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.
When Is It Time To See A Dermatologist For Maskne Treatment
We will do our utmost to help people struggling with maskne to develop a good skincare routine to tackle this issue on their own, but for those who have very deep pimples and cysts or painful breakouts, it may be time to come into the office for more advanced treatments. You should also visit a dermatologist at least once each year for a skin exam to check for warning signs of cancer, keep track of chronic skin conditions, and ensure youre using the right skincare products.
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Differences Between Cystic Vs Hormonal Acne
Once you understand why your breakouts are occurring, this knowledge allows you to determine the best option for treatment. While hormonal acne is seen in men and women going through significant hormonal changes aging, pregnancy or even stress cystic acne occurs at any age as a result of dietary sensitivities and an overproduction of sebum. For that reason, treating these two different types of problem skin often requires unique acne treatment options.
If youre not sure whether your breakouts are hormonal or cystic, there are some distinctive differences to help you determine if your problem skin is more cyclical or caused by something else, like an increase of sebum or inflammation at a deeper level in the skin. Heres the difference between cystic and hormonal acne:
Adopt A Simpler And More Natural Skin Care Routine
When creating a skin care routine for hormonal acne, look for products that are:
- Non-comedogenic i.e. doesnt include ingredients that clog pores.
- As natural as possible. In particular, you want to avoid potential hormone disruptors or pro-inflammatory ingredients. This means watching out for ingredients like parabens, triclosan, phthalates, siloxanes, BHA and BHT.
Also, be careful not to over clean your skin. Even though oily skin and clogged pores can lead to an overgrowth of bacteria, over cleaning the skin especially with harsh ingredients can also destroy the healthy bacteria that naturally sits on the skin.
Overall, less is usually better.
As for how to get your hands on more natural products, you can go the DIY route or buy from a company like S.W Basics. Their products usually contain 5 or less ingredients. With so few ingredients, theres no junk to worry about.
Here are some of their products to consider for your routine:
- S.W Basics Toner: a non-toxic blend of water, organic apple cider vinegar, organic witch hazel and healing essential oils.
- S.W Basics Cleanser: A gentle cleanser with no harsh soaps or weird hormone disruptors.
Lastly, consider using a simple oil like jojoba oil as your daily moisturizer.
Now, you might think this would make your acne worse, butjojoba oil is the only oil that is closest to the natural sebum that our skin produces.
In addition, jojoba oil is non-comedogenic so your pores can actually breathe!
Pay Attention To Everything That Comes In Contact With Your Face
Real talk: I gave up wearing sweaters with any kind of collar that rubs on my jaw because they seemed to increase irritation and I could never be sure that they were totally clean . Pillows are often eyed as potential bacteria nurseries, but think also about shirts, scarves, and coats that come in contact with your skin.
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Over The Counter Treatment
Over the counter, look for products that contain benzoyl peroxide or salicylic acid, shares Dr. Zeichner. Benzoyl peroxide reduces levels of acne-causing bacteria on the skin, which promote inflammation. It can also help remove blockages on the surface of the skin. Salicylic acid is a beta hydroxy acid that removes excess oil and exfoliates dead cells from the surface of the skin.
Some of his favorite products include Neutrogena Stubborn Acne Rapid Clear Daily Facial Mask, which he says can help treat pimples that you already have, as well as ones that have not yet surfaced, plus Clean & Clear Bubble Cleanser with Salicylic Acid. If those approaches dont seem to be helping much, its a good idea to visit a dermatologist for more powerful treatmentslike a topical retinoid, antibiotics, hormone-blocking drugs, or topical acne prescriptionsthat can both treat acne and prevent permanent scarring.
Add More Hormone Balancing Foods To Your Acne Diet
The most high impact step that you can take to clear up your skin is to eat more hormone-friendly foods.
There are 5 categories of hormone-balancing foods that I suggest focusing on:
- Cruciferous vegetables: theyre ideal for detoxing excess estrogen and therefore, supporting a healthy ratio of estrogen to progesterone. Remember that even if your body is making more androgens and less estrogen, your estrogen to progesterone ratio can still be off balance. Therefore you can still be in an estrogen dominant state that contributes to acne. Example of foods to eat are cauliflower, bok choy, radishes, broccoli, kale, collard greens and cabbage.
