Thought your acne days were over? Think again. Even if you didn’t experience breakouts as a teen (lucky you), hormonal acne is extremely common in women ages 20–40. So frustrating! To make matters worse, it can be difficult to treat—but certainly not impossible.
The first step to getting rid of hormonal acne is to understand the cause of it and which treatments are most effective.
Hormonal acne, also known as adult acne, is triggered by hormonal fluctuations, or shifts in your hormone balance. You’ll usually notice breakouts during certain points in your menstrual cycle, or during pregnancy and menopause.
Quick science lesson: When your levels of estrogen and progesterone shift, your levels of testosterone rise. Increase in testosterone can increase oil production, particularly around the jaw and chin area. You may also experience worsening breakouts on your back, chest and shoulders. You’ve probably noticed that your hormonal breakouts tend to occur in the same place each month around the same time in your cycle—this could be because a particular pore has become enlarged or simply produces more oil as a result of the hormone fluctuations.
What makes it worse? Stress.
In addition to testosterone, cortisol, our natural stress hormone, is affected by estrogen and progesterone fluctuation, too. Bad news: If you’re already prone to hormonal breakouts in the first place, and then add stress into the mix, you’ll further worsen your breakouts with the addition of cortisol fluctuations. This might be why you notice some changes in severity of the breakouts from month to month. Ugh.
Hormonal breakouts are typically deep and painful because of the accumulation of oil and debris trapped in the pore for a long period of time. They also tend to pop up in the same locations over and over, and are more chronic areas of breakouts. These are different from the inflamed papules and comedones noted in teenage acne—which is why hormonal acne can be more difficult to treat than traditional acne (which usually responds well to antibacterial treatment and exfoliation).
Although hormonal acne is difficult to treat, it’s certainly not impossible. Cue the celebration!
First and foremost, consistency with products is going to help—especially when it comes to exfoliation. You want to make sure dead skin cells are being regularly removed, which helps decrease the opportunity for them to get trapped in the pore with excess oil (warning: this is the perfect situation for a breakout to occur).
However, once you start struggling with hormonal acne, you’ll want to make an appointment with your dermatologist sooner rather than later. Oftentimes, you’ll need help regulating your hormones, which can be done with certain medications you can only get from your physician.
Let’s take a deeper dive into the five most effective types of hormonal acne treatments…
Look for a good salicylic acid or glycolic cleanser, like Cerave’s Renewing SA (Salicylic Acid) Cleanser. This will help remove dead skin cells and turn over cells more rapidly, lessening the chance of them getting trapped in your pores and causing breakouts. You’ll also want to use your cleanser on areas of your body that tend to break out, like your back, chest and shoulders. Follow it up with an exfoliating leave-on treatment like Versed Back-Up Plan Acne-Control Mist for your body and Otto Skin Goods Multitasker Night Serum for your face.
When to see a dermatologist: If you’re unable to control your acne with cleanser or leave-on exfoliating treatments, notice consistent breakouts throughout your cycle, or experience scarring from hormonal acne—it’s time to see your dermatologist. They’ll be able to offer you the following therapies…
I’m not a fan of treating adult acne with over-the-counter retinoids. They’re fine for anti-aging or mild teenage acne, but mostly ineffective for adult acne—so don’t waste your time. Instead, see your dermatologist for a prescription-strength topical retinoid to help control oil supply with superior exfoliation results.
Birth control pills are a good alternative for those with sensitive skin who can’t use harsh exfoliating products or prescription-strength retinoids. Treating hormonal imbalance by regulating your cycle might be the easiest way to control your cyclical breakouts. Luckily, there are now pills designed specifically for hormonal breakouts by stabilizing your hormone levels.
Spironolactone is the most common androgen-blocking medication. If you don’t love the idea of being on birth control pills, but believe stabilizing your hormones is the best option for treating your breakouts, spironolactone might be your answer. This pill works by blocking androgen receptors in the body, which decreases the testosterone levels. In turn, it reduces oil production in the skin, which is often the cause of chronic breakouts.
This medication gets a lot of bad press, but the bottom line is that it works for a lot of people. While it may be less effective for hormonal acne versus other types, it’s still an option—especially when other therapies have proven unsuccessful. Deciding whether or not you’re a good candidate for this therapy can only be determined by your physician. Even if it may not be right for you, let’s keep the judgment of it to a minimum. It’s been extremely helpful for many, especially those who haven’t responded to other treatments.
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