Anyone suffering from hormonal acne knows that it can be particularly challenging to treat. A study published in the Journal of the American Academy of Dermatology showed that 50% of women in their twenties, 35% in their thirties, and 26% in their forties suffer from hormonal and adult acne. This type of acne occurs when the body's hormones (estrogen, progesterone, and testosterone) are out of balance. This imbalance leads to overactivity in the oil-production glands. Most dermatologists agree that combining effective topical treatment with hormonal modulation is the best way to clear up hormonal acne breakouts. That's where Diindolylmethane (DIM) comes in.
What is DIM?
DIM is the main biologically active compound in a group of plants called cruciferous vegetables or Brassica. This botanical family includes cruciferous vegetables such as cabbage, Brussel sprouts, broccoli, and cauliflower. When you eat these superfoods, your stomach acid breaks down indole-3-carbinol to produce a new DIM compound. A few studies have found a correlation between a diet rich in cruciferous vegetables and a reduced risk for certain cancers, including breast and prostate cancer. Some dermatologists believe it might work similarly to spironolactone, a drug often recommended to treat hormonal acne.
What does DIM do?
Extensive research shows that DIM can balance hormones and help restore estrogen balance. It is believed that DIM may help balance hormones by blocking the effects of excess testosterone, an androgen (male) hormone responsible for producing excess acne-causing sebum (oil) in the skin. DIM is believed to help with estrogen balance by increasing beneficial 2-hydroxy estrogens and reducing the unwanted 16-hydroxy variety.
How does DIM help with hormonal acne?
The root cause of hormonal acne is an imbalance of estrogen, progesterone, and testosterone, which affects the skin's oil-producing glands. With that in mind, most dermatologists agree that the best way to clear hormonal acne is to combine effective topical treatment with hormonal modulation. Hormonal modulation can occur via prescriptions (such as birth control pills) or natural supplementation. Estrogen imbalance, in particular, is a common cause of acne. Since DIM works to balance estrogen receptors, it can help clear up adult hormonal acne in women.
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Is DIM a hormone?
The DIM is one of the most popular natural supplements for women with hormonal imbalances and hormonal breakouts. DIM is not a hormone. Instead, DIM balances the body's natural response to estrogen and testosterone. It does this by adjusting the activity of metabolic enzymes and estrogen receptors, reducing the amount of "bad" estrogen in the body. Like spironolactone, it is believed the DIM binds to the androgen receptor and reduces its effects on the skin's oil glands.
Wait, what do you mean by "bad" estrogen?
There are three types of estrogens: estrone (E1), estradiol (E2), and estriol (E3). E2 is the most common form of estrogen in non-pregnant females from puberty to menopause. In menopause, E1 becomes the primary estrogen. It's considered the "bad" estrogen and may be the source of estrogen's cancer-causing properties. E3, on the other hand, is regarded as a "good" estrogen and may protect against cancer. E2 is a neutral estrogen.
What is estrogen dominance?
Estrogen dominance happens when the body produces too much estrogen. The body produces less progesterone for women with estrogen dominance but keeps producing the same estrogen levels, causing a hormonal imbalance. These imbalance symptoms include mood swings, decreased sex drive, worsening PMS, bloating, weight gain, anxiety, irregular or heavy menstrual periods, and hair loss.
What is the effect of excess androgens on acne?
Androgens represent the skin's most important sebum-producing hormones in both males and females. As more androgens (testosterone) bind to the sebaceous glands' receptors, more sebum is produced. This androgen-dependent secretion of sebum is regulated by testosterone and the more potent dihydrotestosterone (DHEA). This leads to acne breakouts and a dull complexion.
Do DIM capsules help with "bad" estrogen?
DIM capsules support the activity of enzymes that improve estrogen metabolism by increasing the levels of 2-hydroxyestrone, e.g., the "good" estrogen.
DIM supplements and weight loss
Taking DIM supplements as part of a healthy diet was found to help with abdominal fat loss. Estrogen dominance was linked to abdominal fat gain, common in post-menopausal women. DIM activates the enzyme that converts E1 and E2 to the "good" estrogen, E3. DIM inhibits an enzyme called aromatase, which converts testosterone to estrogen. It may also help decrease the effects of 16 alpha-hydroxyestrone linked to weight gain. DIM supplements may also stimulate fat breakdown and inhibit fat cell formation. In one lab study, DIM significantly reduced the formation of new fat cells.
