One of the most frustrating symptoms of hormonal imbalance in women is adult acne. 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 acne. Having acne does not mean that you are doing anything wrong, and it does not mean you are dirty. Acne is not contagious; you can't spread it or catch it.
Below, we'll cover some of the most common causes of hormonal imbalance and how women can treat hormonal acne.
Hormonal imbalance and acne
A fluctuation in your hormones causes hormonal acne. Hormonal-related adult acne appears on the lower part of the face, around the jawline, chin, and lower cheeks.
Hormonal acne starts when there is an increase in androgens. More androgens trigger sebum production, which in turn, When overproduced, clog the skin pores and cause more acne breakouts. Many women will notice that their breakouts flare up at the same time every month during their menstrual cycle. Some women also deal with breakouts during menopause due to falling estrogen levels. While every woman will deal with these hormonal fluctuations to some degree, some are more sensitive to this change and are more likely to experience acne.
What causes hormonal imbalance in women?
Numerous factors can lead to hormonal imbalances. In addition to the natural fluctuations women experience during puberty, pregnancy, menstruation, and menopause, adult acne can be made worse by a few other factors.
● Stress: We all deal with stress to some degree, but chronic or extreme periods of stress can have a significant impact on hormones. Stress causes the adrenal glands to secrete higher than normal levels of adrenaline and cortisol (AKA stress hormones). With that rise in cortisol comes a decrease in progesterone (a female sex hormone) because it blocks progesterone receptors.
● Poor Sleep Quality: When we sleep, our body produces the hormone melatonin, which (among other functions) helps manage cortisol. If we aren't getting enough sleep, our body cannot correctly keep cortisol in check.
● Unbalanced Diet: A balanced, nutrient-rich diet is crucial for hormonal support and overall well-being. A high sugar diet, refined carbs, and overly processed foods may affect hormone levels.
● Exposure to Endocrine Disruptors: Endocrine disruptors (or endocrine-disrupting chemicals) may negatively impact the normal function of the endocrine system, resulting in an imbalance of the hormones. While further research needs to be done on their effects on humans, these disruptors may be found in some beauty products, plastics, pesticides, foods, and more.
● Thyroid disorders: Hypothyroidism (an underactive thyroid) and hyperthyroidism (an overactive thyroid) directly affect hormone levels and cause an imbalance.
● Polycystic Ovary Syndrome (PCOS): PCOS is a condition that affects women's hormones, causing them to overproduce male hormones.
What are the best treatments for hormonal acne?
There are different over-the-counter and prescription medications – both topical and oral – that women can take to address acne. Here are some of the most common treatment options:
● Oral Contraceptives (Birth Control Pills): Hormonal oral contraceptives containing ethinyl estradiol – an estrogen that balances out the effects of androgens – are commonly used to treat hormonal acne. If you're already taking birth control pills, a doctor may help you find a better option that is more targeted toward acne.
● DIM supplements: The DIM + cruciferous supplements are an excellent addition to any hormonal acne treatment. They contain natural extracts of cruciferous vegetables (kale, broccoli, alfalfa, and spinach), specially formulated to help balance hormones. Check this link for more info.
● Topical Retinoids: Retinoids derived from vitamin A are a prevalent acne treatment option for mild to moderate acne. They help increase cell turnover to eliminate dead skin cells clogging the pores, helping to achieve clear skin. You can find over-the-counter retinol products to add to your skincare routine, but a dermatologist can determine whether a prescription is more suitable for your needs. The best topical retinoids for women with adult acne are retinol (0.25% or 0.5%) combined with Niacinamide. Check this link for more info.
● Anti-Androgen Drugs: Spironolactone is one of the most commonly used anti-androgen drugs for women with hormonal acne. While the prescription medication is primarily used to treat high blood pressure, many dermatologists prescribe it to women with hormonal acne, preventing the body from overproducing androgen hormones.
● Isotretinoin: In severe acne cases, a dermatologist may prescribe isotretinoin, commonly referred to as Accutane (although this specific brand hasn't been produced in over ten years). Isotretinoin is a vitamin A derivative that reduces the amount of oil produced by the oil glands. It is taken orally – typically for around 4 to 6 months. This medication has some serious side effects, the most notable being extremely dry skin.
Are there other symptoms of hormonal imbalance in women?
It's important to note that acne isn't the only sign of a lack of balance in hormones. Many women dealing with hormonal imbalances won't develop hormonal acne. This type of imbalance is multi-faceted and can manifest differently depending on the person and their unique situation. In addition to acne, some common symptoms of hormonal imbalance in women include anxiety, depression, insomnia, fatigue, irregular or painful menstrual cycles, PMS, ovarian cysts, weight gain, headaches and migraines, and thinning hair.
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