used with or without tretinoin. Spironolactone and oral contraceptives, in particular, are a great pairing for tretinoin if you suffer from hormonal breakouts because they specifically address the hormonal causes of acne.
Next, well take a closer look at each.
Paulas Choice Clear Regular Strength Acne Kit 2% Salicylic Acid & 25% Benzoyl Peroxide For Facial Acne & Pores Redness Relief Packaging May Vary
- Paulas Choice Skincare makes products that work. No fragrance, no parabens, no fluff. Just effective, science-backed formulas that target any concern from wrinkles to breakouts.
- EASY-TO-USE ACNE FIGHTING SYSTEM: This 3-step skin care system works quickly to combat and control stubborn acne, breakouts, blemishes, and blackheads all without causing dryness or redness. Over time, it effectively unclogs & minimizes the look of pores while improving signs of sensitivity. PACKAGING MAY VARY.
- These lightweight formulas are gentle yet tough on breakouts, enlarged pores & acne. The work together to provide skin-perfecting, pore-clearing & hydrating benefits. Use as your morning and evening daily skincare routine to see & maintain best results. Always finish with SPF 30+ in the morning.
- Paulas Choice CLEAR collection also includes our Ultra-Light Daily Hydrating Fluid SPF 30+ for daytime, the CLEAR Oil-Free Moisturizer for weightless hydration, and the CLEAR Purifying Clay Mask to control excess shine & clogged pores.
- Paulas Choice CLEAR Regular Strength Acne Kit contains 3 products: CLEAR Pore Normalizing Cleanser, CLEAR Regular Strength Anti-Redness Exfoliating Solution with 2% Salicylic Acid , and CLEAR Regular Strength Daily Skin Clearing Treatment with 2.5% Benzoyl Peroxide. Its suitable for normal, dry, oily & combination skin including skin prone to cystic acne.
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Causes Of Hormonal Acne
There are two main indicators: Your breakouts happen along the lower third of your face, and they get worse before your period when there is an excess build-up of testosterone, according to Joshua Zeichner, MD, the director of cosmetic and clinical research in dermatology and assistant professor of dermatology at Mount Sinai Medical Center in New York City.
Besides Aunt Flow, there are a few other hormonal acne causes. Pregnancy and the fluctuating hormones that come along with it, for one. Also, the decline in reproductive hormones can cause hormonal acne due to your body adjusting to fluctuating levels. Polycystic ovary syndrome is another culprit. It can occur in women at a reproductive age and causes a fluctuation in hormones that can increase the length of your menstrual cycle, cause obesity, and result in breakouts.