- Plant proteins: plant proteins are more nutrient-dense and more anti-inflammatory than animal proteins. Example of foods to eat are nuts, seeds, beans, quinoa and broccoli.
- Naturally fatty foods: fats are the raw material for all of our sex hormones as well as all the adrenal hormones. Example of foods to eat are avocados, coconuts, nuts, seeds, nut butters and olives.
- Antioxidant-rich fruits: antioxidants help fight off the damaging effects of inflammation at a cellular level. Example of foods to eat are oranges, blueberries, melons, papayas and mangoes.
- Green vegetables: theyre high in chlorophyll which supports detoxification. Example of foods to eat are cucumber, kale, spinach, broccoli, arugula, microgreens, dandelion greens.
Recommended Reading: Estradiol And Progesterone Side Effects
Add A Salicylic Acid Cleanser To Your Skincare Routine Mid
Dr. Zeichner recommends this ingredient to remove excess oil and dead skin cells from the surface of your skin, which will help keep your pores clear. And as mentioned in the previous tip, cleaner pores mean less jawline acne. He suggests Aveeno Clear Complexion Foaming Cleanser for this step. Unlike some harsh cleansers, this unscented formula is gentle enough for sensitive skin and was created specifically for those with acne-prone complexions.
Aveeno Maximum Strength 1% Hydrocortisone Anti
Instead of spending money on cortisone shots to treat hormonal breakouts, investing in an ointment like Aveeno Maximum Strength 1% Hydrocortisone Anti-Itch Cream will help you decrease the size and redness of your cystic acne without a trip to dermatologist. Designed to soothe, this top-rated, cult-favorite acne remedy uses a blend of 1% hydrocortisone, aloe, vitamin E and the brands triple oat complex to reduce inflammation, soothe irritated skin and restore nourishing moisture.
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Other Supplements That May Help
Aside from vitamin D and green tea extract, the following supplements may help reduce acne symptoms:
- Fish oil. Some evidence suggests that supplementing with omega-3-rich fish oil may reduce acne severity in some people. However, the results are mixed, with some people experiencing worsened symptoms (
Vitamin D, green tea extract, B vitamins, and zinc are just some of the supplements that may benefit people with acne.
How Is Cystic Acne Managed Or Treated
Acne cysts can be difficult to treat. Because they can scar, you should seek help from a dermatologist instead of trying over-the-counter acne products. A dermatologist can teach you how to treat cystic acne.
It can take three months or more to clear up acne cysts. Treatment often involves taking oral antibiotics and applying prescription-strength topical gels or creams to the skin.
Cystic acne treatments include:
- Antibiotic creams, gels solutions and lotions to kill bacteria and decrease inflammation.
- Azelaic acid or salicylic acid to kill bacteria and get rid of excess dead skin cells.
- Benzoyl peroxide to reduce the number of bacteria on the skin.
- Retinoids , vitamin A derivatives that help slough dead skin cells.
What Causes Cystic Acne
Ugh, bad luck? Just kidding. Maybe. Fundamentally, everyones skin is the sameeveryone has hormonal fluctuations, oil productions, and acne-causing bacteria in their skin that could cause a huge breakout at any time, says Mona Gohara, MD, associate clinical professor at Yale School of Medicine. But, BUT! The sebaceous glands in some people are just naturally more sensitive to these triggers, causing a larger and more frequent inflammatory response.
And if youre someone with cystic acne, heres what that inflammatory response looks like: Your follicle gets pissed off and clogged, trapping the oil and bacteria deep within your pore and causing intense inflammation. That inflammation then ruptures the sides of the pore and leaks bacteria into the surrounding skin, resulting in a big-ass, super-painful cystic zit with no escape route. Honestly, your risk of developing cystic acne only partially has to do with how you take care of your skin, says Dr. Gohara. Translation: Its not your fault.
Is Menopausal Acne A Form Of Hormonal Acne
Many women begin to experience menopause in their 40s and 50s. This causes a natural decline in your reproductive hormones, resulting in an end to menstruation.
Some women experience acne during menopause. This is likely due to a drop in estrogen levels or an increase in androgen hormones like testosterone.
You may still experience menopausal acne even if youre using hormone replacement therapies to ease your menopause symptoms. This is because some HRTs use an influx of the hormone progestin to replace the estrogen and progesterone your body loses. Introducing this hormone to your system can cause your skin to break out.
