Acne is one of the most common skin problems, affecting not only teenagers but also adults. People often think acne is just a problem of youth, but hormonal fluctuations, which can occur at various stages of life, are one of the main causes of breakouts. Hormonal acne is often harder to treat and tends to recur, so it is important to recognise it correctly and get effective treatment.
WHAT IS HORMONAL ACNE?
Hormonal acne is caused by hormonal changes in the body, especially when androgen (male sex hormone) levels rise or the body reacts sensitively to them. Androgens stimulate the skin's sebaceous glands to produce more oil (sebum). Excess sebum, together with dead skin cells, clogs pores and creates a favourable environment for the bacterium Propionibacterium acnes to multiply. Bacterial growth causes inflammation, redness, swelling and eventually pimples.
Unlike regular acne, which is usually caused by excess oil or environmental factors, hormonal acne is often inflammatory, painful and deeper. It can appear not only on the face but also on the neck, shoulders, chest and upper back – areas rich in sebaceous glands.
It is important to note that hormonal acne is not only a teenage problem. Women often experience hormonal acne during the menstrual cycle, pregnancy or menopause. Hormonal disorders such as polycystic ovary syndrome (PCOS) can also cause severe, long-lasting acne that requires specialist treatment.
HOW TO RECOGNISE HORMONAL ACNE
Several clear signs that differ from regular acne help to recognise hormonal acne:
- Location: hormonal acne most often appears on the chin, jawline and neck. These areas are particularly sensitive to hormones because they have many androgen receptors. Unlike oily-skin acne, which usually appears in the "T-zone" of the forehead, nose and chin, hormonal acne may be more widespread below the chin and along the jaw.
- Type: it is often inflammatory cystic acne that is deep, painful and can leave scars. These are not just surface whiteheads or blackheads, but often inflamed nodules that can sometimes develop into large cysts.
- Severity and fluctuation: hormonal acne often gets worse before menstruation or during other periods of hormonal change, such as early pregnancy or menopause. Such breakouts often appear cyclically rather than constantly.
- The "dirty skin" myth: contrary to popular myths, hormonal acne has nothing to do with dirt or poor hygiene. Even perfectly cared-for skin can suffer from hormonal acne. It is important to understand this so that people do not over-wash or use harsh skin care products, which can only make things worse.
- Standard products don't work: if pimples persist for a long time despite standard treatment or skin care, this may be a sign that the cause is hormonal and specialist treatment is needed.
TREATING HORMONAL ACNE
Treatment depends on the severity of the acne, age, individual health factors and hormonal status. Several treatment strategies are usually combined:
Medical consultation and diagnosis
The most important step is to see a dermatologist, who may recommend further tests. A consultation with an endocrinologist may be needed if a hormonal disorder such as PCOS or another sex hormone imbalance is suspected. Laboratory tests, such as a blood hormone profile (testosterone, LH, FSH, DHEA-S, etc.), help identify hormonal imbalances and choose the right treatment.
Topical medicines
- Retinoids – vitamin A derivatives that improve skin cell turnover and reduce clogged pores and inflammation. They help clear pores and prevent new breakouts. Retinoids are often the first line of topical treatment. However, using them requires patience, as the effect becomes visible after several weeks or months, and at first the skin may become red or flaky.
- Antibiotics – used to reduce the Propionibacterium acnes population and inflammation. Topical antibiotics are usually prescribed together with other medicines to avoid bacterial resistance.
- Combination products – creams or gels combining retinoids, antibacterial and anti-inflammatory components are more effective than a single component alone.
Systemic treatment
- Contraceptives – many women with hormonal acne are prescribed combined oestrogen-progestin preparations, which regulate hormonal balance and reduce androgen levels and sebum production. This not only improves the skin but also regulates the menstrual cycle.
- Anti-androgens – medicines such as spironolactone suppress the effect of androgens on the sebaceous glands, reducing breakouts. This treatment is often prescribed together with contraceptives or when contraceptives are contraindicated.
- Oral antibiotics – prescribed for severe inflammatory acne. They act on systemic inflammation and bacterial growth. However, antibiotics should only be taken for a short time due to the risk of resistance.
Lifestyle changes
Lifestyle factors can significantly affect the course of hormonal acne:
- Diet: although the link between food and acne is not entirely clear, research shows that high-glycaemic foods (sugar, refined carbohydrates) and some dairy products may promote inflammation and breakouts. It is recommended to eat more foods containing antioxidants, omega-3 fatty acids and vitamins C and E, which strengthen the skin's defences.
- Stress management: chronic stress increases the production of hormones (cortisol), which can promote inflammation and breakouts. Relaxation techniques are recommended – meditation, exercise and good-quality sleep.
- Skin care: gentle, regular skin hygiene is essential, avoiding harsh products that can irritate and promote inflammation. It is recommended to use soothing, non-comedogenic products.
Aesthetic procedures
Professional procedures can help improve the skin and reduce inflammation:
- Chemical peels: gently remove dead skin cells, stimulate collagen production and reduce inflammation. They help smooth the skin surface and reduce scarring.
- Laser therapy: acts on skin inflammation, reduces bacteria and promotes regeneration. There are various types of lasers used depending on the type of acne.
- Microneedling: promotes skin healing and collagen production and improves penetration of active ingredients into deeper skin layers.
- Phototherapy (LED light therapy): designed to reduce inflammation and bacteria in the skin.
WHEN TO SEE A SPECIALIST
It is important to see a specialist in good time if:
- The pimples are very inflamed and painful, or cysts or nodules form.
- The acne does not go away for a long time or home treatment does not work.
- The acne leaves scars or pigmented spots.
- The acne is accompanied by other signs of hormonal disorders (menstrual irregularities, excessive hair growth, weight changes).
- You feel that the acne is affecting your psychological well-being and quality of life.
Professional treatment not only improves the skin but also helps address underlying hormonal problems and prevent scarring.
Hormonal acne is a complex and common problem that requires a careful approach. Understanding how hormones affect the skin and their role in acne makes it possible to recognise the problem early and choose the right treatment. Well-chosen treatment, combining medical measures, lifestyle changes and sometimes aesthetic procedures, can significantly improve the skin and quality of life. Remember that acne treatment is a process that requires patience, time and professional care.
Our recommendation. For local care of blemish-prone skin, choose BIG PACK zinc ointment. Zinc oxide helps dry and soothe irritated areas of the skin.
SOURCES
- American Academy of Dermatology: Acne and Hormones
- Mayo Clinic: Hormonal Acne
- National Health Service (NHS): Treating Acne with Hormonal Therapy
- Journal of the American Academy of Dermatology: Hormonal Therapy for Acne
- Endocrine Society: Hormonal Influences on Skin and Acne
- Cleveland Clinic: Causes and Treatment of Hormonal Acne
- DermNet NZ: Hormonal Acne
- MedlinePlus: Acne Vulgaris
- British Association of Dermatologists: Acne
- PubMed Central: Hormonal Treatment in Acne Vulgaris
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