Hormonal Acne and How to Deal With It

As we go through various life stages, it is natural that our bodies will undergo several shifts in hormone levels. These hormonal changes in our body then in turn have an effect on our face. For some individuals, it can manifest in the form of acne. While this is a complex issue, we are lucky to have access to more scientific knowledge about this condition. With a better understanding of its root causes, we have been able to develop new, advanced solutions.

Thankfully, there are also better ways to curb this issue through lifestyle changes, updates to your skincare routine and even with the help of professional aestheticians. Adopting such a multi-pronged approach can help you control the extent of your hormonal breakouts. Read on to find out more about how you can rise above your skincare issues.


Understanding the Complex World of Hormones

Our hormones can actually affect many of our body functions, thus, it is important to know what each hormone actually does. From there, we can uncover the best possible methods to cope with the changes and enact the positive change to our health.

1. Testosterone

While testosterone is widely recognised as a predominantly male hormone, women have been found to produce small amounts of it from the adrenal gland and the ovaries. What is the purpose of testosterone? It actually stimulates the sebaceous glands and produces sebum (natural oil) in both genders. This would have an effect on the development of adult skin during puberty — girls would be more likely to develop pimples earlier than boys since they experience puberty earlier.

2. Oestrogen

The counterpart of testosterone, oestrogen is the vital female hormone responsible for transforming girls into women. As far as the skin is concerned, oestrogen is considered by medical experts to be the fountain of youth — this hormone allows for denser skin and normalises its moisture as well as pigmentation levels. Therefore, when oestrogen levels are at optimum levels, the effects of ageing like wrinkles and age spots are often delayed. Unfortunately, oestrogen levels in women do not always stay at the same level all the time. They typically peak the highest shortly after puberty and begin their decline when you enter your mid-20s.

3. Progestogen

Progestogen is the other female sex hormone and functions as the main hormonal support during pregnancy. This hormone helps regular menstrual cycle in the second part of the cycle after ovulation. If no egg is fertilised, the progesterone and oestrogen levels would rapidly decrease causing the endometrium (the lining of the womb) to break down and result in what is commonly known as menstruation. It has been widely recognised that premenstrual syndrome (PMS) is caused by high levels of progesterone and it is the imbalance between oestrogen and progesterone levels during the end of the menstrual cycle that causes your sebaceous glands to become overactive and lead to your monthly breakouts.


How to Determine if You Have Hormonal Acne?

From its name, it would be easy to decipher that hormonal acne would inherently be related to your hormones. As mentioned previously, it is the sporadic fluctuation of one’s progesterone and oestrogen levels (especially during that time of the month) that would be responsible. In addition, the varying ratio between both hormones can actually influence testosterone production in women and that could lead to increased oil production in the pores and bring about hormonal acne.

According to dermatologists, there are a number of tell-tale signs pointing towards breakouts caused by hormones. These include:

1. Pimples Around Your Lower Face Area

One indicative marker for hormonal acne lies in its location. If the red dots seem to gravitate towards the lower area of your face, the probability that it is hormonal acne would be high. Excess hormones in the body typically trigger the oil glands that are found around the chin and jaw. But don’t be surprised if you notice these tender red bumps occasionally running down your neck or finding its way along the sides of your face; those do happen!

2. Being Past Your Teenaged Years

Flare-ups and breakouts can occur at any given point of time and hormonal acne is likely to strike those between 20 and 40 years of age.  This is often the period where women are most hormonally active with those in their 20s in their peak when childbearing age is concerned; making them prone to the hormonal fluctuations of lactation, childbirth and pregnancy. Women beyond the age of 40 are not spared either — studies have revealed that menopause has the tendency to trigger a resurgence of breakouts during the later years.

3. Suffering from Painful Cysts

Hormonal acne can come in the form of painful cysts, which are in an entirely different category than your regular whiteheads (pint-sized white flecks of bacteria trapped in your pores) and blackheads (dark brown spots containing pus). These agonising cysts have a habit of popping up at the same exact spot repeatedly and require a clinical method of treatment to tackle the problem from the inside out instead of the use of topical remedies.

