If you’re over 21, there’s a good chance you’re struggling with hormonal acne — which honestly, really doesn’t seem fair. After all, most women in this age bracket were brought up to believe that acne was a teenage thing; but according to a recent survey of over 1,000 women from BodyLogicMD, hormonal acne is on the upswing… as is the average age of acne sufferers. Luckily, modern dermatologists now have a deeper understanding of this issue than ever before — including some fresh ways to treat hormonal acne that you probably haven’t tried yet.
“Even though teenagers are still the most common age group affected by acne, in my practice I am seeing more and more women between the ages of 20 and 50 who still have this complaint,” Dr. Kelly Wood, a board-certified endocrinologist and hormone specialist based in Atlanta, tells The Zoe Report. This aligns with the findings of BodyLogicMD’s survey, in which 60 percent of millennials and nearly 40 percent of Gen X participants report struggling with acne. Of those, a whopping 74 percent believe hormones are to blame.
What Is Hormonal Acne?
"The male sex hormones, androgens, which are present in both men and women (though higher in men), contribute to hormonal acne," Dr. Wood explains. "These androgens, such as testosterone, trigger the oil glands to make more oil and also cause the skin cells that line the hair follicles to become overly sticky and clog the pores, thereby leading to breakouts."
The oil glands on our chin and jawline are particularly sensitive to this change as well, Dr. Caroline Robinson, a board-certified dermatologist, tells The Zoe Report. “Because of this, acne that is limited to the lower face is one telltale sign that acne may be hormonal in nature.” You can also tell if a breakout is hormonal based on what time of the month it appears — if pimples pop up the week before your period or the week of your period, you can probably chalk them up to natural hormone shifts, as this is when androgens typically surge. “These tend to be deeper, inflamed bumps and cysts, and are less likely to be whiteheads and blackheads,” the dermatologist adds.
The Causes Of Hormonal Acne
“The concern that hormonal acne is more prevalent could be due to several factors, like women talking about it more, increased environmental toxicity, and the prevalence of xenoestrogens — or chemicals that cause hormone imbalances — in our environment,” Dr. Jolene Brighten, a functional medicine naturopathic medical doctor and the author of Beyond The Pill, tells TZR. “We also need to acknowledge the role of processed food and medications that can lead to nutrient depletions, hormone disruption, and poor gut health.”
“Birth control use is on the rise, and the hormonal changes which occur after discontinuing or starting a birth control pill [or hormonal IUD] also cause acne,” Dr. Wood says; while Dr. Robinson adds that patients with Polycystic Ovary Syndrome (PCOS), a hormonal disorder, will often present with hormone-related acne, as well.
Basically, this type of acne is “multifactorial,” as Dr. Brighten says. From diet to lifestyle to birth control and plain old hormonal imbalance, there are multiple causes of hormonal acne — and often, more than one is present in each individual patient — which makes it hard to pin down a single effective treatment.
How To Treat Hormonal Acne
Dermatologists usually treat hormonal acne in one of three ways: with birth control, Spironolactone, or retinoids. “The Food and Drug Administration has approved several oral contraceptive pills for use in the control and management of acne,” Dr. Robinson explains. “These pills can help regulate hormonal levels and their impact on skin.” (But given the fact that starting and stopping birth control can actually lead to more hormonal acne, this might not be the best course of treatment for you.) Spironolactone, on the other hand, is actually a prescription blood pressure medication that blocks the effects of hormones on oil glands and acne. “Topical retinoids are helpful in all forms of acne, because of their effect on unclogging pores,” Dr. Robinson says. “This can also help to control excess oil related to hormonal acne.”
While you should talk to your dermatologist about all of these standard options if you haven’t already, there’s research to support seven new, prescription-free methods for battling hormonal blemishes. Ahead, all the derm-approved options you probably haven’t tried yet.
Cut Out Dairy: “Elimination of dairy has helped many of my patients resolve acne,” Dr. Brighten says. “Don't hate me! Often, women need to give it a good six weeks of zero dairy to see results.” Dr. Wood notes that skim milk is a major offender, and suggests swapping out the skim in your morning coffee for almond milk.
Eat Hormone-Healthy Foods: “Foods with a high glycemic index, such as such as white bread, highly processed foods, pasta, and sugary drinks have also been associated with acne and should be avoided,” Dr. Wood says. “These foods increase blood sugar levels and promote insulin levels, which causes your skin to produce more oil.” Instead, she suggests loading up on low-glycemic foods like whole grains, fruits, and vegetables.
“Increasing zinc and vitamin A in your diet by eating more sweet potatoes, broccoli, oysters, and pumpkin seeds can not only feed your skin, but also help your immune system clear organisms that contribute to acne,” Dr. Brighten adds.
Try Bioidentical Hormone Therapy: BodyLogicMD, the company that conducted the aforementioned study, offers something called “bioidentical hormone therapy” to help level out hormonal imbalances. “Our programs help hormone-related acne by replacing and balancing one’s own hormones with bioidentical hormone therapy,” a representative for BodyLogicMD tells TZR. “Many times, acne is related to either too little progesterone or too much testosterone or DHEA. Balancing all of the hormones almost always results in improvement of the skin, not just the acne.”
Start Seed Cycling: “Seed cycling is the practice of eating specific seeds to support hormone balance through your entire menstrual cycle,” Dr. Brighten says. “The practice is quite simple: During your follicular phase (the first day of your period until ovulation), you'll eat one to two tablespoons of fresh ground flaxseeds and raw pumpkin seeds, which supports both estrogen production and metabolism. Following ovulation, which can vary for each woman, you switch to one to two tablespoons each of raw sunflower and sesame seeds. These seeds support progesterone levels, which is the key hormone during the luteal phase (the phase following ovulation until your next period).” The company Food Period offers monthly seed cycling kits to make natural hormone balance as easy as possible.
Reduce Stress: “Researchers have also found an association between stress and acne flare up, and as a society, we are under more and more stress,” Dr. Wood tells TZR. Theoretically, reducing stress in your life — whether through meditation or using an anxiety-reducing app — could also reduce your breakouts.
Use Period-Friendly Skincare: “There are certain skincare ingredients believed to affect hormone activity on a local level — so-called ‘endocrine disrupting chemicals,’” Dr. Robinson says. According to the Environmental Working Group (EWG), commonly used ingredients like BPA, glycol ethers, and phthalates fall under this umbrella. In these cases, your skincare could actually be making your hormonal acne worse.
“It was essential for us to ensure our ingredients have top EWG safety ratings and are known for being gentle and mindful of the female reproductive system,” Jeana Chung, the VP of Marketing at clean beauty company Knours, tells The Zoe Report. All of Knours’ products are formulated to support skin throughout monthly hormonal fluctuations. The brand’s latest release, the Be Kind To Your Skin Sheet Mask, is ideal for treating dull, flaky, pimple-prone PMS skin. “It is recommended to be used as a substitute of your daily skincare regimen, so you can have all of the necessary nutrients you need to keep your skin in tip-top shape, especially during that time of the month, with no excessive skincare,” Chung says.
Clean Out Your Makeup Bag: It’s not just skincare that might be messing with your hormones — endocrine disruptors could be lurking in your makeup products, too. “Avoid cosmetics with known endocrine disruptors, which are chemicals that cause hormone imbalance and can contribute to acne,” Dr. Brighten says. Cross-check your go-to products' ingredient lists with the EWG’s database to make sure your concealer isn’t hurting more than it’s helping.