Hormonal Acne Types

Have you ever found yourself battling those really persistent breakouts well into your adult years? You've probably experienced that specific kind of frustration when trying different remedies and nothing seems to work. Later, you find out it’s not just acne in general, but a specific type with unique patterns and triggers. This type of acne is often referred to as hormonal acne.

Hormones are vital chemical messengers that influence various bodily processes, including those that impact your skin. Hormone fluctuations can lead to increased sebum (oil) production in the skin, which clogs pores and can lead to inflammation and breakouts. This is usually triggered by androgens such as testosterone. Other hormones, such as estrogen, progesterone, insulin, and cortisol, all play complex roles that affect sebum production.

Unlike regular acne, which spreads more widely, hormonal acne has specific patterns and triggers that make it easier to identify. Recognizing these patterns is important for effectively managing the condition. It's a concern for many women, as it frequently aligns with natural hormone cycles. If you’re someone worried about breakouts, knowing how to fix hormonal acne can help achieve clearer skin.

What Is Hormonal Acne?

Hormonal acne is a type of acne primarily driven by hormonal fluctuations, resulting in overproduction of sebum or skin oil and subsequent pore clogging, inflammation, and breakouts. While hormones play a role in all acne, this specific type is distinguished by its onset or persistence in adulthood, often affecting individuals in their late 20s, 30s, 40s, and beyond. It's a common concern, but a natural part of many people’s hormone cycles.

What Does Hormonal Acne Look Like?

What do you know about hormonal acne? Hormonal acne appears as deep, painful cystic nodules or red, inflamed pimples that can be tender and last longer than expected. What makes this acne particularly challenging is its persistence, which is deeply influenced by the subtle shifts in our body's hormones and internal chemistry.

Hormonal Acne Types

Hormonal acne types include the following:

• Comedonal hormonal acne presents as non-inflammatory whiteheads and blackheads on the forehead and cheeks, often associated with early puberty or mild hormonal shifts. 

• Inflammatory hormonal acne is characterized by red, tender papules and pustules on the chin and jawline, often associated with hormonal imbalance. 

• Hormonal cystic acne results in deep, painful lumps without a "head," mainly on the chin and neck, often indicating conditions like Polycystic Ovary Syndrome (PCOS) and typically requiring oral medication. 

• Adult-onset hormonal acne, occurring in those aged 25 and older, can manifest in any of these forms and is often triggered by stress, pregnancy, or perimenopause.

Hormonal Acne Location

Hormonal acne has predictable patterns of appearance on the face and body, often providing clues to its underlying cause. It can appear on the:

• Chin

• Jawline

• Lower cheeks

• Neck

• Chest

• Shoulders

• Back

• Other parts of the face

Hormonal acne on cheeks and jawline

Breakouts on the cheeks and jawline are closely linked to androgens, such as testosterone, which can increase oil production. This is often seen during menstruation, pregnancy, or in conditions like PCOS, where androgen levels are elevated.

Chin acne and what it means

Chin acne often signals hormonal changes, especially during the late luteal phase of the menstrual cycle. These fluctuations can increase oil production and inflammation. Persistent chin acne may suggest a hormonal imbalance that needs further investigation.

Neck acne causes

Neck acne, although less common than facial acne, can be influenced by hormones, particularly in women during hormonal fluctuations. Other factors include friction from tight collars, sweat, and residue from hair or skincare products. It's essential to consider neck acne in diagnosis, particularly if other hormonal symptoms are present.

What Causes Hormonal Acne?

Acne, hormonal in nature, can be complex. Understanding the root causes is crucial for effective treatment. These causes can be broadly divided into those that are beyond your control and those that you can manage.

Hormonal Acne Causes You Can’t Fully Control

These are natural phases or predispositions that influence your hormone levels. It’s reassuring to remember these are natural processes, not personal failures.

• Puberty: Increased androgen hormones lead to higher oil production and acne.

• Menstrual Cycle: Fluctuating estrogen and progesterone can cause oiliness and inflammation, especially pre-menstruation.

• Pregnancy & Postpartum: Hormonal changes, notably increased progesterone, can trigger or worsen acne.

• Perimenopause & Menopause: Declining estrogen may result in androgen dominance, contributing to adult-onset acne. Consider using the Menopause Transitions Kit, paired with the Menopause Transitions Mode in the Mira App for tracking.

• PCOS: Elevated androgen levels cause irregular periods, excess hair growth, and hormonal acne; PCOS supplements can be complementary to the main treatment.

• Genetics: A family history of hormonal acne can indicate an inherited tendency for similar breakouts.

