FAQ: How To Internally address Hormonal Acne?
Balancing acne-causing hormones with a holistic point-of-view
As a licensed naturopathic doctor who specializes in holistic acne solutions, many people commonly ask me:
How does someone internally address hormonal acne?
If you are wondering the same as well, I wrote this blog post for you.
I wanted to write this blog post as a launch pad for folks who: Want to learn about 1) Hormonal acne and 2) The root issues behind hormone imbalances that trigger acne.
So, as someone who believes that the skin is a visual representation of overall health, I believe that looking within may provide some answers regarding what root-cause solutions are available.
In this holistic hormonal acne blog post you will learn about:
Which hormones play a role in acne
How hormones trigger acne
6 root issues behind acne-triggering hormone imbalance
Some root-cause solutions for hormonal acne
Keep on reading to learn more!
DISCLAIMER: THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS POST DOES NOT CONSTITUTE AS MEDICAL ADVICE. The information in this blog post does not constitute as medical advice; is not meant to diagnose, prevent, treat, or cure any conditions or disease; and is meant for educational purposes only. The information in this blog post does not replace the medical advice of your medical provider. Speak to your doctor or medical provider before starting anything new.
What hormones play a role in hormonal acne?
Hormonal acne may manifest as cyclical or worsening acne or pimples, occurring 1-2 weeks before someone’s menstrual period. Most folks say that hormonal acne appears along the jawline.
Hormonal acne usually first occurs during puberty because of hormone changes that occur during that stage of life.
According to literature, one main family of hormones that play a role in acne is called androgen hormones.
Androgen hormones are commonly known as “male sex hormones,” and some examples include: Testosterone, DHEA, and more.
Keep on reading to learn how these hormones contribute to acne!
How do these hormones play a role in hormonal acne?
Acne is more than just skin deep, especially when hormones are involved.
Conventional knowledge surrounding hormonal acne is that androgens tell the skin to make more oil.
However, there are many reasons WHY someone has higher androgen hormones. Keep on reading to learn more about these root issues!
6 root factors behind Acne-triggering hormone imbalances
The process by which more androgen hormones are made starts to dabble into the holistic mindset. By that, I mean that we start to look at someone’s whole health and wellness, and we start to consider 1) how other organ systems, 2) how someone’s mental wellbeing, and 3) how other factors could be playing root-cause roles in someone’s hormonal acne.
So, let’s briefly talk about 6 inner factors behind hormonal acne that everyone needs to know about:
1- Blood sugar and androgens
There seems to be a link between blood sugar and acne. Scientists found that eating foods that quickly spike blood sugar (called high glycemic index foods) is linked to acne. Additionally, researchers of a 2023 study found that 81% of subjects with acne have insulin resistance after measuring C-peptide, which also suggests a link between blood sugar and acne.
So, what’s going on? Well, Baldwin and Tan’s 2021 journal article gives us some insight.
Baldwin and Tan suggest that high blood sugar triggers insulin output, and higher levels of insulin from higher levels of blood sugar may tell the body to produce more androgen hormone.
While there are many ways to assess for blood sugar with labs, some providers might find it helpful to look at someone’s diet to see if they consume many high glycemic index foods.
According to Harvard Health, some examples of high glycemic index foods are: “White bread, rice cakes, most crackers, bagels, cakes, doughnuts, croissants, most packaged breakfast cereals.”
Other that diet, it’s also vital to look at someone’s lifestyle and how much healthful movement they engage in, as literature suggests that regular exercise may be supportive for optimal insulin sensitivity in folks with blood sugar issues, like diabetes.
Beyond diet and lifestyle, some folks may have to start medications if labs indicate bigger blood sugar issues. And, there’s some cool science showing that a pharmaceutical medication for blood sugar reduced acne severity in females with PCOS.
What’s PCOS? Read below to learn more!
2- Ovarian health and androgens
In females, testosterone can be made by the ovaries. And, there is a condition called Polycystic ovarian syndrome (PCOS) that can display as hormonal acne due to high androgen output in addition to a constellation of other symptoms.
