Acne vulgaris is a common disorder often thought of only in adolescents during their pubescent years with prevalence upwards of 70-87% (Ebede, 2009). Acne vulgaris, often just termed acne is more common in adolescents but may also be seen in adults. Now there are many factors that can affect the appearance of someone’s skin such as gender, genetics, sebum or oil production, medications and hormones. It is estimated that in the United States over $1 billion is spent on acne (Ebede, 2009). I want to focus on acne in relation to hormones; how it begins and what can be done to minimize or eliminate it altogether. The skin is the body’s largest organ is important and when your hormones are out of balance, many things can occur.
If you are between the ages of 20-45, there are many over the counter and prescription medications that have varying degrees of effectiveness against hormonal acne but will not treat the underlying cause; hormones. The age for hormonal acne is not limited to this age range but tends to be more prevalent here.
Your skin is particularly sensitive to excessive production of androgens such as testosterone. Androgenic steroids can cause an increase in secretion of oils. This can further exacerbate the problem by clogging skin pores, inflammation and infected follicles. This is when the body can develop what is called cystic acne. Although the driving force for hormonal acne is testosterone, other hormones play their own part in hormonal acne. Large estrogen levels or progesterone that is out of sync with estrogen is the predominant cause of pre-menstrual breakouts. When this happens, insulin levels are increased which leads to excess androgens. Testosterone is converted to a metabolite dihydrotestosterone (DHT), by an enzyme 5-alpha reductase. This enzyme has been shown to be inhibited by progesterone, thus slowing the progression to DHT, which is a 5-10 times more potent androgen than testosterone. DHT will greatly increase oil production, which can lead to acne. Estrogen in sufficient quantities has shown suppression to oil production. The key for women seems to lie within the balance between estrogen and progesterone.
What do we do about hormonal acne? There are many factors to consider. The obvious treatment is balancing your hormones but it is important not to leave out diet, stress, probiotics and exercise. There is a correlation to high glycemic index foods and hormonal acne. Oddly enough, almost all of these conditions can cause low progesterone. I say that facetiously because are we starting to see a pattern? You can slow your digestion by increasing complex carbohydrates and proteins rather than high sugar intake. Probiotics replenish the body with good bacteria, can help with immune health and improve skin health. Stress and exercise help regulate hormonal imbalances.
So, if this applies to you; the question is what are you waiting for? Your doctor can evaluate your hormone levels and provide much needed supplementation in certain situations. Hormonal acne will not resolve on its own, so take control of your body to make a more confident and healthier you!
Ebede, T. L., Arch, E. L., & Berson, D. (2009). Hormonal treatment of acne in women. The Journal of clinical and aesthetic dermatology, 2(12), 16–22.
Grice, E. A., & Segre, J. A. (2011). The skin microbiome. Nature reviews. Microbiology, 9(4), 244–253. doi:10.1038/nrmicro25