4. Experiencing Regular Breakouts

Another trait of hormonal acne is that it often parades in a regular cyclic pattern similar to a woman’s monthly menstrual cycle. This can even affect women who are already in their postmenopausal period as they still undergo varied fluctuations in their progesterone and oestrogen levels from month to month. Additionally, these hormonal breakouts tend to exhibit themselves at around the same facial spot every month. Dermatologists claim that this is mostly due to a pre-existing pimple that causes a particular pore to increase in size.

5. Being Overly Stressed

The skin performs its many assigned functions quietly in normal time. But when disruptions occur (such as a lack of sleep), your body functions differently and the hormone that is produced will instead wreak havoc on the skin. New research suggests that sebaceous glands can act as their own independent endocrine organs. This means that your brain can directly stimulate sebaceous activity by the release of the corticotropin-releasing hormone during stressful periods.


What are the Common Treatments For Hormonal Shifts?

You might be surprised to find oral treatments as one of the most popular treatments for adult acne since it targets the underlying cause that is hormonal shifts. If you find that your monthly breakouts are following a pattern linked to your menstrual cycle and your pimples are showing up around your jawline, neck, chest or back, you might be a suitable candidate for hormonal acne treatment. But with that said, considering how treatments for hormonal problems affect your entire body, you will need a visit to your regular healthcare practitioner to ascertain if this is the best treatment for you.

Treatments for hormonal shifts are effective on its own but to combat the other unwelcome companions of adult acne, like wrinkles and brown spots, the combination of oral medication with topical medical creams has been found to be more effective for some. These are some of the common treatments for hormonal shifts that are commonly prescribed:

1. Oral Contraceptives

Oral contraceptives work by suppressing sebum-triggering androgen production in the ovaries, raising protein (serum hormone-binding globulin or SHBG) in the blood that picks up excess circulating androgen and reducing its production by the adrenal glands.

2. Anti-Androgens

Another approach is to block the androgen receptors on the sebaceous glands. Anti-androgens can reduce the local conversion of androgen to the active dihydrotestosterone, reducing sebum production. They can also inhibit androgen synthesis by the ovaries and increase the level of a particular protein that binds androgens in the bloodstream.

3. Hormone Replacement Therapy

Hormone replacement therapy (HRT) is the common treatment used to relieve symptoms of the menopause. It replaces hormones that are at a lower level as you approach the menopause. The therapy is usually used to suppress severe acne flares linked to the hormonal fluctuations of perimenopause and menopause. However, if your HRT includes testosterone, you may find that you are breaking out more than you ever did before.


Oral Antibiotic Therapy in Detail

If you had experienced moderate to severe acne as an adolescent, chances are you would have been advised by doctors to be placed on long-term oral antibiotic therapy. What that does is to control the P. acnes bacteria, however, they have been discovered to carry a greater risk of systemic side effects than topical antibiotics do. To add to that, the bacteria might grow resistant to the medication over time.

At present, most doctors would prescribe oral antibiotic therapy for those with acne on a short-term basis and for it to be combined with topical treatments. The idea is for the patient to consume the antibiotics over a period of time to get rid of the bacteria, but not long enough for the bugs to develop resistance against it. This is also usually paired with a comprehensive skin care programme. It is important to make the distinction that not all oral antibiotics are suited to combat acne. The medication has to have the ability to penetrate the oil-clogged follicles that certain medication like penicillin wouldn’t be able to. To make it simpler, oral antibiotics for acne treatments typically come from two families, tetracyclines and macrolides. In the following section, we will go into detail about the two different types.

