How to Heal Hormonal Acne Naturally
I think that hormonal acne is one of the trickiest types of acne to deal with. I deal with it, and many thousands of others deal with it. It sucks, and it's persistent, and it's annoying.
Clinically, patients with hormone-related acne can be recognized by the concentration of lesions along the jaw line, cheeks and chin. This is generally called the "beard" area/the muzzle/etc., and is considered the hormonal acne area because it is a hormone-sensitive area (men grow beards, women get acne - due to an increase in certain hormones). Acne on other parts of the face is generally not considered to be hormonal, although acne on the body may be hormonal.
Hormonal acne also tends to be nodular, acne that is large and deeply embedded, which seldom comes to a head and tends to stick around for prolonged periods of time. This is because hormones pump sebum deep into the follicle, making the pimples deeper rather than superficial.
Hormones are molecules that are involved in just about every biological process that takes place in the body, which includes:
Organ and cellular growth
Control of energy levels
Hormones work by carrying instructions from endocrine glands, tissues and cells to points all over the body. They are released and travel throughout the body, either in the blood stream or in the fluid around the cells, looking for target cells with a receptor that fits.
Once they bind with a receptor, they change the cell's activity, and send a signal to the cell to produce a certain protein, or to multiply.
The protein receptor then "reads" the hormone's message and then either influences gene expression or alters cellular protein activity. These actions then produce a variety of rapid responses and reactions in the body.
It seems that no matter what we do, complete treatment eludes us - we are always left with some amount of hormonal acne and hormonal breakouts (at least until we "grow out" of our hormones).
On that note, some people have a misconception of when we truly grow out of those hormones, and for the most part we never really do. Just because you're a 20-something or 30-something doesn't mean you're too old for acne (unfortunately - acne isn't just a condition of teens). No, no, my dear, you're just as susceptible to hormonal changes influenced by a multitude of factors. Women tend to suffer hormonal fluctuations right up until menopause, although some women experience their hormones balancing during their twenties, after pregnancy, during pregnancy, etc. Everyone is different. But the point is, if you're still dealing with acne into your forties - it's probably hormonal! Males, however, tend to experience one large hormonal flare-up in their teens and it usually tapers off from there (although it can be influenced by hormonal therapy, such as for transgender individuals on hormone medication, or people using steroids). Lucky buggers.
90% of acne patients spontaneously remit before 30 years of age, leaving the rest with an unpredictable course or persistence well into our 40s, and sometimes even 50s.
Though most acne patients remit spontaneously, for the ones that do not or are unresponsive to conventional therapy or have obvious cutaneous signs of hyperandrogenism, hormonal therapy is the next option in the therapeutic ladder.
So, now that we know that women especially can still experience hormonal acne well into their thirties and forties (sorry, ladies!), what are our treatment options?
Conventional Treatment Options
Most hormonal therapies are directed at suppressing ovarian or adrenal sources of androgens or blocking activation and action of androgens in sebaceous gland and probably follicular keratinocytes, as well. This can be accomplished by using the following:
1. Oral contraceptives are generally not encouraged for young women, as it can impede the natural hormonal process of aging, which may actually result in hormonal acne after ceasing use, later in life. This is a similar scenario for what happened to me and why I got bad acne - I went on the pill at a young age, and stayed on it for many years. This inhibited my body's ability to grow and develop naturally without endogenous hormones, which caused a hormonal reaction when I quit taking it. But don't fear, this is mostly common in younger women.
However, one of the best treatments for hormonal acne is oral contraceptives as they help to reduce sensitivity and inflammation in the skin, as well as help to increase estrogen levels, which are generally regarded as beneficial to the skin. Estrogen, in high doses, decreases the size of sebaceous gland and reduces sebum production by reducing endogenous androgen production via a negative feedback effect on the pituitary gonadal axis.
2. Androgen inhibitors are another common hormonal acne therapy. This may be referred to as DHT medicated acne, a specific anti-androgen which inhibits the enzyme 5a Reductase, without actually blocking the androgen receptor.
Like oral contraceptives, androgen inhibitors are only prescribed by doctors. Anti-androgen drugs that contain cyproterone acetate (CPA) appear to have a very positive effect on hormonal acne control. This is due to its anti-androgen profile and the impact that androgens have on our skin (such as androgen receptors in the follicle, as well as sebum production, and hyperkeratosis).
Overall an improvement of 75-90% has been reported in patients treated with CPA 50-100 mg daily prescribed for 3-6 menstrual cycles.
However, hormonal anti-androgen treatment is limited to female patients who present additional signs of peripheral hyperandrogenism or hyperandrogenemia.
3. One of the better acne treatment options is Azelaic acid, a naturally-occurring Dicarboxylic acid. The acid is a potent inhibitor of 5A reductase. It's anti-bacterial and anti-keratinising which means that it normalizes the abnormal growth of skin cells. It is also a scavenger of free radicals helping to reduce inflammation, which is an added bonus!
Treating hormonal acne through the use of topical antibiotics is not ideal and may actually end up being counter-productive.
Non-Conventional Treatment Options
While the above-mentioned options are the best bet for anyone suffering from hormonal acne, there are of course people who either cannot use those methods (for health or other reasons), or who choose not to. Whatever the prerogative, there are some less-guaranteed but equally promising methods available.
1. Green tea consumption may have the potential as an alternative hormone therapy. Green tea supplementation may have the potential to improve insulin hormone levels. Furthermore, there is some inconclusive but still interesting data that suggests that green tea has the potential to decrease testosterone levels.
Keep in mind that these results are preliminary and are not yet fully understood or tested.
2. There's some evidence to suggest that omega-3 consumption (in the form of things like short-chain fatty acids like ground flax and walnuts, or long-chain fatty acids like sea algae) may be beneficial for hormones.
Dairy milk's main purpose is to stimulate growth in baby calves - why on earth would you be consuming it?
4. Spearmint tea may have anti-androgen properties reduce the level of free testosterone in the blood, while leaving total testosterone and DHEAs unaffected. After treatment with spearmint teas, there was a significant decrease in free testosterone. This, however, does not necessarily translate into having clear skin - but it may be worth a shot.
5. SKIN+ Tea has a bunch of different ingredients, which I go over in my eBook that may be especially great for hormonal acne. You can get it here. It's something that I personally drink every day, sometimes twice a day - I notice that when I drink it, I don't get any pimples around my period!
6. Sometimes cortisol levels can have an effect on hormonal acne. This is the stress hormone, and even though you don't feel stressed your cortisol could be telling a different story. Be sure to check your cortisol levels by seeing your doctor for an adrenal saliva test at which point you can consider alternative treatments like Seriphos (keep in mind that this will help lower high cortisol levels, and an adrenal saliva test is imperative to determine if/when your cortisol levels are high; it's important not to take Seriphos at a time in the day when your cortisol is typically already low).
7. Insulin levels may also play a role in your hormonal acne. It's important to ensure you're not consuming insulinotropic foods; stick with foods high in fiber and fat (avocado, sweet potato, beans, etc.)
As with everything else, a diet full of fresh fruits and vegetables and a good skin care routine are also important in clearing your skin.
Whatever route you choose, make sure to get hormone testing done to rule out any underlying health problems; and remember: just because you have hormonal acne, doesn't mean your hormones are out of whack - your hormone levels could be just fine. It simply means that your skin is more hormonally-responsive.
While there is still a long way to go before we find a safe and effective way to completely rid us of hormonal acne, science is certainly making advancements in finding a treatment.
For more information on hormonal acne, and what you can do to clear your skin of its grips, check out my eBook.