Other than hormonal acne, folks with PCOS may experience other high-androgen symptoms, such as scalp hair loss and facial/body hair growth. Beyond high-androgen symptoms, literature indicates that folks with PCOS may also experience irregular or absent menstrual periods, ovarian ultrasounds showing 12 or more follicles, and/or difficulty conceiving.
With all of that, PCOS is a prime example of how skin health is truly a reflection of overall health. And, if someone has hormonal acne, it might be worthwhile to take note of other symptoms, as someone’s body is trying to communicate to them that some internal imbalance is taking place.
Now, if someone’s doctor ends up diagnosing them with PCOS, there are many medications that can be prescribed to them to address PCOS and the hormone imbalances that occur in PCOS.
3- Adrenal glands and androgens
Have you heard of the adrenal glands before? If not, the adrenal glands are responsible for making an androgen called DHEA.
DHEA is important to consider within the context of hormonal acne since DHEA is converted to testosterone. And because of the adrenal glands being activated during puberty (called adrenarche), many folks can start to experience acne because of higher output of DHEA at that stage of life.
However, folks with other adrenal issues may continue experience acne past puberty, such as with a condition called Congenital Adrenal Hyperplasia (CAH). And, if someone has high-androgen symptoms, like PCOS, it is suggested by literature to first rule out conditions like CAH.
4- Supplements and androgens
Some common supplements may be the culprit behind acne. Whey protein is common protein supplement used by folks and it can also be naturally found in dairy.
Researchers of a 2024 study found that whey protein supplements were linked to acne in subjects.
So, if someone was prescribed whey protein by their provider, and they started to experience acne after starting whey protein supplementation, it may be worthwhile to speak to the prescribing provider about protein supplement alternatives they would suggest.
5- Medications and androgen receptors
It might be surprising to some folks that their medications might be contributing to their acne.
One common medication that has been linked to acne is hormonal birth control. A 2022 study published in the Journal of the American Academy of Dermatology found that hormonal intrauterine devices (IUDs) were linked to acne.
To explain why this may be occurring, researchers suggest that synthetic hormones found in some forms of hormonal birth control may activate the receptors that androgen hormones work on to produce its hormonal effects.
According to Table 2 of Mathur, et al.’s 2008 article, some types of synthetic progesterone (called progestins) found in hormonal birth control have high androgenic effects, such as Levonorgestrel and Norgestrel. They go on to list some other progestins that have low to no androgenic effects and one form that was antiandrogenic.
All in all, there are several hormonal birth control options that someone can speak to their prescribing provider about.
6- Genetics and androgen receptors
When speaking about androgen receptors and acne, genetics may also play a role. According to a 2019 study, researchers found that acne is linked to genetics that may make androgen receptors more-sensitive to androgens.
Holistic hormonal acne solutions
You’ve made it to the end! By now, you know what hormones play a role in acne and some underlying issues may influence those hormones.
As a brief recap, androgen hormones are what we primarily think about when it comes to hormonal acne as it tells the skin to make more oil.
When looking deeper, researchers suggests that blood sugar, insulin hormone, and diet may influence androgens; ovarian health and PCOS may impact androgen; adrenal gland health may influence androgen levels; and there are factors that influence androgen receptor activity (like genetics and some forms of progestins).
So, if someone wants to holistically address their hormonal acne, looking at their whole health may be worthwhile - especially if they believe that the skin is a reflection of overall health and wellness.
To holistically address hormonal acne, labs may shine a light on what root issues can be addressed for holistic solutions. And holistic solutions can look like addressing hormones directly and/or addressing the root issues behind acne-triggering hormone imbalance.
Now, if someone truly wants to identify and treat the root issues behind their acne, working with a holistic-minded provider, such as a licensed naturopathic doctor, may be worthwhile.
For those in the Los Angeles-area who are looking for holistic acne solutions, book your appointment with me at The Things We Do by clicking the button below:
For individuals outside of California, you can find the nearest licensed naturopathic doctor (ND) to you on the Institute for Natural Medicine’s directory of licensed providers by clicking here: Find an ND here
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