Hormonal Acne Causes You Can Manage

Be gentle on yourself; even small proactive steps can lead to significant improvements. Focusing on these manageable factors can help you regain control over your skin's health.

• Chronic stress elevates cortisol, a hormone that can stimulate oil glands and contribute to breakouts. 

• Diets high in refined sugars and processed foods can lead to insulin spikes, which in turn can increase androgen activity and inflammation, thereby worsening acne.

• Lack of sleep and poor stress management disrupt hormone regulation, including cortisol, which can exacerbate acne.

• Products labeled "comedogenic" can clog pores, trapping oil and dead skin cells, which can lead to breakouts. Opt for "non-comedogenic" alternatives.

• Both starting and stopping hormonal contraceptives (like certain birth control pills) or other hormonal medications can cause temporary or persistent hormonal shifts that trigger acne.

Hormonal Acne Symptoms

Identifying the symptoms, such as hormonal pimples, is crucial since hormonal acne may not always look severe; it tends to be stubborn and persistent.

Disclaimer: Only a medical provider can identify the cause of your acne. If you have irregular periods, fatigue, or ongoing acne, seeking guidance on hormonal balance may be beneficial. Consider personalized consultations through the Hormone Health Clinic for Fertility.

Hormonal Acne Diagnosis

While hormonal breakouts can often be diagnosed clinically by a dermatologist based on their location, pattern, and your medical history, some cases may require further testing to confirm an underlying hormonal imbalance.

• Skin examination: A thorough skin examination by a dermatologist is the first step in the process. They will assess the type and location of your breakouts, looking for characteristic patterns and other signs of hormonal imbalance.

• Hormone tests: These may be ordered to check levels of key hormones, including testosterone (total and free), estrogen, progesterone, 17-OH progesterone, androstenedione, TSH, fT4, prolactin, DHEA-S, and cortisol.

• Panorama Lab Test: A convenient hormone panel test to help understand the causes of acne.

• Hormone Monitor, Mira App, and Wands: These tracking tools provide insights into LH, FSH, estradiol, and progesterone metabolites, such as E3G and PdG, highlighting potential imbalances throughout your cycle. You can share this data with your healthcare provider for a comprehensive diagnostic picture.

• Thyroid panel or androgen levels, along with prolactin: These may be checked if conditions like PCOS or thyroid dysfunction are suspected, as they can significantly impact skin health.

• Pelvic ultrasound: In some cases of suspected PCOS, a pelvic ultrasound may be performed to check the ovaries.

It's essential to note that dermatologists and endocrinologists may collaborate to develop a comprehensive treatment plan if deeper hormonal issues are identified as the cause of your acne.

How to Tell If Acne Is Hormonal?

Identifying whether your acne is hormonal can guide you toward the best treatment for hormonal acne. Here are the key signs:

1. Breakouts consistently appear around your menstrual period.

2. Acne is predominantly on your jawline, chin, and neck.

3. You experience deep, painful cysts or nodules that don't come to a head.

4. Your acne doesn't significantly improve with over-the-counter or prescription topical acne medications.

5. Your acne started or significantly worsened in your mid-20s or later.

6. You may also exhibit other signs of hormonal imbalance, such as irregular menstrual cycles, excessive hair growth, or hair thinning.

7. Your breakouts seem to worsen significantly during periods of high stress.

If you recognize several of these signs, discussing a hormone panel test with your doctor could be a valuable next step to confirm if hormones are the primary driver of your acne and to develop a strategy for how to stop hormonal acne.

Hormonal Acne vs. Other Acne Types

How to Treat Hormonal Acne

If you’ve been wondering how to help hormonal acne, you’re not alone — and the good news is, there are effective solutions available. Typically, the first line of treatment includes topical retinoids, such as tretinoin and adapalene, which help unclog pores and reduce inflammation. In many cases, treatment also involves a combination of oral medications (such as hormonal therapy or antibiotics) and lifestyle changes like improved diet, stress management, and consistent skincare routines.

Over-The-Counter and Prescription Options

For mild cases, over-the-counter (OTC) topicals, such as salicylic acid, topical retinoids, and benzoyl peroxide, can be effective in managing symptoms. While more severe or persistent acne may require prescription retinoids, oral antibiotics, oral contraceptives, antiandrogens such as spironolactone, or other hormonal therapies, which your doctor can prescribe.

How to Treat Hormonal Acne Naturally

A low-GI (glycemic index) diet can help manage hormonal acne by reducing inflammation and improving skin health. Focus on non-starchy vegetables, such as broccoli, spinach, beans, and lentils. DIM (diindolylmethane), found in cruciferous vegetables, may provide anti-inflammatory benefits and support hormone balance. 

