Acne has a huge prevalence worldwide, with data suggesting that it’s the 8th most frequent disease globally! That means 9.4% of the world population has, or will have acne in their lifetime.
It can be such a debilitating condition, causing painful cystic bumps and can cause people to feel self-conscious and frustrated when they don’t find a permanent solution.
While many people find that antibiotics, topical creams, Accutane or the Oral Contraceptive Pill may reduce their symptoms for a while, once they stop the treatment their acne returns.
This is because none of those treatments get to the core of why the acne is occurring, and in many cases it’s to do with underlying hormonal imbalances.
What exactly is hormonal acne?
This can occur when there is overproduction of sebum (or oil) in our follicles causing oil, dirt, and bacteria to be trapped in our pores and cause a breakout of pimples. Hormonal acne can be located on the chin, cheeks, chest, back and anywhere on the face and it may be red, inflamed, and sore to the touch.
There is a particular bacterium that can cause the growth of acne, Cutibacterium acnes (C. acnes, formally known as Propionibacterium acnes), but for this to be overgrown there needs to be a change in the sebum production and follicles that creates the perfect environment for these guys to thrive.
Sometimes this is also paired with excess hair growth on the face, chest or back, oily skin, an irregular menstrual cycle, PMS symptoms and a monthly breakout.
What causes hormonal acne?
Many factors are involved in the production and maintenance of hormones, from blood sugar imbalances, stress, the oral contraceptive pill and other methods of birth control, diet and gut health, so let’s take a deeper dive into each of these and how they can affect your skin
An increase in insulin can increase your androgen hormones to lead to acne. To keep this in check its best to adopt a low GI diet, meaning you opt for low Glycaemic index (GI) carbohydrates such as brown rice that have a slow release of energy and don’t spike your insulin. Snacking between meals can also help, aim to eat small meals or snacks approximately every 3 hours.
Chronically elevated cortisol, our primary stress hormone, can cause some of our hormones to be suppressed or drive-up adrenal androgens such as DHEAS, which can cause hormonal breakouts. This is where adaptogenic herbs come in handy, to decrease the stress response and support hormone production
3. OCP or hormonal contraceptive use
Post pill acne occurs typically between 3-6 months after coming off hormonal birth control and Is usually caused by a surge in hormones once they are not being supressed by the pill. There are ways to avoid this by working with a practitioner to prepare your body for coming off the pill.
For some people, cows milk dairy has an inflammatory effect on their skin due to the insulin growth factor 1 (IGF-1) made by casein, a protein contained in cows dairy products. Its not the case for everyone and its not usually the cause, but if you already have an underlying hormonal imbalance, sensitivity to cow’s milk dairy can cause an increase in inflammation and break outs.
5. Gut health
A healthy gut microbiome is essential for all aspects of health, so it applies that we need to have a varied and diverse mix of beneficial bacteria to reap the rewards of clear skin! Plenty of fibre, a large range of plant-based foods, prebiotics like fermented foods and starchy carbohydrates form the basis for a thriving microbiome.
What is the connection between acne and PCOS?
Acne is indeed one of the diagnostic criteria of PCOS, and this is a condition I see clinically go hand in hand. This is because the same underlying factors are at play, so often whatever is causing the Hormonal Acne is also driving the PCOS and vice versa.
For this reason, it is helpful in both conditions to understand the underlying divers and address these instead of treating the symptoms.
Here are some ways to investigate
– Hormonal testing
– Blood testing to check for insulin resistance and / or blood sugar dysregulation
– Comprehensive gut testing or food intolerance testing
Supplements and herbs that are great for Acne
Zinc is often depleted in people who suffer from acne, and research tells us that treatment with zinc can help to reduce inflammation in acne without side effects. As a nutrient, zinc is necessary for repair and regeneration of skin cells, reducing inflammation and to promote skin healing.
2. Licorice and Paeony
This combination is used in PCOS to reduce androgens, which is why it works well for people who have acne due to high androgens such as testosterone or DHEAS. Together it helps to lower the Luteinising hormone (LH) and Follicle stimulating hormone (FSH) ratio which in turn will help to facilitate ovulation.
The Paeony helps to reduce high testosterone by stimulating the release of an enzyme that converts testosterone to estrogen, so its also super helpful if estrogen is low compared to testosterone creating an imbalance.
It’s been found that licorice can regulate skin microbes by altering the metabolic balance, and it can also support stress hormone production to ameliorate that affect on sex hormones.
This nutrient plays a role in ovulation, follicle development and insulin signalling, so can be extremely helpful in cases of an irregular cycle where the person is not ovulating or has high insulin levels.
This herb has an anti-androgen effect, so it is most effective when there is confirmed high androgens in a case of acne. It works by reducing the enzyme that converts testosterone to the super potent dihydrotestosterone (DHT) that can have a stronger effect on the skin.
Nettle has antibacterial and anti-inflammatory activity on acne, and can also reduce DHT.
A systematic review done in 2021 showed that N-Acetylcysteine (NAC) has multiple actions that make it helpful for treating acne; it has an antibacterial effect on C.acnes, reduces free radicals that can cause inflammation, supports the liver and helps to prevent the growth of acne lesions.
Hormonal acne can be a complex condition driven by multiple factors, so it’s important to cover all the bases to ensure you make a lasting change.
If you feel like you could use guidance on investigating hormonal acne, get in touch for a free base chat!
Hi, I’m Marg and I’m a degree qualified Naturopath working online and in the Hälsa Health studio. I became a Naturopath because my own health journey led me to understand the importance of treating the underlying cause of a condition using holistic and evidence-based treatments.
I am passionate about women’s health and have a special interest in hormonal conditions such as Endometriosis, Adenomyosis, PCOS, hormonal acne, PMS, anxiety and reproductive health.
To book a FREE base chat with Margaret click here