Hormonal acne in women: Causes and how to treat it

It’s one thing to have acne as a teenager.  But if you’re a woman having acne in your thirties, forties or beyond is simply unacceptable.  It’s not fair having acne breakouts at a time of your life when you figured you’d be dealing with wrinkles more so than pimples.

Acne is not just a skin problem teenagers experience. According to one study approximately 50 percent of women 20 to 29 years old and 35 percent of women 30 to 39 years old reported having acne.  Women may question if there will ever come a time when they will break up with breakouts for good?

The American Academy of Dermatology states that acne is the most common skin condition in the United States, affecting up to 50 million Americans annually.  Acne often causes significant physical and psychological problems such as permanent scarring, poor self-image, depression and anxiety. 

Women with adult acne are by far some of the most common patients dermatologists see.  There can be women with persistent acne which started in adolescence and has continued into adulthood without interruption.  Then there are women with recurrent acne that first develops in adolescence, goes away but then reoccurs in adult women usually after the age of 25.  A third group are women in their late forties who experience acne in the pre-menopausal period.  Most of these women have acne along the lower third of the face, jawline, and neck, indicating the cause is hormonal.  Their acne flares up right before their periods further backing the idea that the cause is hormonal. 

Why are hormones affecting women’s acne?

Both bacteria and inflammation are two primary reasons for acne but hormones play a significant role also.  If a woman has particularly sensitive androgen receptors, these hormones can trigger excess oil production causing skin cells to become sticky.  This leads to clogged pores and skin breakouts. 

A woman can tell if her acne is hormonally activated if she experiences breakouts along her lower face – specifically cysts along the jawline and even down the neck – and if acne flares right before or during her period.

How to treat adult acne The very first thing all women with hormonal acne should do is make an appointment with a dermatologist.  Dermatologists specialize in treating skin conditions and can prescribe various treatments that have shown to be effective.  Some of these treatments may include the following:

·      Topical treatments

Retinoids, antibiotics and anti-inflammatories, as well as salicyclic acid or benzoyl peroxide, may be used to treat hormonal acne.  Retinoids can unclog pores, allowing other medicated creams and gels to work better. They also reduce acne outbreaks by preventing dead cells from clogging pores.

·      Oral medications

One of the most common hormonally based medications use to treat acne in women is birth control pills. By regulating menstrual cycles, it can help reduce acne. However, some forms of birth control, such as hormonal IUDs like Mirena and Skyla, or an implant such as Nexplanon, which release progestin only, could make acne worse. Its best to use a combined birth control pill containing both estrogen and progestin. Birth control pills for some women, can cause breast tenderness, weight gain, nausea, mood changes, and reduced libido.

Another oral option is spironolactone, a blood pressure medication that, when used in low dosages, can help with hormonal acne as it blocks androgen hormone receptors in the skin. It may cause side effects of dizziness, breast tenderness, spotting in between periods, and frequent urination as spironolactone is a diuretic.

For very severe cases, a vitamin A derivative called isotretinoin, is a well-tolerated prescription anti-inflammatory that may help hormonal acne in some women.

Natural treatments for acne to consider

·      Use a gentle cleanser

Twice a day, a woman should wash her face with a gentle cleanser keeping pores clear of dirt, oil, and makeup.  Good facial cleansers to try are Cetaphil Daily Facial Cleanser, Vivierskin Hexam gentle cleanser, and Vanicream gentle facial cleanser for sensitive skin which is both sulfate- and betaine-free. 

After washing the face, apply a topical acne treatment such as Aczone, a prescription anti-inflammatory and antibacterial gel.  Aczone contains dapsone, a gentle yet effective ingredient ideal for adult female skin.

·      Use oil-free moisturizers

Even with acne prone skin, women still need to use a moisturizer but choose wisely.  A non-comedogenic, oil-free moisturizer is the best bet to use when applied to only areas that tend to feel dry.

·      Consider chemical peels

Chemical peels may not be for everyone but they are effective at sloughing off sticky, dead cells that can clog pores.  Discuss the use of a chemical peel with a dermatologist to get their opinion.  Chemicals peels can also diminish the signs of aging resulting in fewer lines and wrinkles, move even skin color, brighter complexion, smoother skin, and can be effective for treating acne.  When getting a chemical peel, be sure to use someone qualified such as a dermatologist to do the treatment.

·      Eat a better diet

Radiant, clear skin begins with the mantra, “you are what you eat.”  The appearance of skin tends to reflect how healthy one’s food choices are.  Eating at least 5 servings daily of fruits and vegetables will supply skin with skin nourishing nutrients such as vitamins C and A.  Vitamin E protects skin from oxidative damage supporting healthy skin growth.  Foods high in vitamin E include almonds, avocadoes, and hazelnuts.  Monounsaturated and polyunsaturated fats – the types found in avocadoes, fatty fish of salmon and tuna, nuts, and seeds – provide essential fatty acids which act as a natural moisturizer keeping skin supple. 

·      Be sure to move more

Regular exercise is a must in order to boost circulation, helping to calm down skin inflammation.

·      Reduce stress

Stress can have a direct effect on acne.  Sufferers of acne have skin containing clogged pores that are not visible.  Stress causes an inflammatory response in the body and can cause the walls of these pores to break.  When this happens, the body responds with redness around the broken pore leading to an influx of pus or a pimple.  Stress also makes the adrenal glands go into overdrive producing more androgens which leads to more acne.  Women produce a larger percentage of their androgens in the adrenal gland which may explain why stress seems to affect women more than men when it comes to acne. 

Take time each day to practice methods of stress reduction such as yoga, massage, or mediation.