Scientific Evidence for Benefits of DIM
A few studies have looked at the hormonal-modulating effects of DIM supplementation and its possible benefits to people with hormonal acne. Thomson et al. (2016) reviewed DIM's chemopreventive properties in breast cancer, noting its ability to modulate hormonal pathways, which is crucial in managing hormone-related acne. Alois and Estores (2019) highlighted DIM's role in hormonal regulation in PCOS patients, aiding in managing hormonal acne. Kim et al. (2022) showed that DIM inhibits biofilm formation by acne-causing bacteria, potentially reducing acne severity. Additionally, What makes MDacne's DIM capsules unique?
Best DIM supplements for women with hormonal-related acne
MDacne's DIM supplement has significant advantages over traditional DIM tablets.
1. The vegan capsules are smooth and easier to swallow than conventional tablets. If you prefer, you can even open them up and sprinkle the powder into a smoothie or over food.
2. The supplement is vegetarian, gluten-free, and cruelty-free.
3. There is no aftertaste.
4. One MDacne DIM capsule provides the full daily dosage of DIM (250mg). Most tablets require swallowing 2-4 pills/day to get the same dose.
Problem |
Mechanism |
With DIM |
Hormonal acne: |
Hormonal acne appears primarily in areas rich in androgen receptors (chin and jawline. The Androgenic effects of the "bad" forms of estrogen are believed to cause more acne breakouts. |
DIM helps reduce the levels of bad estrogen and helps decrease excessive sebum production and acne. |
Estrogen dominance: (Bad estrogen) |
Poor liver function and obesity metabolize testosterone into the "bad" forms of estrogen. External factors such as birth control pills, excess meat and dairy, plastics, and other toxins may also contribute to estrogen dominance. |
Controlling estrogen dominance and reducing "bad" estrogen levels can help with irregular, heavy periods, weight gain, sleeping problems, fatigue, and low libido. |
DIM FAQs
Do I really need a DIM supplement? Can't I just eat more veggies?
Cruciferous veggies DO contain substantial amounts of DIM. However, you would need to eat 2 pounds of these vegetables to get the DIM contained in one serving of MDacne's DIM skin-clearing supplement. That's a lot of chewing. Besides the sheer volume of veggies you'd need to consume to get the right amount of DIM, there's also the heat issue. Cooking destroys DIM (and raw brassica veggies can be hard on the thyroid). So, a dietary supplement is the only way to get the right amount of DIM.
I have hormonal acne, and I'm taking the DIM. When will I see the results?
Some women will notice initial results in as little as 4-6 weeks. But be patient. For some, it may take six months to see optimal results.
Are there any adverse effects of taking DIM?
Some people get a slight headache when they first start taking the capsule. If this occurs, increase your daily water intake and give your body time to adjust. Once your body has adjusted, the headache should go away. If the headache is severe or you experience any other symptoms while taking DIM capsules, you should stop taking the supplement immediately and consult your physician.
Can my acne get worse before it gets better?
Seeing some extra pimples when you start a new acne treatment is normal. The new blemishes are part of the skin's natural detoxification process called purging. If this happens, you can space out your dose by taking one capsule every two days to give your body time to adjust. It would be best to increase your daily water intake to help flush out toxins and other unwanted things from the body.
Does DIM always improve hormonal acne?
Each body is unique, and everyone responds to dietary supplements differently. Most people taking DIM will start seeing results in three to four weeks and will see their most significant results and better-looking clear skin after six months.
My hormone levels are normal - can I still benefit from DIM?
Most people with "hormonal acne" have normal hormonal tests. In these cases, acne is an overreaction of the skin oil glands to the normal level of androgens in the circulation or the balance between different estrogen types in the blood circulation. Thus, birth control pills, spironolactone, and DIM supplements can help with hormonal acne even if blood work seems to be in the normal range.
I have severe acne. Should I take a higher dosage of DIM capsules?
One MDacne capsule contains the optimal dose of DIM. You should not take more than one capsule/day.
