Skin and Hormones

This month here at Love Luna HQ we have been chatting all things skin and cycles.  

We were curious, how much does our hormones play into our skin health? Hormonal acne is a term we’ve all heard before, but what does it really mean? Who does it affect? Is it the same kind of acne you experience as an awkward teen mid puberty? Or is it entirely different?  

We had the pleasure of chatting with Dermatologist, Dr Shammi Theesan, where we dive into all things hormonal acne, asking her all the questions so you don’t have to. Let's get into it!

 

Luna: Dr Shammi, let's jump right in, what is hormonal acne?   

Dr Shammi: Hormonal acne is a type of acne influenced by hormonal changes in the body, especially androgens. These hormones cause increased oil production, leading to clogged pores and acne breakouts. It often affects the lower face, chest, and back. The primary hormones involved in hormonal acne are androgens, which are male sex hormones that are present in both males and females. In women, hormonal acne is often associated with increased androgen activity during certain phases of the menstrual cycle. Androgens simulate the sebaceous glands in the skin to produce more sebum, an oily substance that can clog pores and create an environment for bacteria to thrive. This, in turn, leads to the formation of comedones (clogged pores), whiteheads, blackheads, and inflamed papules or pustules that are typical of acne. 

 

Luna: What causes hormonal acne?

Dr Shammi: Hormonal acne is primarily caused by fluctuations in hormone levels, particularly androgens. When there is an excess of androgens or a sensitivity to their effects, the sebaceous glands can produce too much sebum. The excess oil can mix with dead skin cells and clog the hair follicles, creating an environment where bacteria can thrive. This results in the development of comedones (clogged pores), whiteheads, blackheads, and inflamed pimples, which are characteristic of acne. For women, hormonal acne is often associated with certain stages of their menstrual cycle, such as just before menstruation (premenstrual phase) when androgen levels are higher. It can also be influenced by other hormonal changes during pregnancy and menopause. Gene:cs can play a role in hormonal acne susceptibility, as some individuals may have a greater sensitivity to hormonal fluctuati Other influencing factors are stress, diet, and lifestyle which can also impact hormone levels and contribute to the development of acne. Overall, the underlying cause of hormonal acne is an imbalance in hormone levels, particularly androgens

 

Luna: How do you treat hormonal acne?

Dr Shammi: Treating hormonal acne typically involves a combination of approaches to address both the underlying hormonal imbalances and the acne symptoms. 

Common remedies include:  

Topical Medications: Over-the-counter or prescription topical treatments containing ingredients like benzoyl peroxide, salicylic acid, or retinoids can help unclog pores, reduce inflammation, and promote skin cell turnover.  

Oral Medications: In more severe cases, a dermatologist may prescribe oral medications, such as antibiotics (e.g., doxycycline or minocycline) to combat bacterial infection or anti-androgen medications (e.g., spironolactone) to block the effects of androgens on the sebaceous glands.  

Hormonal Therapy: For females with hormonal acne, hormonal therapy can be an effective option. Oral contraceptives (birth control pills) can help regulate hormone levels and reduce androgen activity, leading to improved skin conditions. However, it's essential to discuss this option with a healthcare professional, as it may not be suitable for everyone and there are other effects to consider.  

Skincare Routine: A bespoke skincare routine that includes the right cleanser formulation, a suitable exfoliation such as AHAs, and the use of non-comedogenic products can help manage acne and prevent further breakouts.  

Diet and Lifestyle: Making healthy lifestyle choices, including a balanced diet, regular exercise, and stress management, can contribute to overall well-being and may help improve hormonal imbalances. Steer clear of processed foods that increase inflammation; this won’t help.  

Avoid Picking or Squeezing: It's crucial to resist the temptation to pick or squeeze acne lesions, as this can worsen inflammation, lead to scarring, and spread bacteria.  

Professional Treatments: Dermatological procedures like laser protocols, Vitamin A, or prescription medication can be beneficial in managing acne and promoting skin healing.  

Patience and Consistency: Treating hormonal acne may require me and consistency with the chosen treatment plan. Results may not be immediate, but with patience and adherence to the recommendations, improvements should occur over time. 

 

Luna: That's super helpful, do you have any tips and tricks to tackle hormonal acne?

