There’s a lot of factors that can cause acne.

But still, the most common type of acne I see is hormonal acne.

So, let’s look at all the hormones that play a part in hormonal acne.

Firstly, how do we know hormones are a major player for you? (I mean, besides our amazing Skin Appraisal quiz!)

You may have:

• A history of oral contraceptive pill (The Pill) use... maybe being prescribed for the acne or maybe this was prescribed before the acne started

• Painful or irregular periods

• Cycles of acne worsening throughout your menstrual cycle (especially in the two weeks leading up to your period… though I have to say a lot of women I treat aren’t aware of this link until we have been tracking their acne and period for a month or two)

• Acne worse on the jawline/chin area (though hormonal acne isn’t necessarily isolated to this one area… you can have hormonally driven acne also appearing on the forehead, back and chest)

Another big giveaway is if your acne has been helped by the Pill. This is massive because the Pill shuts down a lot of our hormone production, so if putting a pause button on your hormones has paused your acne then booyah, we know our major player.

So, now that you know if you fall into the hormonal acne category, let’s explore some of the hormones that are actually responsible for acne.

Testosterone & Androgens

The infamous bad boy, testosterone. Yep, testosterone is known as the male hormone, but women also produce testosterone. It’s important to produce testosterone in balance. Problems like acne (and period problems) occur if testosterone is too high. Testosterone (and other androgens) affect the sebaceous glands in the skin, making them produce more oil. This can clog the pores, and cause acne.

And, it’s not just testosterone to look at. There’s also derivatives of testosterone, like dihydrotestosterone (DHT) which is actually way more powerful than testosterone. Hormones that act like testosterone are called androgens… and when I’m investigating hormonal acne I make sure that we do an extensive check of these!

Estrogen & Progesterone

These ones are a bit tricky because it all depends on what levels each hormone is at in correlation with the other. To figure this out, I look at the ratio of estrogen to progesterone. This can show estrogen dominance and low progesterone, which is massively important to know so that your hormonal acne can be treated effectively.

So, what’s the deal with estrogen? Well, when it’s not dominant, it’s great for the skin.

Estrogen is supportive and nourishing to the skin. Just as testosterone and androgens stimulate the sebaceous glands to produce too much oil, estrogen does the opposite and helps to bring down sebum oil levels. This is also why your skin can be more prone to infection when estrogen is low, because estrogen supports the skin barrier function. When the skin barrier function is low, infection is much more likely (there’s lots of things that affect skin barrier function by the way!).

If you notice that your acne worsens in the two weeks leading up to your period, then a very likely problem is progesterone. Progesterone increases in the second half of the menstrual cycle and is affected by other hormones that are produced in the brain and the ovaries.

Stress hormones

The major one that I look at in hormonal acne is androstenedione and cortisol. Androstenedione is an androgen that is produced by the adrenal glands. If this is elevated, then it shows me that stress and adrenal function is a huge player in why your hormones are out of whack and why you have hormonal acne.

Cortisol is one of our major stress hormones, which is also produced by the adrenals. Cortisol can throw our progesterone production out of whack, especially if we are experiencing prolonged stress, and usually we will see this alongside high androstenedione and menstrual irregularities. So, stress hormones might be the first place you look for answers to acne, but they can certainly be responsible … I mean, they are hormones after all!

Knowing a bit about hormones is massively helpful in being able to understand more about your acne, and see patterns that you may not have otherwise been aware of in relation to your stress and your period.

I use a lot of hormone testing in the clinic so that we have clear cut answers around what hormones need addressing for the quickest and most effective treatment.

If you are thinking of getting your hormones investigated, make sure you check out this blog all about hormone testing first!

Remember, it is in your uniqueness that you will find your answers.

Let your beauty shine, spots or not.