Understanding what triggers hormonal acne and how to treat it

Around 50% of women aged 20-29 experience acne. While for some, this may present itself in a minor breakout signalling the coming of Aunt Flow, others are cursed with tides of hormonal acne covering their faces.

What is hormonal acne?

Hormonal acne is relatively self-explanatory - its acne that is triggered by a hormone imbalance. In those going through puberty, this type of acne commonly affects the T-zone. However, as we get older, hormonal acne tends to present itself on the lower part of the face, predominantly the chin, lower cheeks and jawline

Hormonal acne commonly takes the form of cysts, papules and pustules, but in some, it can show up as blackheads, whiteheads and small pimples. Cysts, the most common form of hormonal acne, form deep under the skin’s surface and don’t come to a head. These inflamed bumps are often painful and hard to the touch.

What triggers hormonal acne?

Hormonal acne is most often caused by the influx of hormones during menstruation, menopause, increased androgen levels and can even result from polycystic ovarian syndrome. Commonly known as PCOS, this condition causes cysts to form around the ovaries. These hormone fluctuations cause inflammation in the skin, increase sebum production, clog the pores, and increase acne-causing bacteria, all of which can result in a sometimes painful breakout.

How to treat hormonal acne

Unless your acne is very mild, it can be almost impossible to treat it with over the counter products like acne cleansers. Instead, a doctor or dermatologist appointment will be needed to diagnose and prescribe medication.

The most common treatments for hormonal acne include:

Oral contraceptives

Some birth control pills contain active ingredients that target the acne-causing hormones at play. This can be helpful when it comes to the breakouts that often prelude ovulation or menstruation.

Anti-androgen drugs

Both men and women have androgens; when in excess, these male hormones can interfere with the regulation of skin cells and can boost sebum production, often resulting in acne. Androgens can often also be the cause of hormonal acne in men.

Suppose androgens are responsible for your hormonal acne. In that case, a doctor will prescribe anti-androgen drugs to control the production of the hormone and allow your body to reach a hormonal balance.

Retinoids

If your hormonal acne is mild, a doctor may prescribe a topical treatment known as a retinoid. Retinoids are derivatives of vitamin A that can reduce acne by tackling inflammation and unclogging pores.

Retinoids can come in several forms such as gels, creams and lotions and also at different strengths. In some countries, weaker forms of retinoids such as Adapalene are available over the counter. However, a doctor or dermatologist can provide stronger prescriptions if required.

Retinoids can also sensitise the skin when exposed to the sun. For this reason, it’s essential to use your retinoid at night only and follow up with SPF during the day.

Antibiotics

If your hormonal acne isn't responding to retinoids, doctors can also prescribe oral or topical antibiotic treatments as well. These treatments are often carried out over the course of six weeks and work by reducing the amount of acne-causing bacteria around the hair follicle. Antibiotics can also help reduce inflammation by reducing the concentration of fatty acids in the sebum.

Eliminating general acne triggers

Besides prescription treatments, avoiding common acne triggers such as stress and over-exfoliation may help to reduce hormonal acne.

Diet has a controversial role when it comes to acne. However, some people find that eliminating refined sugars, refined carbs, and dairy can help reduce inflammation in the body. If you believe a change in diet may help minimise your breakouts, consult a healthcare professional.