What is hormonal acne and how can a skincare routine help?

Many women suffer from breakouts. In fact, the percentage of female acne sufferers is significantly higher than men across all age groups(1). This is because of the numerous hormonal changes that occur throughout their lives. It’s commonly believed that breakouts only affects those with oily skin. However this is not always the case, as often those who are prone to acne can suffer from with dry skin conditions(2).

The initial development during puberty coincides with an increase in androgen receptors stimulation and leads to more sebum. However because the menstrual cycle and hormonal fluctuations are linked, adult female acne is sometimes referred to as hormonal acne(1).

Why does hormonal acne occur?

There are a number of hormones that are associated with the presence of acne. Hormonal acne is linked to a raised level of circulating testosterone in the bloodstream(3). Many acne sufferers experience increased sebum production, which is because of activity at the sebaceous follicle(4). It is believed that there is a genetic predisposition to developing adult female breakouts(5). In addition, many women experience premenstrual acne symptoms, because of hormones like estrogen (responsible for the development and regulation of the female reproductive system) and progesterone (which is involved in the menstrual cycle and during pregnancy).

Hormonal acne is not the same for everyone. It’s important to determine the cause of your breakouts (whether it be hormones, wrong skincare selection, genetics, stress or medication) in order to treat it. Acne that is recurrent is seen in 75-85% of adult females, whereas late-onset acne is less common, developing in 20-40% of cases(2). It’s possible to say that there’s a high correlation between those who suffered from adolescent acne and hormonal acne, but it’s not a prerequisite.

You may be suffering from hormonal acne if:

The flare ups occur around your chin and jawline
If you’ve noticed a concentration of pimples around your lower face, it’s likely to be hormonal. The excess hormones in your body stimulate the sebaceous glands, many of which are in the chin area. Other areas that may be pointing to this type of acne include the side of your face and/or along the neck(2).

Your flare ups are painful cysts rather than blackheads and whiteheads
In addition to feeling deeper than other types of pimples, they’re usually more painful and are tender to the touch. This is because they accumulate oil over a period of days or weeks and can cause an accumulation of inflammatory reactions.

Your outbreak occurs once a month
Hormonal acne often happens in a cyclical pattern, following that of a menstrual cycle. They tend to appear in the same place, because a particularly pore has been enlarged by a previous pimple.

Your outbreaks occur when you feel stressed
Cortisol, known as the stress hormone, is increased, which is a sign of inflammation commonly found in acne.

Yes, as they have different characteristics. Hormonal acne differs from adolescent acne in that it presents as deep-seated, mild-to-moderate inflammatory lesions located on the lower third of the face, jawline and neck(5). 

While adolescent acne can present as whiteheads, blackheads and painful pimples on the face, neck, shoulders, chest, back, shoulders, and upper arms.

What’s the best skincare routine for hormonal acne?

1. Find a skincare routine that works for you and stick to it.
2. Use only non-comedogenic products to reduce the risk of clogged pores.
3. Ideally follow a routine of cleanser, mild exfoliation and treatment product everyday, to exfoliate dead cells in order to prevent clogging.
4. Wash your face in the morning and the evening to keep skin clear of dirt, oil and other bacteria…

Sources:
1. Ebede, T.L. et al, 'Hormonal Treatment of Acne in Women' in The Journal of Clinical and Aesthetic Dermatology 2.12 (2009) pp. 16-22
2. Zeichner, J.A. et al, 'Emerging Issues in Adult Female Acne' in The Journal of Clinical and Aesthetic Dermatology 10.1 (2017) pp. 37-46
3. Elsaie, M.L. 'Hormonal treatment of acne vulgaris: an update' in Clinical, Cosmetic and Investigational Dermatology 9 (2016) pp.241-248
4. Ghosh, S. et al, 'Profiling and Hormonal Therapy for Acne in Women' in Indian Journal of Dermatology 59.2 (2014) pp. 107-115
5. Geller, L. et al, 'Perimenstrual Flare of Adult Acne' in The Journal of Clinical and Aesthetic Dermatology 7.8 (2014) pp. 30-34