Hormonal Acne: What is It and How to Get Rid of It?

Acne is something we all are familiar with. It is that annoying skin condition that knows no age. It can affect all, newborns as neonatal acne, teenagers as acne vulgaris, and adults as hormonal and fungal acne.

Yes, you heard it right, acne can affect adults too, and some may even experience it for the first time in adulthood. In this blog, we discover the causes of the most common type of acne, hormonal acne in adults, and how to effectively manage it.

What is Hormonal Acne?

Hormonal acne as the name suggests is linked to the hormones in our body. These hormone-fueled zits can appear anywhere on the body but are more common on the face. They usually appear as whiteheads, blackheads, and cysts.

Hormonal acne is caused when there is a change in hormones especially in androgens. This hormonal imbalance can lead to overproduction of sebum by sebaceous glands. This excess sebum mixes up with the dead skin cells and clogs the pores, which causes small bumps on skin a.k.a. acne. 

Hormonal acne is not an official medical term. However, when a person experiences acne due to changes in hormones it is said to be hormonal acne.

What Causes Hormonal Acne?

Hormonal acne is believed to be caused by a change in hormones. Androgens or testosterone is considered the most common culprit for hormonal acne. These hormones are naturally present in the sebaceous glands and can trigger sebum production.

Some other common hormones that can trigger hormonal acne are:

• Estrogen
• Corticotropin-releasing hormone (CRH)
• Progesterone
• Growth hormone (GH)
• Insulin-like growth factor-1 (IGF-1)
• Adrenocorticotropic hormone (ACTH)

The change in the hormones can trigger the sebaceous glands to start producing more sebum. The excess sebum present on the skin in turn allows for a bacteria that is part of the skin flora, C acnes, to flourish which creates inflammation. There is importantly an interaction with the previously described bacteria and inflammatory molecules and dead skin cells in the base of the hair follicle, called a microcomedo, and this leads to what we see with the naked eye…pimples.

Pimples are technically called open comedones and closed comedones. Closed comedones can be further distinguished as papules, pustules, and acne cysts or acne nodules. Hormonal acne is more common in women than it is in men. The reason for that is the hormonal changes that women experience during

• Pregnancy
• Menstruation (Period acne) 
• Menopause (menopause acne)
• After discontinuation of birth control pills

What Does Hormonal Acne Look Like?

Hormonal acne looks similar to the acne you experienced during your teenage years. However, adult acne has a different acne face map than that of puberty. During puberty, hormonal acne usually appears on the T-zone of the face, forehead, nose, and chin. Adult acne appears on the bottom of the cheeks and around the jawline. 

Hormonal acne can appear on other parts of the body and is more common on:

• Face
• Neck
• Chest
• Back
• Shoulders 

Hormonal acne can cause 

• Inflammation
• Redness
• Painful cysts
• Whiteheads (closed comedones)
• Blackheads (open comedones)
• Papules (raised bump or skin tissue)
• Pustules (pus-filled lesion)
• Nodules (firm lump inside the skin)

How to Treat Hormonal Acne?

Mild acne can be easily managed at home by following a proper skincare routine. This can help you reduce the symptoms and prevent future breakouts. The best skincare for acne includes the following steps:

• Keep the skin clean with a gentle cleanser twice daily. Once in the morning and once before going to bed.
• Protect your skin from direct sunlight with the help of sunscreen.
• Make sure the skincare products you use on your skin are free from fragrance, parabens, and sulfates.
• Use a mild face wash instead of harsh soaps to clean your face.
• Use lukewarm or cool water to wash your face.
• Avoid popping or picking the pimples, it can cause scarring.
• Exfoliate the skin gently 2 to 3 times a week. But avoid using harsh scrubs.
• Choose the makeup you are using on your face wisely. Use water-based or non-comedogenic makeup.

