We’re all sold the ideal of perfect skin by skin care companies. But sometimes the cause of our breakouts is more than skin deep. So how do we know if our skin troubles are hormone-related? Read on to find out.

Quick facts:

• Hormonal acne is caused by hormonal imbalances or fluctuations. 
• It’s common during puberty but can also affect adults at any point. 
• In females, causes can be linked to excess androgen hormones and low oestrogen. 
• There are lots of treatments available including topical, oral and lifestyle management.
• Testing your hormones can help you get to the root cause of hormonal flare-ups.

What is hormonal acne?

Hormonal acne is acne or breakouts that are related to hormonal fluctuations or imbalances. 

Typically hormonal acne is found on the lower face, cheeks and jawline chest, neck, shoulders and back. 
Hormonal acne can affect people of all ages. Whilst it’s common during puberty when lots of hormonal changes are occurring, it can also be common as an adult, especially for women and people who menstruate, due to hormonal fluctuations throughout the menstrual cycle.

What causes hormonal acne?

Your skin has many small glands, called sebaceous glands, that produce an oily substance called sebum. Sebum helps keep your skin supple, smooth and healthy. 

These glands also have receptors for our sex hormones, particularly androgens like testosterone, and oestrogen. Both of these hormones stimulate the production of sebum.

When excess sebum is produced, this buildup causes visibly oilier skin and can clog the pores, resulting in inflammation and acne breakouts.

Hormonal acne and androgens

When our bodies produce excess amounts of androgens, it can cause hormonal acne and other skin problems. If androgen levels are higher than normal, there is more androgen binding to the sebaceous gland receptors, promoting more sebum production. 

There can be lots of reasons for elevated androgens. A common cause is Polycystic Ovary Syndrome (PCOS). Those who experience PCOS are more likely to experience excess androgen-related symptoms like acne, excessive facial and body hair growth (hirsutism) and skin darkening. 

Trans and non-binary people who begin taking testosterone as part of their transition journey may also notice acne breakouts because of raised androgen levels.

Hormonal acne and oestrogen

Sebum production is also influenced by the menstrual cycle, specifically by the hormone oestrogen. 

Oestrogen fluctuates throughout the menstrual cycle. It’s at its lowest level during your period and gradually rises to a peak at ovulation, around the mid-point in your cycle.

Although the impact of oestrogen on the sebaceous glands is not fully known, it has been shown to suppress sebum production at high levels. Therefore when your oestrogen levels are higher, generally your skin will be clearer. This is why lots of people experience hormonal acne flare-ups just before or during their periods when oestrogen levels are low. 

Oestrogen is also associated with increased collagen production, skin thickness, skin hydration and wound healing—which all contribute to clear-looking, healthy skin. 
After menopause, your oestrogen drops. Some people find that this drop causes hormonal acne and may also leave their skin dry, itchy and saggy. For some individuals, HRT to reduce the symptoms of menopause can also cause hormonal acne.

How to treat hormonal acne?

If you think you suspect you’re suffering from hormonal acne, there a number of treatments you can explore. 

Firstly, if you’re not already, begin tracking when you have flare-ups and your periods. You can do this with a period tracking app or just using a calendar. This will help you to understand when in your cycle you’re getting flare-ups and whether it could be due to hormonal fluctuations during your cycle. 

Testing your hormones will be able to give you answers as to whether you have raised androgen levels. Our at-home hormone tests can help you identify any hormonal imbalances. 

There are topical treatments available that can help with flare-ups, as well as some contraceptives like the combined pill that has anti-androgenic properties. Lifestyle changes like diet, exercise, stress and alcohol reduction can also have a significant impact. 

If you’re struggling with your skin, don’t suffer in silence. Reach out to us and get on a plan to find the root cause of your skin issues.

References:

1. Farage MA, Neill S, MacLean AB. Physiological changes associated with the menstrual cycle: a review. Obstet Gynecol Surv. 2009 Jan;64(1):58-72.
2. Thiboutot D. Acne: hormonal concepts and therapy. Clin Dermatol. 2004 Sep-Oct;22(5):419-28.
3. Wierckx K, Van de Peer F, Verhaeghe E, Dedecker D, Van Caenegem E, Toye K, Kaufman JM, T’Sjoen G. Short- and long-term clinical skin effects of testosterone treatment in trans men. J Sex Med. 2014 Jan;11(1):222-9.