Dr Shammi: Tackling hormonal acne can be challenging, but I always emphasise these 3 tips to my patients: 

Don't Skip Moisturiser: Even if you have oily skin, moisturising is essential to maintain skin barrier function. Choose a lightweight, oil-free, or gel-based moisturiser that won't feel heavy on your skin.  

Don’t Over Cleanse: It’s tempting to cleanse more than we should when active acne is present. Skin the morning cleanse as it’s not necessary and too much can strip the barrier. Cleanse at night only and opt for a rinse of the face in the morning using lukewarm water only.  

Avoid Heavy Makeup: If you wear makeup, opt for products labelled as non-comedogenic or mineral-based. Make sure to remove makeup thoroughly before bedtime, a micellar water before cleansing is strongly advised. 

Limit Dairy Intake: Some studies suggest a link between dairy consumption and acne in certain individuals. Consider reducing dairy intake to see if it improves your acne and other inflammatory foods such as processed items. 

 

Luna: Dr Shammi when do you think someone should seek assistance from a dermatologist for their hormonal acne?

Dr Shammi: You should consider seeing a dermatologist for hormonal acne when the feelings around living with it feel like it’s getting too much to handle. 

These are my tell-tale signs it’s time to engage a dermatologist: 

Persistent or Severe Acne: If your acne is not improving with over-the-counter treatments or home remedies, or if it's causing significant distress or scarring, it's time to seek professional help. 

Cystic Acne: Cystic acne is a severe form of acne characterized by large, painful, and deep cysts beneath the skin's surface. It often requires specialised treatment and should be addressed by a dermatologist.  

Hormonal Acne Flare-Ups: If you notice a pattern of acne flare-ups around your menstrual cycle or suspect that hormonal imbalances are contributing to your acne, a dermatologist can help evaluate and recommend appropriate hormonal treatments.  

Acne that Affects Your Quality of Life: If acne is impacting your self-esteem, causing emotional distress, or affecting your daily activities, consulting a dermatologist can provide effective solutions and improve your quality of life. Don’t lose your identity to acne, help is out there.  

Risk of Scarring: If your acne lesions are leaving scars or you have a history of acne scarring, a dermatologist is the right avenue for you. Dermatologists have access to various specialised treatments, such as prescription medications, hormonal therapies, or dermatological procedures, which can be more effective in managing hormonal acne and will offer a solution you may not find over-the counter or on TikTok. 

 

Luna: Are there other things you recommend clients do when suffering from hormonal acne?

Dr Shammi: Absolutely! In addition to seeking advice from a dermatologist and following a consistent skincare routine, I often recommend these tips for clients suffering from hormonal acne: 

Keep a Skincare Diary: Track your skincare routine, dietary habits, menstrual cycle (if applicable), and stress levels to identify potential triggers or patterns related to your acne. This information can be valuable for you and your dermatologist when developing a treatment plan 

Avoid Abrasive Scrubbing: Scrubbing the skin vigorously or using harsh exfoliants can worsen acne and cause irritation. Opt for gentle exfoliation methods and use them sparingly, no more than once or twice a week. Ensure it’s never a physical exfoliating method.  

Change Pillowcases Regularly: Bacteria and oil from your face can transfer to your pillowcase, potentially exacerbating acne. Change pillowcases frequently, at least once a week. 

Limit Sun Exposure: While a small amount of sun exposure can have a positive effect on acne, excessive sun exposure can lead to skin damage and worsen inflammation. Always use a non-comedogenic sunscreen when going outdoors.  

Seek Emotional Support: Dealing with acne can be emotionally challenging. Seek support from friends, family, or a mental health professional if you're feeling overwhelmed.  

Remember that everyone's skin is unique, and what works for one person may not work for another. It's essential to find a treatment approach that suits your specific needs and skin type but most importantly, seek emotional support, it’s not just a physical condition but often an emotionally taxing one, too. 

 

We’d like to thank Dr Shammi for Ode Dermatology for taking the time to discuss hormonal acne with us. We know better than anyone just how painful, distressing and downright frustrating hormonal acne can be. We hope this article gives our readers some better insight or advice to help combat their hormonal acne. 

If you’d like further information on Dr Shammi and her practice you can find her on Instagram @drshammitheesan or online at https://odedermatology.com.au/

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