What You Need to Know About Hormonal Acne
When you hear the term “hormonal acne,” you probably think of those deep, red, painful pimples that plagued you as a teenager. But for many, those breakouts aren’t just a distant memory because hormonal acne can still show up much later in life.
Hormonal acne is most common in women between the ages of 20 and 40. You might think you’re in the clear once you hit your 40s, but that’s not always the case. You can even experience angry breakouts around menopause due to the fluctuating hormones in your body.
So, if you’re dealing with adult acne, how can you tell if those sudden chin breakouts are hormonal or just your typical patch of pimples?
What is hormonal acne, anyway?
First, it’s important to understand the difference between hormonal acne and ordinary pimples. Hormonal acne normally involves “cyclical breakouts” that usually coincide with a woman’s menstrual cycle. It can also match up with other hormonal shifts in your life, meaning your menopausal acne or postpartum pimples could be hormonal.
An important note: Hormonal Acne is technically not a medical term. However, when a person tends to get very specific types of breakouts around the time of their period or when their body is experiencing vast hormonal shifts for other reasons (such as conditions like PCOS), doctors generally describe it as hormonal acne.
What causes hormonal acne?
The hormones that cause this type of acne are fluctuations of estrogen and progesterone, which both vary widely throughout the menstrual cycle. In addition, the ratio of each of these hormones to each other can affect women’s testosterone levels, and can also contribute to hormonal acne. Cortisol, the stress hormone, can affect all of these hormones too.
Hormonal fluctuations, which can be menstrual or cyclical (or both) in women, can cause increased oil production in the pore. This is how skin-care experts believe hormonal acne starts, although the actual cause is yet to be determined.
How do you know if acne is hormonal?
Here are a few signs that your pimples are related to hormones:
· You’re not a teenager.
Acne flare-ups are possible at any time, and hormonal acne is the type that’s most likely to attack in your 20-something years, since those are the years when women tend to be most hormonally active, and often the peak childbearing age. This makes women more prone to the intense hormonal fluctuations of pregnancy, childbirth, and breastfeeding.
But age alone won’t determine whether or not you’ll break out. Genetics can dictate when hormonal breakouts start and stop.
· Your acne appears around your jawline and chin.
One of the tell-tale signs of a hormonal breakout is its location on the face. If you’re noticing inflamed cystic acne on your chin or jawline area, it’s probably hormonal acne. We don’t know exactly why this beard of acne is so common, especially in women, but it likely comes down to too much oil production clogging up your pores.
This is because these excess hormones in your body stimulate the oil glands—many of which are around your chin area. These excess oil glands make your skin a prime spot for these types of breakouts.
Though the chin and jawline are extremely common places for hormonal acne, it may also pop up along the side of your face or down your neck. If you also develop acne on your back, chest, and shoulders, especially around your menstrual cycle, these too could point to hormonal acne.
· Your breakouts happen around the same time each month.
Hormonal acne often occurs in a cyclical pattern, much like women’s menstrual cycles. This is true even in postmenopausal women, because these women still experience monthly fluctuations in their estrogen and progesterone levels.
Hormonal breakouts tend to pop up in the same place each month as well. This is usually the result of a particular pore being enlarged in size by a previous pimple. However, it could be that the actual pore opening happens to trap oil naturally.
· You’re extremely stressed out.
Cortisol, the stress hormone, can affect all your other hormones, too, causing them to be all out of whack. Women who are prone to monthly hormonal fluctuations, which are quite steep, and have periods of acute stress, are setting up a ‘perfect storm’ for themselves to get a hormonal acne flare.
· You have deep, painful cysts instead of just blackheads and whiteheads.
Blackheads (surface-level brownish spots that typically yield gunk) and whiteheads (tiny white dots of bacteria stuck in your pores) are not in the same category as hormonal acne, which can come in the form of painful cysts. These painful cysts are deeper bumps that are under the skin’s surface and cannot be extracted with normal manual extraction. They are usually tender to the touch because they’ve accumulated oil over a period of days or weeks that then causes an inflammatory reaction.
They tend to pop up in the same place over and over again, becoming subacute or chronic. Because they have an inflammatory component, they require a more clinical approach to treatment that starts from the inside out rather than treating them topically alone.
Does hormonal acne go away?
If you have hormonal acne, you’re not doomed to live with it forever. All forms of acne, including hormonal acne, can improve over time as your body adjusts to hormonal or physiological changes. However, in many cases, it’s a chronic problem that will be tough to get rid of without personalized treatment.
What gets rid of hormonal acne?
Before you get depressed about hormonal acne, remember that it’s pesky, but perfectly normal. So normal, that there are many methods to help treat it.
Most people with hormonal acne have tried over-the-counter treatments to no avail. If they aren’t working for you, you may need to seek the help of a doctor, who can offer prescription hormonal acne treatments. In general, it’s a good idea to see your doctor if you have deep or cystic pimples, because they could be a marker of something more serious, such as a thyroid condition or abnormal hormone levels.
If you’re considering “natural” treatments for hormonal acne, like using certain essential oils or other home remedies, be cautious – they can sometimes make the situation worse. I recommend discussing one of the hormonal acne medications or treatments listed below with your doctor instead:
Topical retinoids
In acne patients of any age, topical retinoids are often the first step for treatment of mild to moderate acne, especially when it’s hormonal. Retinoids help your skin shed dead skin cells at a more normal rate so the dead skin cells don’t bind together and clog your pores. They are the preferred avenue for long-term treatment because of the limited severe side effects and are known for preventing new acne in the long term.
While you can get retinol-containing products over the counter, your doctor can prescribe you much higher concentrations, which is likely the level of strength you’ll need to get rid of hormonal acne.
An important note: Retinoids, especially prescription ones, can be super harsh on your skin when you first start them. So make sure to follow your doctor’s instructions carefully. And if you have particularly sensitive skin or a skin condition like rosacea, retinoids may be too harsh for you to handle, possibly resulting in even more breakouts. You should also avoid retinoids if you’re pregnant. Your best bet is talking to your doctor before jumping in.
Over-the-counter cleansers
Hormonal acne treatment includes good over-the-counter cleansers. When choosing yours, look for alpha or beta hydroxy acids, such as glycolic, lactic, or salicylic acids. As you wash your face, each of these ingredients helps exfoliate the skin by unclogging pores to varying degrees of intensity. Finding the right kind that works for you might take some careful experimentation.
Birth control
If you’ve ever been on birth control, and then stopped it, you probably noticed your skin go into total panic mode. This type of reaction is totally normal, as oral contraceptives are a form of hormonal therapy that can do a great job of clearing acne in women.
In fact, some may be recommended for the treatment of hormonal acne. These oral contraceptives are typically composed of synthetic forms of estrogen and progesterone, which work together to alter levels and activity of hormones that can trigger acne. If you’re not on the Pill, you might want to ask your doctor if they recommend it to help stabilize your hormones and treat hormonal acne.
Bottom line: You don’t have to live with Hormonal Acne.
There are also oral therapies such as antiandrogen drugs and Vitamin A, which your doctor can prescribe for you.
Hormonal acne can be painful, affect your self-esteem, and even become pricey to manage - but you don’t need to just put up with it. Don’t give up on working with your doctor to find a solution, which may require a combination of over-the-counter and prescription treatments.