1. Tetracyclines

Tetracyclines are the most commonly prescribed oral antibiotic for acne therapy because they are effective and relatively cheap. To take them, patients are typically advised to consume them on an empty stomach four times a day. Doxycycline, a newer kind of tetracycline, is one of the few that can be taken once a day with meals. A low dosage-formulation of doxycycline has been found to be effective in combating inflammation from acne. When administered in a lower dosage, the chances of potential side effects and antimicrobial resistance would be much lower.

2. Macrolides

For those who are allergic to tetracycline, macrolides have shown to be a reasonable oral alternative to treat acne. Oral antibiotics under the macrolide family can be found under many brand names like azithromycin. While they may not be as active against the P. acne bacteria as compared to the previous option, it works as the next best option for short-term oral antibiotic therapy.


4 Types of Acne Treatments You Should Consider

It is understandable that some individuals might prefer not to pad their tummies with medications and man-made chemicals for fear of disrupting their well-oiled system with the potential side-effects. With the many advances over the past decade or so, dermatologists have taken technology under the wing and have started to offer a wide range of medical remedies to help troubled individuals with their acne issues. As a whole, most of them are non-invasive and do not inflict damage onto the skin, making them an extremely viable treatment option towards clear and beautiful skin. For those hoping to leave behind their acne-ridden past behind, here are some treatments for consideration.

1. Microdermabrasion

Microdermabrasion has been recognised as one of the common techniques to treat these skin concerns. This mildly-invasive procedure removes the outermost layer of dry, dead skin cells. Through the intense exfoliation, it opens up the pores and prevents them from being congested by the build-up of dead cells over time. This would then allow any topical acne medication to penetrate to the deeper layers and solve many of your skin-related concerns. Particularly suitable for adults, the microdermabrasion procedure reduces signs of UV damage like brown spots (lentigines), fine lines and even any bumpy, uneven texture.

2. Handheld Thermal Devices

It might seem dangerous and even slightly nefarious but treatment using handheld thermal devices has been approved by the FDA for the safe handling of mild to moderate acne. These handheld thermal devices often work by delivering a precise and controlled dosage of heat to a pimple via a metal pad. This would then bring about a heat-shock response to the microorganisms that give rise to acne and force the bacteria to self-eliminate. Typically, the pimple can die away in a matter of hours with a suggested two to three sessions that is fairly drawn out over a 24-hour period. The drawback is that the procedure is mostly used as a spot treatment for existing pimples and would not help in the prevention of new ones.

3. Light-Emitting Diode Treatments

Light-emitting diodes have proved to be effective in the remedy of mild to moderate acne. From the implementation, the blue light would destroy the bacteria and address any inflammation issues. Its advantage is in its nonthermal and non-ablative characteristics and this would mean that the treatment is less invasive and would also require much lesser downtime. Following a few sessions, your existing breakouts would improve and any formation of new pimples would be reduced. On certain machines updated with the latest technology, your skin would appreciate the additional collagen-formation benefits.

4. Sonic Skin Cleansing (Ultrasound)

The sonic skin cleansing treatment may run under many names like the Ultrasonic, but that doesn’t mean that it is any less popular — the ultrasound is one of the most consistent and dependable treatments when it comes to solving your skin issue through its gentle and effective deep-cleansing formula. They typically rely on an oscillating brush to loosen any dirt and oil from the surface, stimulate the skin and clear the pores with a micro-massage action. For those with sensitive skin, this device is clear for use since it cleanses without irritation and can be used on a variety of skin types. Because of its effectiveness and safety, many established aesthetic centres like Geo Aesthetics offer the sonic skin cleansing procedure to their clients.


The Takeaway

It is important — though sometimes hard — to keep your acne issues in perspective. At some point in time, it is only normal for us to start observing a few spots or two peeking out from beneath. However, if they refuse to leave or start appearing at a higher frequency, it would be highly advised to make an appointment with a dedicated skincare specialist. While it might not seem like much help, these specialists are in a better position to identify what type of acne you are encountering and can administer the treatment for you with minimal fuss. From there, you can keep up your usual skincare routine and maintain your dazzling new complexion.