Facial acne or acne in general is one of the worst things that haunts most of us as early teens or adolescents. For many individuals, acne can show up in their adulthood. Acne that occurs after the age of 25, up until 45, is called adult acne. Another name for adult acne is hormonal acne. 

Learning about acne can help us manage and prevent it better. So, let’s dive in! 

What is hormonal acne? 

Acne is a condition where hair follicles are clogged with excess oil called sebum, produced by sebaceous glands. Hormonal acne is caused by an imbalance or fluctuations in hormones that result in the overproduction of oils that clog the pores of the skin.  

Some hormones that are responsible for hormonal acne are Androgens and Testosterone. Falling Estrogen levels can also make you prone to acne. 

How do you know if your acne is caused by a hormonal imbalance? 

Acne during early adolescence usually manifests as a breakout in the T-zone which comprises the forehead, nose, and chin.  

Adult hormonal acne usually erupts in areas that are considered ‘hormone-sensitive.’ The lower third part of your face or the jaw, chin, and lower cheeks are sites of hormonal acne.  

Hormonal acne includes blackheads, whiteheads, cysts, and papules. These can often feel sore to the touch or redden due to inflammation. 

What triggers hormonal acne? 

Hormonal acne occurs when there is a hormone imbalance within the body. Hormonal imbalances may be triggered by various conditions.  

They are:

• Menstruation 
• Menopause 
• PCOS 
• Pregnancy  

Menstruation

It is highly common to see a pimple break out right before or during your period. This happens because there is a sharp drop in estrogen and progesterone levels, but testosterone levels remain the same. These hormonal fluctuations trigger excessive production of sebum which clogs the pore, causing acne. 

Acne before menstruation is the last thing we need, but the good part is, that it goes away as your period progresses. So, chill out! 

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Menopause 

When you approach menopause, you may experience acne breakout due to the same reasons that plagued you during puberty and menstruation —hormonal fluctuations! 

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PCOS 

PCOS is a common and chronic, hormonal disorder seen in people of reproductive age group. Most times it is diagnosed when women get checked for difficulty conceiving or irregular periods. Hormonal acne that comes along with PCOS is common but slightly different.  

Acne caused by PCOS in the hormone-sensitive zone can feel more tender and inward rather than bumpy. Sometimes persistent acne, along with other symptoms, can prompt doctors to check for PCOS. 

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Pregnancy

During the first trimester of pregnancy, acne might be common due to –yes, you know it– hormonal fluctuations. While it is hard to say who will develop acne during pregnancy, having a history of acne breakouts makes you more vulnerable.  

But let’s skip to the good part, which is if you haven’t developed acne in the first trimester, it is unlikely you will develop acne as the pregnancy progresses. 

It’s always wise to know what not to do when you have or are highly prone to acne so you don’t empower the enemy(acne)! 

What can make hormonal acne worse? 

• Stress/depression: We all try to avoid it but experiencing some level of stress is inevitable. However, excess stress can throw hormones off-kilter and worsen your acne. The hormone released under stress called cortisol can ramp up the oil production leading to clogged pores.  

• Pollution: Harmful particles present in polluted air can contribute to a lot of skin problems. These particles directly contribute to making skin unclean and also break down and enter layers of the skin acting as an irritant. This clogging can deplete the skin of hydration and moisture, prompting oil glands to produce more oils. Now we have one more reason to curb pollution.  

• Picking at those pimples: Pimples are indeed annoying and how much ever you feel the urge to treat your skin like it is bubble wrap –please don’t!  Squeezing and popping can make way for bacteria to reach deeper into your skin and even leave you with scars and lead to pus formation. 

• Sugar: Yes, a tub of ice cream on your period soothes like nothing else, but having a sugar diet leads to a spike in insulin. To manage the excess insulin, your body produces more androgens that increase oil production. Insulin resistance is also a huge symptom seen in people with PCOS. Too much insulin in the blood deteriorates the quality of your skin. 

Treatment for acne caused by hormonal issues:  

Depending on the severity of the breakout, various drugs may be prescribed by your dermatologist, they are:  

• Birth Control pills: These are recommended as they act as hormone therapy for acne treatment. They contain both estrogen and progesterone that reduce the level of androgens produced in the body, thereby reducing oil production by sebaceous glands. Birth control pills for acne may not be advisable if you have a history of blood clots. Studies suggest that prolonged use of birth control may increase the risk of breast and cervical cancer. 

• Anti-Androgens: These drugs are used to counteract the effect of excess male hormones such as testosterone. Anti-androgens work by limiting androgen production, inhibiting androgen receptors, and reducing insulin resistance. Some common side effects of anti-androgens include breast tenderness, headaches, nausea, fatigue, dizziness, and irregular menstrual bleeding. 

• Topical Retinoids: A retinoid is a form of vitamin A that has been shown to treat severe acne. Retinoids act as exfoliators that unclog pores and help other anti-acne medications work better or reduce the effect of acne-causing bacteria.  Side effects of retinoids include warm sensation, redness, irritation, and burning on areas of application. It can also flare acne but usually subsides soon.  

• Exercise, Diet & Healthy Habits:  Having an active lifestyle, diet, and adequate sleep can also help balance hormones which in turn may help prevent the causes of acne. 

Drinking plenty of water and keeping your body hydrated also play a major role in preventing acne.  

Some other things you can do to manage your acne: 

• Manage stress/depression 
• Wash your face regularly with a light face wash 
• Maintain a healthy diet 
• Get enough sleep 
• Wear sunscreen 
• Use gentle skin products that do not increase oil production 
• Stay hydrated 

Acne can be more than just minor discomfort but it can have a profoundly negative impact on your self-esteem.  The relief is facial acne is still manageable.  

And if you already have many acne scars, it is absolutely beautiful to carry them with confidence. You are so much more than your looks. 

Nothing beats your inner glow when you choose self-love! 

Do you suffer from PCOS acne and related problem? Stop worrying as we are here to help you! 

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