Did you know that acne affects almost one in every 10 people worldwide? For that reason, acne, or acne vulgaris, has become one of the world’s most prevalent diseases.

Acne is most common in postpubescent teens, especially boys, but anyone can develop it. Even older people, including women at their menopausal stage, can experience breakouts.

After all, acne is a skin condition that hormones exert a lot of influence on. In particular, researchers believe there’s a link between acne and estrogen in women.

So, how and why exactly do hormones cause acne, and what are the roles of estrogen in this case? Is there anything you can do about hormonal acne?

We’ll answer all these questions in this guide to hormones and acne, so be sure to read on!

What Exactly Is Acne?

Acne occurs when the hair follicles beneath the skin become clogged with oil and dead skin cells. There are two main types: non-inflammatory and inflammatory acne.

Non-inflammatory acne, such as whiteheads and blackheads, usually doesn’t cause swelling. Inflammatory acne is what you likely know as pimples. It’s the inflammatory type that causes red, swollen zits.

Non-inflammatory acne is often easier to treat with over-the-counter products. Salicylic acid is one of the most common ingredients used in OTC acne treatments. Be careful when using salicylic acid products, though, as some people are allergic to it.

Inflammatory acne can be harder to deal with as it can result from bacterial infection. Propionibacterium acnes (P. acnes) is the bacterium species associated with inflammatory acne. P. acnes can lead to the formation of comedones and lesions and exacerbate swelling.

What About Estrogen?

Estrogen is one of the two main female sex hormones, the other being progesterone. However, men also have a small amount of estrogen, just like how women also have some testosterone.

Estrogen is the hormone responsible for puberty, which brings about characteristic female features. It’s also crucial for menstruation, reproduction, child-bearing, and even cholesterol control.

What Then Is the Connection Between Acne and Estrogen?

Some health professionals say that acne and hormones always go hand in hand. According to these medical doctors, hormones mediate all cases of acne. So, it’s no wonder that up to 85% of adult women say their acne worsens days prior to their menstrual cycle.

Hormones trigger acne since hormonal fluctuations can affect skin processes. One such process that hormones can affect is sebum production.

Sebum, in turn, is the oily, waxy compound that moisturizes and protects the skin. The body’s sebaceous glands are responsible for producing this substance. These glands are in the skin’s middle layer, known as the dermis.

While sebum is crucial to keeping the skin moisturized, too much of it can lead to acne development. Increased sebum production caused by hormones can then lead to hormonal acne.

Estrogen, in particular, seems to play a role in acne by influencing sebum production. Researchers also think that this hormone counteracts the acne-causing effects of testosterone. Moreover, they believe that estrogen may have regulating effects on the sebaceous glands.

What’s the Link Between Estrogen and Testosterone in Acne Development?

Testosterone is an androgen (male sex hormone) that the female body also produces. However, the female body only makes between 1/10th and 1/20th of the testosterone the male body produces.

As crucial as testosterone is to bone health and sex drive, too much of it can lead to excessive sebum. This may then lead to the inflammation of the sebaceous glands. As a result, an acne breakout may follow.

According to researchers, estrogen can inhibit testosterone secretion. In this way, it may lower the levels of free testosterone in the body. Lower testosterone levels, in turn, may result in acne improvement.

When Is Hormonal Acne a Problem?

Hormonal acne can be a problem not only during puberty but also up to the menopausal stage. An early study found that about two-thirds of female teens in the U.S. and more than half of those in their 20s have it. The same survey revealed that acne affects one in four women in their 40s and 15% of those in their 50s or older.

In menstruating women, hormonal acne may be more common just before they menstruate. It’s at this time of the month wherein the estrogen and progesterone levels are at their lowest. By contrast, testosterone levels remain constant and undisturbed.

Acne can also occur during perimenopause, wherein estrogen levels start to decline. This usually occurs eight to 10 years before the menopausal stage, but it can happen earlier. So, even if it commonly starts around the age of 40, some women in their 30s can already transition to this stage.

The body then stops producing estrogen by the time a woman hits the menopause stage. This may help explain why some women in their 50s experience a resurgence in acne.

How To Get Rid Of Hormonal Acne

OTC products may work on mild acne, but oral medications may be more effective for more severe cases. These include estrogen medications such as oral contraceptives, as well as anti-androgen drugs.

Prescription retinoids, which are vitamin A derivatives, may also help. These are usually topical products applied directly on acne-affected skin. Since they are prescription-grade, these are more potent than OTC retinoids.

Making healthier dietary choices, especially when it comes to cholesterol, may also help. After all, a small amount of cholesterol in sebum, so high cholesterol diets may also affect acne. In fact, researchers found patients with acne to have higher cholesterol levels.

Keep Your Skin Clear of Acne

There you have it, everything you need to learn about acne and estrogen, as well as testosterone. Just remember that even if you can’t control your hormones, it doesn’t mean you can control acne.

However, it’s best to seek your doctor’s advice before you start using acne treatments. This way, your doctor can help you choose the right products while you get to avoid aggravating your zits.

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