Acne is commonly the result of hormonal fluctuations, which is why it often occurs in puberty. Over 85% of teenagers will have problems with hormonal acne on their face, neck, shoulders, chest, back, and/or upper arms. Hormonal acne can range from mild to severe, and while it can sometimes be annoying or painful, acne can usually be managed with diligent treatment.
Hormones generally aren’t a factor in adult acne, hormone levels may contribute to hormonal acne in adult women with underlying medical conditions. It may be this imbalance that gives rise to acne flares.
The primary characteristic of acne is clogged pores, which appear on the surface of the skin as whiteheads or blackheads.
Causes of Acne
Hormones are your body’s way of chemically communicating to itself when it’s time to do certain things. An excess of hormones can result in hyperactivity and is essentially what happens in the skin during puberty.
When there’s an excess of the hormones called androgens (primarily male hormones), the glands in your skin’s pores can’t control the excess amount of sebum production. Sebum then clogs the pores or hair follicles in your skin. If this clogged pore becomes irritated and inflamed, it will form a pimple (zit).
If skin cells close around the clog, then a whitehead will form a bulge in the skin that is white in the center and possibly red around the edges. If the pore is open, the sebum will oxidize and turn black, forming a blackhead.
The increase in oil production on your skin also makes a friendlier environment for the acne-causing bacteria, Propionibacterium acnes. These bacteria normally live on your skin without causing any problems, but with the extra oil, they can overgrow and produce pimples. Infected pimples will bulge, turn red, and inflame. A cyst may form, characterized by a large and painful bump that forms deep in a pore underneath the surface of the skin.
Fluctuating hormones, dead skin cells, bacteria, and excessively oily skin, all-cause acne and contribute to hormonal acne breakouts.
What Triggers Acne?
Women with fluctuating hormones are more prone to acne than usual. This includes:
- Teenagers and pre-teens going through puberty
- Women who have changed hormonal birth control methods
- Pregnant women
- Women approaching their menstrual periods
- Women approaching menopause
Some things that can aggravate acne include:
- Comodegenic facial creams or cosmetics
- Greasy hair products
- Clothing or laundry detergents
- Heat and humidity
Many treatments for acne are available over-the-counter, and most of the population will find that they are effective. Look for formulas that contain:
- Salicylic acid
- Glycolic acid
- Azelaic acid
- Lactic acid
- Benzoyl peroxide
You may have to try a few different products to find one that’s effective for you. Most products won’t provide results overnight for clearer skin, so give each product 3-4 weeks to work. Wash your face thoroughly, removing all cosmetics, then apply the solution before bedtime.
For more severe acne (cystic acne), your doctor may prescribe:
- Birth control pills (contraceptive pills)
- Oral vitamin A that reduces the amount of oil released by oil glands in your skin
- Spironolactone, an anti-androgen drug
- Topical retinoids
- Antibiotics – could come in a topical treatment or oral medication
- Steroids – typically in a cream, but can be injected into very large cysts to reduce the size
- Isotretinoin (Accutane) – for severe acne (cystic acne), with large cysts and scarring
You may not be able to prevent all acne, but you can greatly reduce its appearance by controlling the oil production of your skin. Wash your face in the morning and before bedtime with a soft washcloth, warm water, and mild, unscented soap. Use gentle motions and try not to scrub, which can irritate the skin. Use non-comedogenic (non-clogging moisturizers, and skin care products. Avoid picking at your pimples, as this can cause scarring.
If you believe you are experiencing symptoms of, or suffering from Hormonal Acne, or have questions about it, please see your doctor.
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