In most cases, prescription medication can clear up menopausal acne. Some women may find success using natural treatment methods. Talk to your doctor about which options may be right for you.
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Cystic Acne And Hormones: Oil Production In The Skin
There are three separate layers to the skin, and pores traverse these layers. To adequately protect your body and keep toxins on the outside, the outer layer of the skin must be hydrated and strong.
To do this, pores deliver oil from the bottom layer to the top of the skin. In healthy skin, oil comes up through the pores and oozes onto the surface, lubricating the skin and making it look soft and glowy. Think of it like a well, or a hot spring, or an oil rig.
Try An Oral Contraceptive To Balance Hormones
If you’re comfortable and if a gynecologist says you’re a good candidate, oral contraceptives can help balance out your hormones, including those that are responsible for acne. Zeichner says that the best prescription options for hormonal acne are birth control pills and Spironolactone . Birth control pills help regulate your hormones and decrease testosterone levels, which can mean fewer hormone-induced breakouts. Zeichner notes the four birth control pills currently approved for acne: Yaz, Beyaz, Ortho Tri-Cyclen, and EstroStep.
Another option is the aforementioned Spironolactone. Though not specifically designed to treat acne, it is often used for exactly that purpose because it prevents testosterone from stimulating the oil glands. “Less oil means less shine, fewer clogged pores, and less food to feed acne-causing bacteria,” Zeichner explains.
“Certain oral contraceptives have even been approved by the FDA to be used in the treatment of acne,” explains Fenton. “If you are already on birth control or thinking of going on it, make sure to ask your gynecologist for an oral contraceptive that will also help your acne.”
“In addition to clearing existing acne, Differin Gel will also help to prevent future breakouts from forming by increasing skin cell turnover to minimize clogging of pores.” Additionally, Fenton recommends using an OTC acne wash and non-comedogenic moisturizer regularly.
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How To Know If Your Acne Is Hormonal
In general, acne is considered to be hormone-related if it :
- Occurs on the lower part of the face, such as the chin and jawline.
- Flares up before your period, during menopause, during pregnancy or other phases of life when theres a significant shift in hormones.
- Becomes worse as you go on or off hormone therapies .
In addition to the above, hormone-related conditions like PCOS can also cause acne to worsen.
This is mainly due to the fact that high androgens and insulin resistance are quite common in PCOS patients. And as weve seen, imbalances in both of those hormones contribute significantly to inflammation and hormonal acne.
NOTE: the tips in this section are general guidelines. The only way to know for sure if your acne is hormone-related to get your hormones tested by a doctor.
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.
How Is It Hormonal
Hormonal acne is triggered by fluctuating hormone levels. Thats why you might get more breakouts if you have a vajayjay.
Females are more susceptible to hormonal acne since we experience fluctuations in female sex hormones estrogen, progesterone, and testosterone monthly with our menses, says Zenovia Gabriel, MD, FAAD, a board-certified dermatologist and hormonal skin care expert.
A breakout can be the first sign of hormonal imbalance. The pimples are proof your body is adjusting.
An increase in testosterone stimulates our oil glands to produce excess sebum, which is one major cause of acne, says Zenovia.
The 5 Natural Supplements You Need To Stop Hormonal Acne
Using the right natural supplements every day can get you to where you want to be much faster than using food alone.
Ready to recover your glowing complexion and regain your confidence? Here are my top five natural supplements for preventing and healing hormonal acne:
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The Key To Acne Sanity Is Knowing The Difference Between A Purge And A Breakout
This is tricky. A purge is when you introduce a new active such as AHA, BHA, or tretinoin to your routine and crap in your skin surfaces and forms blemishes. Its in there, it needs to come out, this is positive, if annoying. It will make your skin clearer overall.
A breakout is when your hormones or a product or sweat or the fucking magnetic pull of Pluto who knows cause your skin to form zits. If your breakout is possibly caused by a product, you probably want to bench it.
How do you know the difference? ahh, its tough. If youre a woman, track your monthly cycle and note when your skin breaks out. Limit your testing of new products to one at a time. Study your skin in different lights and at different angles to see where you have tiny bumps below the surface that could indicate clogs that need to come up.