So, does DIM actually change my estrogen levels?
No, DIM capsules do not increase or decrease your estrogen blood levels. They will only change your body's ratio of good to bad estrogens.
How long can I take DIM capsules? Do you have to wean yourself off of them?
You can take DIM capsules as long as needed, but most people use the supplement for about six months to a year. You can stop taking DIM at any time.
Can I combine DIM capsules with other medications or supplements that I am taking?
Just as with any supplement, please consult with your doctor before taking DIM if you are on prescription medications.
Can I take DIM capsules while on birth control?
Yes. Women can take DIM capsules while on birth control. Taking DIM can help with both adult acne and the side effects of synthetic hormones. DIM capsules will not interfere with the effectiveness of your birth control pills or your IUD.
I have low estrogen. Should I still take DIM capsules for my acne?
Please consult your physician if you have low estrogen levels or any known endocrinological issues.
Can DIM help with PCOS?
There are two types of sex hormones. Female hormones like estrogen and progesterone and male hormones like testosterone. Both are present in varying amounts in males and females. People with polycystic ovary syndrome (PCOS) have high levels of androgens, specifically DHEA and androstenedione. PCOS can cause irregular menstrual periods, insulin resistance, and an increase in testosterone and other male hormones). More male hormones can to increased facial hair growth) acne, and hair loss (androgenetic alopecia). As DIM can balance the estrogen levels and reduce androgen's effects, it may help reduce PCOS symptoms. That said, if you have PCOS, please consult your doctor before you start taking DIM.
Can DIM help with symptoms of menopause?
Reduced estrogen levels result in the symptoms of menopause: The more common symptoms are hot flashes, night sweats, skin thinning, hair thinning, acne breakouts, and mood swings. A few studies have shown that by interacting with estrogen receptors, DIM may be helpful for menopausal symptoms.
Can I take DIM when I am pregnant or nursing?
No, we do not recommend using DIM tablets while pregnant or breastfeeding.
I have noticed a change in the color of my urine. Is this normal?
When you start taking DIM, your urine may temporarily take on a slight orange/brown color. This color change is standard and a sign that the product is working. If the color concerns you, you can increase your water intake and reduce your meat/dairy intake as your body adjusts.
My DIM capsules have a strange smell. Is that normal?
Yes, and that scent is a good sign! Natural, high-grade DIM made from cruciferous veggies has a strong smell. In fact, if your current DIM capsules don't have a scent, it likely means your supplement contains fewer active ingredients and will be less effective.
Should I take my DIM capsules with a meal?
You can take your DIM capsules with or without a meal. Taking the pills with a meal may help with absorption and increase the supplement's benefits.
Is it ok to drink alcohol while taking DIM capsules?
We do not recommend taking DIM capsules along with alcohol.
Can I open the DIM capsule?
Yes. You can open the DIM capsule and sprinkle the powder over food or smoothies. However, do not heat or cook the powder.
Can children and teens take DIM tablets?
DIM capsules are thought to be safe for use in children as young as 12 years old. However, we don't recommend using DIM in people younger than 18.
Can males use DIM capsules?
Males developing breasts and suffering from obesity due to high estrogen levels can benefit from DIM capsules. That said, males should consult their physician before taking a DIM supplement.
Can DIM help with hair loss?
There is not enough data on the effects of DIM on hair loss. That said, Hair loss is often due to excess DHT. DIM may be able to help with hair loss through its anti-androgen (anti-DHT) effects.
Will the cruciferous vegetables in DIM affect my thyroid?
The pure DIM and the brassica extract in DIM capsules aren't believed to affect thyroid function. However, people with thyroid dysfunction should consult their physician before taking DIM.
Can I take DIM capsules if I have cancer of any type?
If you have cancer, you should not take DIM.
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References
- Diet and estrogen status: the cruciferous connection
- Endocrine disruptors and reproductive development: a weight-of-evidence overview.
- Abnormal oxidative metabolism of estradiol in women
- Effect of diindolylmethane supplementation.
- Indole-3-carbinol and diindolylmethane in T47D human cells.
- The effect of DIM supplements on weight loss
- The Link between bad estrogen and obesity
- The best treatment for post-partum hair loss.
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