Additional evidence-based options include vitamin D, zinc, spearmint tea, omega-3 fatty acids, and green tea extract. Some herbs, such as saw palmetto and berberine, are also being studied for their potential in treating hormonal acne.

If you’re in search of a gentle, supportive herbal remedy, then the Mira Fertility Tea might be your answer. This tea is an herbal blend specifically designed to support hormonal health, relaxation, and balance naturally. Additionally, prenatals, even when taken outside of pregnancy, can support nutrient balance and hormonal health by providing essential nutrients, such as folic acid, zinc, and vitamin D. 

Treating hormonal acne takes time, so don’t get discouraged by slow progress. With consistency and patience, you can see results. Always consult with a healthcare professional before trying natural solutions, as they may also suggest hormonal therapy. 

How Long Does Hormonal Acne Last?

The duration of hormonal acne varies significantly depending on its cause. 

If we don't address the root cause, hormonal acne can continue to recur. So, how can you prevent hormonal acne?

How to Prevent Hormonal Acne

To prevent hormonal acne, maintain a simple skincare routine, consider over-the-counter treatments, and try reducing dairy and sugar in your diet. Managing stress can also be beneficial, and hormonal birth control may help balance hormones for some women.

Skin Care Tips to Prevent Breakouts

• Wash your face gently twice daily with mild soap and warm water, especially after sweating. Use clean towels and washcloths regularly. 

• Avoid harsh scrubs and pore-clogging makeup, and opt for non-comedogenic, fragrance-free products instead. 

• Avoid picking or squeezing pimples to prevent worsening inflammation and scarring. 

Diet and Supplements

• Limit or avoid dairy, sugar, and high-glycemic foods, such as white bread. 

• Focus on omega-3-rich foods, such as wild-caught salmon, and include avocados, fruits, and cruciferous vegetables. 

• Incorporate gut-healing foods, such as bone broth and fermented vegetables, and stay hydrated. 

Stress and Sleep Management Strategies

• Regular exercise improves circulation and skin health while reducing stress.

• Engage in stress-reducing activities like yoga, meditation, or deep breathing, as high cortisol levels can trigger breakouts. 

• Prioritize sleep to maintain hormonal balance and prevent acne. 

When to See a Dermatologist

It’s advisable to consult a dermatologist if over-the-counter treatments are ineffective after 6-8 weeks of consistent use, if your acne is causing significant emotional distress or impacting your quality of life, or if you suspect an underlying hormonal condition.

Severe or Cystic Hormonal Acne

This type of acne causes deep, painful lesions with a high risk of permanent scarring. Early and aggressive intervention is vital to minimize this. A dermatologist can prescribe stronger topicals, oral medications, or isotretinoin.

Long-Lasting Breakouts

OTC products are generally formulated for mild to moderate acne. If breakouts continue despite OTC treatments, it's time to seek professional help, as these options may not suffice for chronic cases. A dermatologist can assess the severity, identify potential triggers, and prescribe stronger medications or recommend procedures.

Underlying Hormonal Conditions

Hormonal acne can signify issues like PCOS or thyroid dysfunction. If you have symptoms such as irregular periods, excess hair growth, or fatigue, consult your doctor for testing and targeted treatment. Addressing these conditions is crucial for long-term skin health.

Many dermatologists agree that a combination of lifestyle changes and targeted medical treatments provides the best hormonal acne treatment for women.

Conclusion

It can be frustrating, but understanding how to stop hormonal acne is crucial to effectively managing it. Knowledge fosters self-awareness and empowers you to seek targeted solutions. Its duration varies based on factors like postpartum changes or PCOS, so early intervention is essential to prevent scarring. If over-the-counter treatments fail, consulting a dermatologist or endocrinologist is vital for achieving clear skin and overall well-being.

Frequently Asked Questions

Is there a difference between hormonal acne and adult acne?

Hormonal acne is usually triggered by hormones before menstruation and clears up afterward. In contrast, adult acne often appears randomly, typically due to increased oil production and bacterial growth.

How to know if my acne is hormonal or bacterial?

To differentiate between hormonal and bacterial acne, look at the breakout's location, timing, age of onset, and treatment response. Bacterial acne often occurs in oily areas, while hormonal acne typically appears on the lower face and jawline, worsening before menstruation or during ovulation. 

Can skincare help hormonal acne?

Yes, to a limited degree, skincare can help manage and reduce the effects of hormonal acne, but your doctor will need to directly address the underlying hormonal imbalances.