In severe cases of acne, it is better to visit a dermatologist who may prescribe OTC acne products and prescription topical and oral medications to treat the symptoms. These medications may include:

OTC Products

OTC products that contain the following ingredients can help reduce and soothe hormonal acne symptoms:

• Benzoyl peroxide
• Salicylic acid
• Alpha hydroxy acids
• Glycolic acid
• Beta hydroxy acids

Topical Retinoids

Topical retinoids help remove the dead skin cells from the skin. With the help of retinoids, the dead cells don’t stick together and clog the pores. This medication causes limited side effects and can help prevent future acne breakouts.

Triamcinolone

Hormonal cystic acne can cause cysts inside the skin which is why they can be very painful. These can be treated with the help of triamcinolone. These are corticosteroid injections that are injected into the lesions to reduce scarring.

Antiandrogen

A change in hormones or an increase in androgen hormones can cause adult acne. If this is the cause for your hormonal acne the dermatologist may prescribe antiandrogen medications. These medications block the androgen receptors that reduce the impact of testosterone on the body.

Isotretinoin

It is an oral acne medication that helps reduce the amount of sebum released by sebaceous glands. When the skin starts producing an adequate amount of sebum the chances of future breakouts are reduced and relieves the existing symptoms.

Hormonal Therapy

Hormonal therapy is advised for women. It includes the use of contraceptive pills to reduce acne. Contraceptive pills that contain FDA-approved ethinyl estradiol can help clear out acne and breakouts in women. 

The medications mentioned above should only be used if prescribed by the dermatologist. Never use them on your own.

Hormonal Acne Diet

During your teenage years, you may have come across that your acne is caused by the junk food (High-Glycemic Foods) you eat. This is somewhat true there are certain foods when consumed too much can lead to increased inflammation and trigger acne such as 

• Sugar
• Red meat
• Refined carbs
• Dairy products
• Alcohol 

While there are some foods that can help reduce inflammation like

• Omega-3 fatty acids
• Vitamin E
• Antioxidants
• Zinc

Fungal Acne Vs Hormonal Acne

Fungal acne and hormonal acne are very difficult to tell apart. They look quite similar and sometimes need a dermatologist to diagnose which acne you are experiencing. However, there are a few prominent differences that can help you identify which type of acne you have.

The main difference between fungal and hormonal acne is its cause. Hormonal acne is caused due to a change in hormones. Fungal acne is caused by the reaction of the skin towards a fungus present on the skin known as Malassezia yeast. 

Hormonal adult acne usually appears on the lower cheeks, chin, and jawline and fungal acne is more common on the forehead and hairline. The pimples caused by hormonal acne can be different in shapes and sizes but the pimples caused by fungal acne are very small and look similar to one another.

In the case of fungal acne, many people have found benefits in using a pyrithione zinc medicated anti-dandruff shampoo for seborrheic dermatitis as this active ingredient has anti-fungal properties. 

When to Consult a Doctor

If you are experiencing severe acne then you should immediately consult the doctor. It is best to consult a dermatologist as they specialize in skin conditions and issues. If you are experiencing any of the following it is advised to visit a dermatologist.

• Acne is getting worse
• Painful lesions
• Any signs of infection
• OTC cleansers are not making your acne better
• Risk of scarring

If you are unsure about whether you are experiencing fungal acne or hormonal acne, see a dermatologist. They will be able to diagnose your condition and provide you with accurate treatment. 

Conclusion

Hormonal acne is caused when there is a change of hormones in the body. Certain hormones like androgen are the main reason behind hormonal acne. Acne can be experienced by anyone however hormonal acne is more common in adults. 

Adult acne can cause whiteheads, blackheads, pimples, and cysts on the skin. It usually appears on the jawline, lower cheeks, neck, back, shoulders, and chest. Hormonal acne can be managed by following a proper skincare routine and keeping the skin clean with a gentle acne cleanser. 

In moderate and severe acne cases, it is best to consult a dermatologist who may prescribe the use of OTC medications, topical retinoids, antiandrogen, and isotretinoin.

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Dr. Eddie Valenzuela

Dr. Eddie Valenzuela is an award winning pediatrician and the founder and CEO of Pediatric Solutions, LLC.

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