What Hormone Causes Acne in Females?


Acne is a common skin condition that affects people of all ages, though it is most prevalent during puberty. For many females, acne flare-ups tend to coincide with hormonal changes during puberty, menstruation, pregnancy, and perimenopause. This has led to questions around what hormone causes acne in females.

What Hormone Causes Acne in Females

The Role of Androgens in Acne

The main hormone that causes acne in both males and females is androgens, or male sex hormones. While androgens are present in larger amounts in males, they are also naturally found in females. The primary androgens are testosterone, androstenedione, dehydroepiandrosterone (DHEA), and dihydrotestosterone (DHT).

So what do androgens have to do with acne? Androgens stimulate the sebaceous glands in the skin to produce more sebum, or oil. Excessive sebum production is one of the main causes of acne. The androgens also increase the turnover of skin cells inside hair follicles, which can lead to clogged pores when the dead skin cells are not shed properly. Clogged pores combined with excess sebum provide the perfect environment for acne-causing bacteria to multiply and cause infection and inflammation.

Androgen Level Fluctuations and Acne

In adult women, androgen levels normally rise and fall cyclically during the menstrual cycle. In the days leading up to ovulation, androgen production increases, which can trigger acne breakouts.

Many females also experience premenstrual acne flares about a week before their period starts, when progesterone levels drop and androgen activity rebounds. The rise in androgens just before menstruation causes the sebaceous glands to ramp up oil production, leading to clogged pores and acne lesions.

During pregnancy, increased androgen production from the ovaries and adrenal glands can worsen acne, especially during the first and second trimesters. Acne flares are also common during perimenopause, as hormone levels fluctuate erratically. Though androgen levels decline with menopause, some women continue having hormonal breakouts due to increased sensitivity of the oil glands to androgens.

In adolescent girls, rising androgen levels that come with puberty are responsible for the onset of acne. Even small increases in androgens can trigger breakouts by revving up sebum production. Girls with polycystic ovary syndrome (PCOS) tend to have elevated androgen levels and are therefore more acne-prone.

Other Hormonal Factors That Influence Acne

While androgens drive excess sebum production, other hormones also play a role in acne by influencing skin cell growth and inflammation.

Insulin - Elevated levels of insulin can exacerbate acne, especially in women with PCOS. Insulin stimulates the ovaries to produce more testosterone, and also ramps up sebum secretion.

Estrogen - Estrogen counters the effects of androgens and helps keep acne under control. When estrogen levels drop during the premenstrual phase, androgen activity increases, leading to breakouts.

Progesterone - In the latter half of the menstrual cycle, increased progesterone relaxes the walls of oil glands, allowing more sebum production. Progesterone levels plummet right before menstruation, triggering acne flares.

IGF-1 - This growth factor promotes skin cell growth and reproduction. Excess IGF-1 can increase keratin production in hair follicles, promoting acne.

Cortisol - Stress leads to increased cortisol, which ramps up sebum production. Cortisol also exacerbates inflammation which can worsen acne.

How Exactly Does Acne Form?

Now that we’ve covered the main acne-causing hormones, let’s look briefly at how hormonal fluctuations translate into acne blemishes on the skin:

  • Androgen stimulation causes the sebaceous glands to produce excess sebum.
  • More sebum combined with rapid skin cell turnover clogs up hair follicles.
  • Clogged follicles become the ideal breeding ground for acne-causing bacteria Propionibacterium acnes (P. acnes).
  • These bacteria trigger inflammation and infection in the clogged follicle, leading to red, swollen acne lesions.
  • In severe cases, the hair follicle may rupture, spilling oil, bacteria and skin cells into the dermis. This provokes more inflammation and results in nodules and cysts.

The key is to prevent that initial clogging of follicles by controlling excess sebum production with the right acne treatments. Let’s look at some solutions next.

What Treatments Can Help with Hormonal Acne in Females?

