BREAKING DOWN HORMONAL ACNE

What’s the deal with adult hormonal acne?

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Gone are our days of pimply puberty, but adulthood has a new problem to throw our way: hormonal acne. Although it may resemble regular acne, hormonal acne has a more complex system of causes and treatments. The cystic nightmare is one of the most common skin conditions in adult women (it affects them more frequently than men), which means there’s fortunately lots of information and solutions for combating it.

THE UGLY TRUTH
As the name suggests, hormonal acne is caused by an imbalance of hormones and can affect anyone. It’s often characterised by ‘cyclical breakouts’ coinciding with your menstrual cycle, but can also align with physiological shifts such as during pregnancy, childbirth or menopause, or hormonal changes linked to conditions like polycystic ovarian syndrome (PCOS). Usually, the acne shows up on the lower chin, but can extend to the entire face, neck and back.

Your sex hormones are mostly to blame: oestrogen, progesterone and androgens. They stimulate your sebaceous glands (responsible for secreting oil called sebum), which can clog pores and cause acne. Oestrogen helps to regulate and lower sebum production, whereas progesterone and androgens (testosterone in particular) ramp it up. This acne is inflammatory and suddenly occurs or worsens when you’re in your 20s, but can affect all ages. More than 50% of women experience it.

"HORMONAL ACNE ISN'T YOUR FAULT - WE ALL GO THROUGH FLUCTUATIONS IN OUR HORMONES"

EW! GET RID OF IT
Hormonal acne isn’t your fault – we all go through fluctuations in our hormones and have different skin types, some of which secrete more sebum. Your best bet is to consult a dermatologist, who can get to the root cause of the acne, especially if you’re experiencing cystic (inflammatory) acne. If you have mild to moderate blackheads and whiteheads, then you can treat it with lifestyle changes and skincare treatments, but if you’re facing cystic acne, you may need to use prescription oral or topical medications.

The two major oral medications prescribed for regulating and stabilising hormones are birth control pills and spironolactone, both of which decrease the effects of androgens in your body.

Accutane (a potent form of vitamin A) could be prescribed, but it can be harmful, so your doctor will monitor your dosage through blood tests. If you’re interested in using topical treatments, retinoids are a first line of defence. They help to keep your oil glands clean so that bacteria don’t have anything to feed off to create inflammation in your skin. Prescription strength retinoids are most effective against cystic acne, as many of them are formulated with additional benefits like antibiotics and anti-inflammatories. You will also find over-the-counter benzoyl peroxide formulas, topical ointments that assist with unclogging pores and preventing the build-up of bacteria. They can be harsh on sensitive skin, so always test it out first or speak to your doctor before buying.

FIGHT FROM THE INSIDE
Your diet greatly affects your skin. Sugar, oily food, dairy, processed foods, caffeine and alcohol can spike acne-causing hormones – as well as other hormones like insulin, which has a ripple effect on the rest of the hormones that can cause inflammation and breakouts. Try limiting your intake of these foods significantly for at least two weeks to see if your skin calms down.

Stress and lack of sleep can also worsen hormonal acne, since the stress hormone cortisol can send your oil glands into overdrive, leading to excess oiliness, inflammation and pimples. When your cortisol levels are continuously high, it can trigger breakouts. Get your eight hours of sleep in, and practise good stress management. Hormonal acne can be an annoying part of life – especially when it’s in plain view of everyone. But it won’t last forever. Speak to your doctor about treatment options and adopt a lifestyle that reduces stress and triggers.

DEALING WITH ADULT ACNE
– Resist the temptation to pick or squeeze pimples.
– Expect to use treatments for at least two months before seeing results. Be sure to use them correctly.
– Choose an oil-free moisturiser and wear make-up that is oil-free or water-based. Look for ‘non-comedogenic’ on product labels (these should not cause black/ whiteheads) and products containing salicylic acid.
– Cleanse your skin twice daily with a mild soap or gentle cleanser and water.
– It’s best to stay away from facial scrubs or exfoliating products.
– Avoid direct sun exposure and use a water-based sunscreen daily.
– Eat more leafy greens and anti-inflammatory foods (such as oats and berries).


Words by: Saadiqah Schroeder
Photography: Gallo/Getty Images