What are the best treatments for hormonal acne?

Understanding Hormonal Acne in Women

One of the most frustrating symptoms of hormonal imbalance for women is adult acne. A study in the Journal of the American Academy of Dermatology revealed that acne affects 50% of women in their twenties, 35% in their thirties, and 26% in their forties. It’s important to remember that acne is not a reflection of hygiene or cleanliness, nor is it contagious.

Below, we’ll cover some common causes of hormonal imbalance and ways to manage hormonal acne.

Hormonal Imbalance and Acne

Hormonal acne is triggered by fluctuations in hormone levels, typically appearing on the lower face, jawline, chin, and lower cheeks. The main culprit is an increase in androgens, which stimulates excess sebum production. This sebum can clog pores and cause acne breakouts. Many women notice that breakouts worsen around their menstrual cycle or during menopause when estrogen levels drop. While hormonal fluctuations are normal, some women are more sensitive to these changes, leading to acne.

Common Causes of Hormonal Imbalance in Women

Several factors contribute to hormonal imbalances, in addition to natural hormonal changes during puberty, pregnancy, menstruation, and menopause. Here are some common contributors:

• Stress: Chronic stress prompts the adrenal glands to produce cortisol and adrenaline (stress hormones). Elevated cortisol can lower progesterone levels by blocking progesterone receptors, leading to hormone imbalance.

• Poor Sleep: Sleep regulates melatonin production, which helps manage cortisol levels. Insufficient sleep disrupts this process, potentially raising cortisol and increasing the risk of hormonal imbalance.

• Diet: Diets high in sugar, refined carbs, and processed foods can disrupt hormones, while nutrient-dense, balanced diets support hormonal health and overall well-being.

• Endocrine Disruptors: Chemicals in some cosmetics, plastics, pesticides, and foods can interfere with hormone function, causing imbalances. Although more research is needed, reducing exposure to these chemicals may be beneficial.

• Thyroid Disorders: Hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) directly impact hormone production and regulation.

• Polycystic Ovary Syndrome (PCOS): This condition causes an overproduction of male hormones, which can lead to acne and other symptoms of hormonal imbalance.

Treatments for Hormonal Acne

Several treatments, both over-the-counter and prescription, can help manage hormonal acne. Here are some effective options:

• Oral Contraceptives (Birth Control Pills): Certain birth control pills containing ethinyl estradiol (a type of estrogen) can help balance androgens and reduce acne. If you’re already using birth control, your doctor may help you find a formula that specifically targets acne.

• DIM Supplements: DIM (Diindolylmethane) is derived from cruciferous vegetables like kale, broccoli, and spinach. This supplement supports hormone balance and may reduce hormonal acne symptoms. DIM supplements are particularly beneficial for women with adult or hormonal acne.

• Topical Retinoids: Retinoids, vitamin A derivatives, are popular for treating mild to moderate acne. By promoting cell turnover, retinoids help clear dead skin cells from pores. Over-the-counter retinol products are available, but a dermatologist may prescribe a higher-strength retinoid if needed. Retinol combined with niacinamide (0.25% or 0.5%) is especially beneficial for adult acne.

• Anti-Androgen Medications: Spironolactone is a commonly prescribed anti-androgen drug for women with hormonal acne. Although primarily a blood pressure medication, it effectively reduces androgen production, helping control acne.

• Isotretinoin: For severe cases, dermatologists may prescribe isotretinoin (formerly branded as Accutane). This powerful vitamin A derivative decreases oil production by the sebaceous glands. Treatment typically lasts 4-6 months and requires careful monitoring due to potential side effects, including significant skin dryness.

Additional Symptoms of Hormonal Imbalance

Acne isn’t the only symptom of hormonal imbalance. This imbalance can manifest differently in each individual. In addition to acne, women with hormonal imbalances may experience:

• Mood Changes: Anxiety, depression, irritability
• Sleep Disruptions: Insomnia or fatigue
• Menstrual Irregularities: Painful, irregular, or heavy periods
• Physical Symptoms: Weight gain, headaches, migraines, ovarian cysts, and thinning hair

If you suspect you have a hormonal imbalance, consider discussing testing and treatment options with a healthcare provider. Understanding and addressing hormonal acne can lead to clearer skin and improved overall well-being.

DIM supplements for women with adult or hormonal acne.
Retinol treatment system for women with adult acne.

References:

Stress and Hormones

Acne Severity and Sleep Quality in Adults

Emerging Issues in Adult Female Acne

To find the right acne treatments for your unique skin, take the free skin assessment by clicking here.