Exactly What Causes Hormonal Acne, and How to Clear It Up
Your period is swiftly approaching, and that all-too-familiar feeling of an underground, painful cystic bump bubbling under the surface of your skin is here to ruin the day. Trust us when we tell you that you're not alone in this little hormonal acne dance.
"When we say 'hormonal acne,' we mean acne that occurs or gets worse in cyclic flares along with monthly menstrual cycles," explained Dr. Jennifer MacGregor, an NYC-based dermatologist. "It's typically worst during the week right before your period starts when progesterone, [a hormone], is at its peak." She said that some signs that you have hormonal acne are cyclic flares each month and distribution along the lower face, including your jawline and around the mouth. They also tend to be deeper, painful pimples, as opposed to blocked pores, blackheads, and whiteheads.
Fortunately, several treatment options exist that can leave you with clearer skin and, most importantly, reduced pain and discomfort.
Who Gets Hormonal Acne?
When it comes to full-grown adults, hormonal acne refers specifically to period-related acne. "Men also have issues with hormonal acne, but in general, doctors do not call it hormonal acne," dermatologist Dr. Lady Dy said. "The height of a man's hormonal acne is in their teens — 13 years old to early 20s — when they're making the most testosterone. On average, after their mid-20s, men's testosterone levels slowly decrease for the rest of their life."
Dermatologist Dr. Craig Austin added that females typically experience hormonal acne during puberty and well into their 30s.
Because hormonal acne is an "inside" issue, dermatologists agree that oral prescriptions are often the most effective. In fact, Dr. MacGregor said that one of the hallmarks of hormonal acne is that it is typically resistant to over-the-counter remedies. The ultimate goal is to regulate haywire hormone fluctuations from the inside out.
"We almost always need to use oral medication to treat hormonal acne," she said. "Birth control pills — [which] regulate cycles and reduce acne — and spironolactone — which blocks androgen hormone receptors in the skin — are the typical medications used. Occasionally, a trial course of isotretinoin is used for severe cases but doesn't always work. For mild cases, topical Aczone (dapsone) is a very well-tolerated prescription anti-inflammatory that has some efficacy in hormonal acne."
It's important to talk to your dermatologist about a treatment plan that works best for your skin.
Although oral medications are considered the go-to treatment for hormonal acne, you can still incorporate specific ingredients into your regimen that will help reduce and treat bumps. "Glycolic acid is highly recommended, as it's one of the more natural OTC products that actually work and gets to the root cause of the acne by purging the pores of the sebum," Dr. Austin explained. "It not only helps treat the cyst but also helps heal it by speeding up exfoliation, therefore making scarring lighter."
Additional OTC options, he said, include salicylic acid, which acts as an antibacterial to heal the inflammation, and topical retinols, which reduce clogged pores. These ingredients, along with benzoyl peroxide, will also help reduce and treat other acne types, which you may very likely experience alongside hormonal acne.
"Almost every individual suffering from cystic acne will have a combination type of inflammatory and noninflammatory acne comedones (whiteheads and blackheads)," Dr. Dy said. "Treatment always includes benzoyl-peroxide-based products and salicylic-acid-based products. The benzoyl peroxide helps get rid of the bacteria that creates inflammation. The salicylic-acid-based products penetrate the pores to help loosen up the skin cells so that you don't get clogging of the pores."