Skin problems can be frustrating, embarrassing and even painful. Are you struggling with adult acne? If so, you may need to tune into your hormonal health.
Hormones — our body’s chemical messengers — are secreted by the glands of our endocrine system. They communicate with our body’s organs, of which the skin is the largest.
Whether it’s a few irritating extra pimples or a cluster of deep, sore red cysts, a hormonal imbalance often underlies adult dermatological despair. Even a small hormone issue can be reflected in our skin.
Let’s explore the relationship between our skin and hormonal acne. What causes the problem and what treatments options do I have open to me if I’m suffering?
What is hormonal acne?
Also known as adult acne, hormonal acne describes breakouts of spots that appear long after the teenage years. Usually occurring on the lower half of the face, hormonal acne affects adults of any age, but women are more likely to experience it than men.
Hormonal acne is often tied to fluctuations and imbalances in your hormones, in particular a rise in androgen ‘male’ hormones. Menstruation and menopause are particularly closely linked to hormonal acne.
Other common causes of hormonal acne can include polycystic ovarian syndrome (PCOS). PCOS is characterised by our bodies creating more androgen hormones like testosterone, resulting in the skin’s glands secreting more oily sebum.
What are the symptoms of hormonal acne?
The key symptoms of hormonal acne are spots around the jawline, chin and the mouth. This differs from acne that very commonly occurs during puberty, which usually appears in the ‘T zone’ — your forehead, nose and chin.
No two cases of hormonal acne will look the same, but you may notice a range of different types of spots, including:
- Whiteheads: Also referred to as closed comedones, these are closed beneath the skin, appearing as a small white spot.
- Blackheads: Small spots that appear at the surface of the skin — they turn black after interacting with the air. Also known as open comedones.
- Papules: Caused by irritation and inflammation of the hair follicles, appearing as raised red bumps.
- Nodules: Similar in appearance to papules, but larger in size.
- Pustules: Small, raised pimples that contain a yellow-ish head of pus.
- Nodules: These lie deeper in the skin and can be large and painful.
- Cysts: The most serious type of acne, these large, red lumps lie deep in the skin.
How does hormonal imbalance affect the skin?
As our body’s largest organ, it’s probably no surprise that the fate of our skin is so intimately tied to our hormones.
The skin is covered in small sebaceous glands. These secrete a substance called sebum — an essential oil for the health and maintenance of your skin. These glands contain receptors that respond to hormones in our body. They are very sensitive to certain hormones, particularly androgens like testosterone.
The more androgen hormones there are in your bloodstream, the more likely it is that they will bind to the receptors in your sebaceous glands, resulting in greater oil production — and therefore a higher chance of oily skin and clogged pores, which result in acne breakouts.
Our sebaceous glands are also sensitive to oestrogen. It is understood that this female sex hormone stops oil production; oestrogen is known to hydrate our skin, boost collagen levels and support wound healing — all good news for our dermatological health.
What are the causes of hormonal acne?
Hormonal acne is usually caused by hormonal fluctuations that lead to a relative increase in androgen hormones like testosterone. This can be as a result of the menopause, menstruation, polycystic ovarian syndrome, contraceptive pills, or certain hormonal disorders like PCOS. Your predisposition to acne can also be affected by your genetics.
During the menopause, oestrogen levels fluctuate wildly, leading to a