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How to get your hormonal acne under control
By Chelsea Tromans | Apr 29, 2019

What it is, why you have it, and six top treatment options.

Essentially, all acne is hormonal. But when you hear the term ‘hormonal acne’ thrown around, it’s often in reference to acne that’s developed due to fluctuations in hormones, normally due to your menstrual cycle, pregnancy or menopause.

The main hormones that wreaks havoc on your skin (or more specifically, your skin’s oil production) are androgens. “Androgens are produced naturally in the body and they interact with androgen receptors in the sebaceous glands to trigger an increase in sebum production. The main androgens are testosterone and dihydrotestosterone (DHT),” says Daniel Isaacs, Director of Research at Medik8. “An overproduction or imbalance in androgens can trigger changes in sebum production, skin cell activity, inflammation and colonisation of blemish-causing bacterial called P. acnes, all of which can lead to acne,” he adds.

What is hormonal acne?

“Hormonal acne is most commonly caused by natural hormonal fluctuations that can occur at anytime during a lifespan, but namely puberty, pregnancy and menopause,” says Isaacs.

Signs it’s hormonal acne and not just a rogue breakout

“Distribution of the breakout and when the breakout occurs is usually a good indicator of ‘normal’ hormonal acne,” says Dr Michael K Molton MBBS FCPCA (Dip Cosm & Derm Laser) and President of Cosmetic Physicians College of Australasia.

What does hormonal acne look like?

Hormonal acne is usually inflamed and painful with cysts forming below the skin’s surface, but it can also show as blackheads, whiteheads and smaller pimples. “For more advanced cases, cysts can form deep under the skin and don’t come to a head on the surface. These bumps are often tender to the touch,” says Isaacs.

One of the most obvious signs of hormonal acne is where it appears. The common places you’ll find hormonal pimples are on the chin and jawline (sometimes referred to as the ‘hormonal belt’). That said, hormonal acne can also appear on the neck, chest and upper back.

What causes hormonal acne?

Unsurprisingly, hormonal acne is caused by your hormones – more specifically, a hormonal imbalance between estrogen and testosterone. “Although hormones tend to level out in adulthood, they will still ebb and flow throughout the female monthly cycle, and for males throughout the day,” says Isaacs. “These fluctuations can spike oil production from time to time, causing your skin to become slightly oily at certain points during the month. This, teamed with the fact that skin cell turnover slows down as you mature, can increase your risk of blemishes. Because dead skin cells stay attached to your complexion for longer, they can easily become lodged inside a pore when the slightest amount of oil makes an appearance.”

Stress can also cause your hormone levels to become unbalanced.

Hormonal cystic acne may also be an indicator that you suffer from polycystic ovary syndrome (PCOS). “While it is common for some women to get ‘breakouts’ after ovulation, it is important to exclude the diagnosis of PCOS from that of ‘simple’ acne that is a nuisance [and] does not impact on the health of individuals,” says Dr Molton. “PCOS is thought to be related to excess amounts of androgen production in multiple tiny cysts embedded within the ovaries and this can be connected to the excess production of defective insulin as time passes. In women with PCOS, there are multiple ‘bursts’ of androgens occurring throughout the menstrual cycle at odd times, which sends the female hormones into a spin for women of reproductive age. The result is not only acne, but irregular periods and sometimes difficulty in conception.”

Is there a cure for hormonal acne?

There isn’t a miracle cure for hormonal acne, but by learning how to control your hormonal imbalances you may be able to prevent hormonal acne from recurring, or at the very least, reduce its severity.

How to treat hormonal acne

We know, what you really want to know is how to get rid of hormonal acne. And thankfully, there are a number of approaches you can take – many of which you can mix and match to find the winning formula for you.

#1 / With birth control

Oral contraceptives contain estrogen, which can help reduce sebum and androgen production. However, it’s worth noting that while birth control pills tend to keep hormonal breakouts at bay, once you go off the pill they may come back.

#2 / With acupuncture

If you’re after a natural treatment for your hormonal acne, acupuncture is a great choice. “Acupuncture has great success in helping with hormonal acne in a number of ways,” says Dr Vivian Tam (TCM), registered doctor of Chinese medicine and acupuncture and founder of Zilch Acne Formula and Cosmetic Acupuncture Melbourne. “Firstly, we can use acupuncture to treat the whole body system and encourage it to heal by reducing inflammation and removing toxin build-up, but also by encouraging circulation and free-flowing energy to help with balancing hormones. Acupuncture can also be used in the face (cosmetic acupuncture) – specifically targeting problem areas/breakouts – to help reduce inflammation and redness, and encourage healing.” After about five to six sessions your body should become rebalance, so ongoing treatments are unlikely to be necessary.

#3 / With a hormonal acne treatment

There are numerous skin care products you can use to treat the visible signs of hormonal acne (such as at-home chemical peels), but one of the best products is a retinol treatment. “Retinoids (vitamin A) are great at minimising the formation of blemishes; essentially they reduce the blockage of pores and prevent blackheads from forming, helping to promote a clearer complexion,” says Isaacs. “Look out for retinaldehyde (present in Medik8 Crystal Retinal 6 and 10) as it’s the only directly antibacterial vitamin A, perfect for blemish-prone skin types.”

#4 / With supplements

One breakthrough supplement that can help rebalance hormones, thus reducing the recurrence of hormonal acne, is Zilch Acne Formula. “Zilch helps with acne by reducing inflammation and toxins in the body, but also by increasing blood circulation to break up blockages and promote healing,” says Dr Tam. Just note that Zilch cannot be taken during pregnancy.

Another option is a probiotic supplement, which can help increase the good bacteria in your body and improve gut health – read a first-hand review of how The Beauty Chef Glow Inner Beauty Powder helped heal a stubborn case of hormonal acne.

#5 / With a healthy diet

What goes into your body affects how your skin looks on the outside, so improving your diet can help ease the appearance of hormonal acne. High-sugar diets can feed bacteria in the body, so cut down on sweet treats and processed foods. Instead, fill your diet with leafy green veggies, nuts and salmon, which are all top foods for helping regulate your natural hormonal cycle.

#6 / With non-invasive laser therapy

If you’re struggling to see results from over-the-counter acne products and even dermatologist or doctor-prescribed medication, then Dr Molton recommends trying laser. “I have had patients, male and female, where no treatments have worked, including Roaccutane, a special drug for severe acne. I have treated those patients, provided they are off the medicines, with Fraxel re:store laser, or similar non-ablative laser device, with considerable success. Often just one or two treatments can do the trick. Some have not had further outbreaks, especially in the younger set.”