There are several effective medical treatment options for managing feminine hormonal acne:

Oral Contraceptives – Birth control pills that contain estrogen and progestin work by decreasing androgen production and reducing sebum secretion. The estrogen increases levels of sex hormone binding globulin (SHBG) which binds up free testosterone, making it unavailable to stimulate oil glands.

Anti-Androgens – Spironolactone is an androgen blocker frequently prescribed for hormonal acne. It reduces testosterone levels in females by blocking its receptors in the skin’s oil glands. Newer anti-androgens like Aczone also target androgen activity.

Retinoids – Retinoids like prescription Differin and Retin-A help prevent clogged pores by accelerating skin cell turnover. This helps shed excess skin cells inside follicles so they don’t obstruct sebum from flowing out.

Antibiotics – Antibiotics combat the P. acnes bacteria inside clogged follicles to curb infection and inflammation. Options include topical or oral antibiotics like clindamycin, erythromycin or doxycycline.

Hormonal IUDs – Intrauterine devices (IUDs) like Mirena release progestin to prevent ovulation and lower circulating androgens. This helps improve hormonal acne.

Dietary Supplements – Some supplements like omega-3 fatty acids, zinc, vitamin D, spearmint tea and evening primrose oil may help balance hormones and treat acne. Talk to your dermatologist before trying supplements.

Light Therapy - Photodynamic therapy (PDT) uses light energy to destroy acne-causing bacteria inside pores while also reducing oil gland activity. Laser or LED light devices can be used at home for mild to moderate acne.

Chemical Peels - Glycolic acid or salicylic acid peels help exfoliate clogged pores and reduce P. acnes bacteria. Peels help absorb excess oil and improve skin texture.

The best approach is to combine several of these therapies tailored to your specific hormonal acne causes for optimal results. And don’t forget to be consistent and patient - it can take 2 to 3 months to see improvements as hormones rebalance. Tracking your cycle and symptoms in an acne journal helps identify personalized triggers so you can have a better defense against breakouts.

Can You Treat Hormonal Acne Naturally?

There are some natural remedies that may help keep hormonal acne under control when combined with medical treatment:

Green Tea – Green tea contains antioxidants that help reduce inflammation and slow down excessive sebum production. Sipping green tea daily and applying used bags to acne spots may help.

Aloe Vera Gel – Aloe vera has antibacterial and anti-inflammatory effects. Applying pure aloe gel daily can help soothe irritation and redness from breakouts.

Apple Cider Vinegar – The organic acids in apple cider vinegar have antimicrobial effects and help restore skin’s normal pH, deterring overgrowth of P. acnes bacteria. Use diluted ACV as a toner.

Tea Tree Oil – From the Melaleuca alternifolia plant, tea tree oil is a proven topical antibacterial and antifungal agent. Use a 5% dilution to spot treat pimples.

Zinc Supplements - Oral zinc supplements may help reduce inflammation and lower sebum production in acne-prone skin. Don’t take more than the recommended daily dose.

Probiotics – Improving gut health with probiotics may decrease inflammation systemically and lower cortisol. This helps rebalance hormones to improve acne.

Managing Stress – Try relaxation techniques like meditation, yoga, journaling or aromatherapy to lower stress. Reducing cortisol may improve hormonal acne.

Remember to always do a patch test before applying new skincare products to check for allergic reactions. Introduce natural remedies one at a time to determine what works best for your skin. And consult your dermatologist before taking any oral supplements, especially if pregnant.

Takeaway: What Hormone Causes Acne in Females?

In summary, the main hormone that causes acne in females is androgens, specifically testosterone. Female hormonal acne is primarily driven by:

  • Excess sebum production stimulated by androgens
  • Increased skin cell turnover clogging pores
  • P. acnes bacteria triggering infection and inflammation

Fluctuating androgen levels related to the menstrual cycle, puberty, perimenopause or conditions like PCOS often exacerbate breakouts. Other hormones like insulin, IGF-1 and cortisol also contribute by ramping up sebum secretion and inflammation.

