How to tell if my acne is hormonal | causes and treatment
Acneic skin is a common skin condition, affecting over 85% of people in theirteens, with women more frequently affected than men. It is seen in almost 100% of individuals at some point in their lives For some, it is temporary and resolves itself by their mid-twenties; however, more severe cases often take longer to resolve, and it can persist intoadulthood in up to 50% of individuals Although it does not affect overall health, its impact on emotional well-being and functionality can be a source of frustration.
However, with a thorough understanding of this condition and a proper skincare routine, it's possible to minimize acne flare-ups and pimples and promote clear, healthy skin. In this article, we'll explore methods for recognizing hormonal acne, its causes and the most effective skincare strategies for countering this persistent dermatological problem.
What is hormonal acne?
Acne is a chronic inflammatory disease of the pilosebaceous unit, characterized by seborrhea, the formation of comedones, oily skin and a lack of elasticity. oily skinAcne is a chronic inflammatory disease of the pilosebaceous unit, characterized by seborrhea, comedo formation, oily skin, erythematous papules and pustules, less frequently nodules, deep pustules or pseudocysts, and, in some cases, scarring.
Follicular hyperkeratinization, excessive sebum production, hypercolonization of the duct by Propionibacterium acnes, direct or indirect inflammation, and recently, matrix metalloproteinases (MMPs) have been included as having a role in the pathogenesis of acne vulgaris.
Hormonal acne differs from juvenile acne in that it usually appears during puberty, and is closely linked to hormonal fluctuations, particularly female hormones.
The underlying causes of hormonal acne: deciphering hormonal factors
- Impact of sex hormones on the skin
The skin locally synthesizes significant quantities of sexhormones with intracrine or paracrine actions (intracrine regulation is characterized by the production and action of hormones within a target cell itself, while paracrine regulation involves the secretion of hormones acting locally on neighboring cells in the surrounding tissue).
The local level of each sex steroid depends on the expression of each androgen- and estrogen-synthesizing enzyme in each cell type, with the sebaceous and sweat glands being the main contributors.
- The role of androgens
Androgens are a group of male sex hormones, notably testosterone, which are responsible for the development of male sexual characteristics and play a crucial role in various physiological processes in adult men and women around the age of 40.
They affect several human skin functions, such as sebaceous gland growth and differentiation, hair growth,epidermal homeostasis and wound healing.
Their effects are mediated by binding to the nuclear androgen receptor. Changes in androgen receptor levels may have important implications in the development of hyperandrogenism and associated skin diseases such as acne, seborrhea, hirsutism and androgenetic alopecia.
In fact, these hormones stimulate the skin's sebaceous glands to produce sebum, which can then clog hair follicles, creating an environment conducive to the growth of bacteria, particularly Propionibacterium acnes. This bacterial proliferation and associatedinflammation can lead to the formation of comedones, papules and pustules characteristic of acne.
- The role of estrogen
Estrogens are a group of sex hormones, mainly secreted by the ovaries in women, which play an essential role in the development of female sexual characteristics and regulate various aspects of the reproductive system and other physiological functions.
The production of female hormones, such as estrogen, plays a key role in sebum regulation.
However, during the menstrual cycle, hormonal fluctuations can cause sebum overproduction and excess, clogging pores and leading to the appearance ofblemishes, painful red spots and blackheads. The sebaceous glands then become more active, increasing the risk of hormonal acne.
Estrogens are implicated in skin aging, pigmentation, hair growth, sebum production and skin cancer.
- Progestins
Progestins are substances, often hormones, that mimic the effects of progesterone, playing a key role in regulating the menstrual cycle, managing pregnancy, and are used in medical contexts such as hormonal contraception and hormone replacement therapy.
Clinical studies show that they play no role in the pathogenesis of skin disorders.
They do, however, play a major role in the treatment of hirsutism and acne vulgaris, where they are prescribed as components of combined estrogen-progestin pills and as anti-androgens.
Estrogen-progestin treatment can halve the need for shaving and halt the progression of hirsutism of various etiologies, but does not necessarily reverse it. They do, however, reliably reduce acne.
Care strategies: from anti-acne routines to invasive solutions
- Cosmetics and active ingredients: salicylic acid, essential oils and clay
Using anti-inflammatory ingredients such as salicylic acid in cleansers, lotions, serums or moisturizers can help control hormonal acne. These products target inflammation, unclog pores and regulate sebum production. What's more, certain essential oils, such as tea treeoil, are renowned for their antibacterial and anti-inflammatory properties, making them valuable allies in the fight against hormonal acne.
L'clay can also be useful for purifying pores and absorbing excess sebum.- Hormonal treatments: contraceptive pills
For some women, taking birth control pills can help regulate the hormonal fluctuations responsible for acne. The hormones contained in these contraceptives can balance androgen levels, reducing the severity of acne outbreaks.
- Oral care: zinc and retinoids
Zinc, known for its anti-inflammatory properties, can be taken as a dietary supplement to help controlhormonal acne. In addition, retinoids, derived from vitamin A, are often prescribed for their effectiveness in treating severe acne and reducing acne scars.
- Dermatological care: laser treatments and peels
For severe acne or scarring, dermatological treatments such as lasers and peels may be considered. These procedures aim to stimulate cell regeneration, reduce inflammation and improve skin texture.
Hormonal acne can be challenging, but with a holistic approach and a well-balanced skincare routine, it's possible to minimize flare-ups, improve healing, and restore skin confidence.
Whether through topical treatments, hormonal options, or dermatological care, there are strategies for every skin type and acne severity. The key is perseverance and consultation with dermatologists to develop a personalized treatment plan.
Sources
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Thiboutot D. Hormones and acne: pathophysiology, clinical evaluation, and therapies. Semin Cutan Med Surg. 2001 Sep;20(3):144-53. doi: 10.1053/sder.2001.28208. PMID: 11594669.
Zouboulis CC, Chen WC, Thornton MJ, Qin K, Rosenfield R. Sexual hormones in human skin. Horm Metab Res. 2007 Feb;39(2):85-95. doi: 10.1055/s-2007-961807. PMID: 17326004.