Hormonal Acne - Causes, Symptoms, Diagnosis, and Treatment

INTRODUCTION

Acne is a clinical condition that affects the skin. The cause is known to be excessive production of sebum which blocks the pores and causes acne. Various other types of skin lesions include papules, pustules, cysts, and nodules.

Hormonal acne is a type of acne that is caused due to changes in the hormone levels in the body. It is more prevalent in women and is more commonly observed during puberty but can also be observed at any age. Also, menstruation and menopause affect the formation of acne.

What Causes Hormonal Acne?

There can be various factors associated with the formation or progression of acne. Hormones are one of them. The following are the known possible causes or mechanisms associated with the same:

1. TESTOSTERONE:

Testosterone production increases during puberty. This leads to excessive production of sebum creating oily skin.

2. BLOCKED HAIR FOLLICLES:

When the hair follicles get blocked, comedones or “clogged pores” are formed.

3. Any bacterial infection can worsen the comedones.

4. Finally, inflammation happens as the immune system defends the body or skin against bacterial infections.

It is not necessary that all types of acne have to be inflamed. Simple comedones like blackheads and whiteheads are usually not inflamed. Some examples of inflamed pimples include papules, pustules, nodules, and cysts.

Following situations also contribute to hormonal acne formation due to the fluctuation of hormones:

• Periods or menstruation.

• Menopause.

• Increase in androgen levels.

• Polycystic ovarian disease.

What Are The Symptoms Of Hormonal Acne?

The most commonly affected zone by hormonal acne during puberty is the T-zone. T-zone involves the forehead, nose, and chin. The adult type of hormonal acne is usually seen on the lower part of the face which involves the bottom of the cheeks and jawline. Some people may also experience blackheads, whiteheads, and small pimples which can even transform into a cyst. Cysts are tender to touch and usually do not present themselves on the skin surface.

Can Menopausal Acne Be Considered A Type Of Hormonal Acne?

Some women tend to develop acne during menopause. The cause for the same is the decrease in estrogen levels or an increase in the levels of androgens like testosterone. Women using hormone replacement therapies (HRTs) to ease their menopause symptoms may also develop menopausal acne.

How Is Hormonal Acne Diagnosed?

When you visit your physician, you will be asked questions about your medical history, family history, menstrual history, and personal history along with questions related to your current problem and the associated signs and symptoms. If required, the doctor may perform certain tests like blood tests, hormonal tests, etc.

How Can Hormonal Acne Be Treated?

There are various treatment options available to manage this condition. If the hormonal acne is mild, over-the-counter (OTC) medicines or products can be helpful. As this hormonal acne takes the form of cysts that are inaccessible by the topical medication, it is advisable to consult a specialist and take proper treatment.

Certain oral prescription medications can be taken which help in managing acne. The most commonly used oral drugs are oral contraceptives and anti-androgen drugs.

1. Oral Contraceptives:

Oral contraceptives which are used for the management of acne consist of ethinylestradiol along with one of the below-mentioned drugs:

• Drospirenone.

• Norgestimate.

• Norethindrone.

These are more useful during the peak stage of hormones like the ovulation stage. It is important to avoid oral contraceptives if you have blood clots, increased blood pressure, or breast cancer. Also, smokers should avoid oral contraceptives.

2. Anti-Androgen Drugs:

Anti-androgen drugs help in decreasing the male hormone, androgen. Both men and women have these hormones within their normal limits but excess of these hormones can lead to acne formation. Hence, anti-androgen drugs are very useful in such cases.

3. Retinoids:

In mild hormonal acne conditions, topical retinoids can be used. The source of retinoids is vitamin A.

Natural Ways To Manage Hormonal Acne:

Natural products especially those obtained from plant sources can also be used to control or manage hormonal acne. Some of the natural acne management products are:

1. Tea tree oil

2. Alpha hydroxy acid

3. Green tea

Can Diet Modification Help Control Hormonal Acne?

There is no supporting literature to understand the exact correlation between diet and hormonal acne. But, there is some literature supporting usage of certain foods, especially inflammation-fighting foods in controlling hormonal acne.

Foods that are plant-based contain high levels of antioxidants. These antioxidants help reduce inflammation and thus, promote much clearer skin. Another product known to decrease inflammation of the skin is Omega-3 fatty acids.

We see a lot of discussions on junk food causing acne. It is necessary to understand that junk foods alone do not cause acne. Excessive consumption of junk foods can lead to inflammation though.

Some of the food products that can be limited to control hormonal acne are sugar, dairy products, and refined carbohydrates like pasta, white bread, etc. Also, non-vegetarians should avoid red meats.

Apart from these, certain measures can be taken daily to ensure preventing or controlling hormones. The main objective is a skincare routine. You can do the following to keep your skin healthy and clear:

• Washing the face twice daily in the morning and evening.

• Do not use excessive anti-acne products. Limit it to just a pea-size amount. Excessive amounts can lead to skin drying and irritation.

• Apply sunscreen every day.

• It is advisable to use non-comedogenic products. This will help in reducing the risk of developing clogged pores.

CONCLUSION

Hormonal acne is mainly caused due to fluctuations in hormones. It can be controlled either by using over-the-counter products or medical management. It is necessary to consult a specialist to get yourself checked thoroughly to rule out the cause of acne before using any medication. Online medical platforms have made consulting a specialist easy. To know more about this condition, consult a specialist online.