Prescription medications like oral contraceptives, retinoids and anti-androgens help rebalance hormones and treat acne at the source. Natural remedies like probiotics, green tea and zinc may provide additional hormonal support.

Dealing with monthly breakouts can be frustrating, but understanding your personal hormonal acne triggers helps get those pesky pimples under control! Tracking your cycle, symptoms, diet and treatments pays off over time.

Frequently Asked Questions on Hormonal Acne in Females

What is hormonal acne?

Hormonal acne is a type of acne caused by fluctuations in hormones, especially androgens like testosterone. Increases in androgens ramp up oil production and can trigger breakouts. Acne lesions tend to flare up around the time of hormonal changes like puberty, menstruation, pregnancy, and menopause.

What hormone causes acne in females?

The main hormone responsible for acne in females is androgens. While present in smaller amounts, androgens like testosterone stimulate the sebaceous glands to produce more oil, leading to clogged pores and breakouts.

When in the menstrual cycle does hormonal acne occur?

Hormonal acne typically flares up at the start of the cycle around menstruation. This is due to the drop in estrogen right before your period, which causes a spike in testosterone. The rise in androgens increases sebum production, setting the stage for breakouts.

Acne can also occur around ovulation as androgen levels peak at mid-cycle. Some women experience premenstrual acne blemishes due to progesterone levels dropping in the week before their period, triggering increased androgen activity.

What other hormones influence acne?

While androgens are the main driver, other hormones like insulin, cortisol, estrogen, progesterone and IGF-1 also play a role in acne by regulating skin cell growth, sebum production, and inflammation.

Increased insulin from a high glycemic diet can stimulate testosterone secretion and worsen acne. Higher cortisol from stress accelerates sebum production. Estrogen and progesterone coordinate with androgens during the menstrual cycle, impacting breakouts.

How do hormones cause acne?

Androgens stimulate the sebaceous glands in the skin to secrete more oil (sebum). Excessive sebum combines with abnormal skin cell shedding inside hair follicles, causing blockages. These clogged pores become breeding grounds for acne-causing bacteria, leading to inflammatory lesions.

How is hormonal acne different from regular acne?

While all types of acne result from clogged pores, hormonal acne flares in a cyclic pattern along with menstrual cycles and hormonal changes. Breakouts are usually concentrated along the lower face, jawline, chin and neck. Lesions tend to be deeper, larger and more painful than regular whiteheads or blackheads.

What are the best treatments for hormonal acne?

Prescription medications that can treat hormonal acne by reducing androgen levels and sebum production include:

  • Hormonal birth control pills
  • Spironolactone and other anti-androgens
  • Topical or oral retinoids
  • Antibiotics
  • Hormonal IUDs like Mirena

Benzoyl peroxide, salicylic acid, and azelaic acid topicals can help unblock pores and reduce acne bacteria. Laser, light and chemical peels are also effective for hormonal acne.

What natural remedies can help hormonal acne?

Some natural supplements that may support hormonal balance and help improve acne include:

Topical remedies like aloe vera, apple cider vinegar, tea tree oil and green tea can help reduce inflammation, fight bacteria, and regulate oil production.

How can you prevent hormonal breakouts?

To help prevent monthly acne flares:

  • Track your cycle to identify when breakouts occur
  • Avoid triggers like stress and high-glycemic foods before your period
  • Cleanse regularly to remove excess oil but avoid over-washing
  • Use oil-free, non-comedogenic makeup and sunscreen
  • Take prescribed acne medication consistently
  • Get enough sleep and exercise for hormonal balance

When to see a dermatologist for hormonal acne?

See your dermatologist if you have deep, painful cysts or nodules that over-the-counter remedies haven’t helped. They can provide prescription hormonal therapies, antibiotics and retinoids tailored to your acne type and causes. Treatments often take 2-3 months to see full results.

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