If you’ve been struggling with adult acne, it’s possible your research has led you to consider whether testosterone could be causing the problem.
Testosterone, which is a sex hormone responsible for male traits, can contribute to acne in both sexes. So whether you are a man or a woman, it is possible testosterone could play a role in your acne. Other steroid hormones and their metbolites may contribute too.
Dealing with hormonal acne involves making lifestyle changes to balance your hormones and address the root cause, while also treating the acne topically. A dermatologist may also be able to offer medications that can control severe symptoms.
What is testosterone?
Testosterone is often called the male sex hormone, because it is responsible for many of the bodily processes that give men male characteristics. Women also produce small amounts of testosterone, however, and it plays an important role in both sexes.
In men, testosterone is a crucial hormone. It regulates the changes experienced during puberty, such as growth of the penis, maturation of the testicles, the development of facial and pubic hair, muscle and bone growth, as well as sperm production and sex drive.
In women, it plays a more limited, yet still important role, contributing to bone density, ovarian functioning, and possibly sex drive.
What is hormonal acne?
Hormonal acne is acne linked to abnormal levels of hormones or fluctuations in hormones. Hormones are signalling compounds secreted by the body that travel through the bloodstream, and play important roles throughout the body. Sex hormones in particular regulate functions related to sex differences and sexuality.
Hormonal acne can occur for a number of reasons. In men, hormonal acne may be linked to testosterone. Hormonal acne in women can be related to testosterone, other steroid hormones or their metabolites, by a hormonal imbalance, or the monthly cycle.
In women, hormonal acne is often linked to the monthly cycle, which involves many moving parts. In a 2001 study, 44% of women interviewed experienced a flare-up of acne during the premenstrual phase. Notably, women over age 33 were more likely to experience acne flare-ups associated with their monthly cycle, suggesting that hormones play a role in adult acne in particular.
Hormonal acne in women may also be related to testosterone. A 1983 study found that women with acne had significantly higher levels of free testosterone in the bloodstream than acne-free controls. Polycystic Ovarian Syndrome (PCOS) can cause increased testosterone, and this is thought to explain why women with PCOS often experience acne.
One common treatment for hormonal acne in women is to prescribe hormonal birth control, which is believed to regulate the hormones in a way that reduces acne. A 2012 meta-analysis analyzed 9 placebo-controlled trials, and found reduced acne severity, number of lesions, and self-assessments of acne in the group treated with hormonal birth control as compared to placebo.
How does testosterone cause acne?
Testosterone is thought to contribute to acne by increasing production of sebum, an oil that can clog pores. When pores are clogged, it can make it easier for acne bacteria to grow and cause pimples.
A 2011 review reports that acne patients produce more testosterone in the skin than healthy controls. Testosterone enhances the activity of sebaceous glands in the skin, leading to increased sebum production, which then increases acne.
Testosterone is a steroid hormone. Other steroid medications, which may be prescribed to treat a condition or taken as performance enhancing drugs, can also cause acne. Like testosterone, steroid medications increase the activity of sebaceous glands in the skin, contributing to acne.
Low testosterone does not usually cause acne, but treating low testosterone by taking testosterone may cause acne as a side-effect.
Lifestyle changes that may help reduce hormonal acne
When it comes to treating hormonal acne, there isn’t always a straightforward solution. A complete acne treatment plan often involves a combination of lifestyle changes, topical treatments, and in some cases, medication in order to resolve the problem.
The body’s hormones are produced in different quantities in response to many different lifestyle and environmental factors. Therefore, bringing these factors into balance, and embracing a healthy lifestyle, may help bring hormonal imbalances under control.
A multi-pronged approach takes lifestyle factors such as stress and diet into consideration while also treating the symptoms of the problem using topical treatments and medications. By addressing the acne from all angles, it’s very likely that you will see at least some success:
Changes to your diet
Although dietary changes can be difficult to put into practice, they can make a big difference for some people. There is research linking certain foods to acne, so if you want to try changing your diet, you might want to start with these foods. Some people find that identifying and giving up trigger foods helps their acne.
High glycemic or sugary foods
High glycemic load foods have also been associated with acne, and like dairy, these foods are believed to increase the levels of androgens through stimulation of insulin. High glycemic foods include sugar, white bread, and rice, among others.
Introducing healthier foods
When cutting out foods that cause acne, you should be sure to replace them with healthy foods. Fruits and vegetables, lean protein, whole grains and legumes are all recommended parts of a healthy diet.
Certain supplements may help with acne, too. For example, a 2014 Korean study found that fish oil supplementation could improve acne.
Acne is known to be strongly linked to stress. Researchers have found our bodies respond to stress by producing more androgens, which are hormones that stimulate oil glands and hair follicles. Getting your stress levels under control, as well as working on coping mechanisms for dealing with stress, can help your body and mind to be more balanced.
Exercise and breathwork
Things like practicing yoga and meditation, deep breathing, as well as getting regular exercise can all help you to cope with potentially stressful situations without getting stressed out.
Support and coping strategies
Often one of the best ways to cope with stress is to talk through your problems. You may be able to speak with a trusted friend or family member, or with a professional counsellor or therapist. Just having a place to vent can make a huge difference. A recent development in reducing stress is cognitive behavioral therapy, which can now be done online such as this course from Jason M Satterfield, Ph.D.
You may also consider making lifestyle changes, like reducing the amount of commitments you make, if you find you have more stress than you can cope with.
Getting regular sleep is another important way to get stress under control. The body uses sleep to recover from the stressful events of the day, so it’s essential to get enough so that you are recovering fully each night.
How to reduce breakouts
Balancing one’s hormones is not a quick process, and it can take a lot of trial and error before your skin improves.
In the meanwhile, it can help to learn how to cope with breakouts when they happen. Here are some quick tips for dealing with acne breakouts:
- Wash your face 1-2 times per day using a gentle cleanser
- Apply a topical treatment such as benzoyl peroxide or salicylic acid to the affected area
- Stay hydrated: getting enough water can help keep your skin clear
- Try to avoid touching, rubbing or picking at the area
Topical treatments are an important part of any acne treatment plan, and they’re often the first thing we try when battling acne. Although they cannot address the root cause, topical treatments can help address symptoms and reduce scarring.
The most common topical treatments include benzoyl peroxide and salicylic acid, both of which can be purchased over the counter.
A dermatologist may offer prescription strength topical treatments, which can be helpful if drugstore products are ineffective.
It’s important to know that if the acne is hormonal in nature, topical treatments won’t do much to address the root cause. However, they are still very important because they can reduce the symptoms and potentially reduce scarring.
Over time, topical treatments will become less important if the cause of the acne is addressed.
Other causes of acne
While hormones can and do cause acne, it’s important to remember there are many other potential causes of acne, too.
- Certain cosmetics and makeup products, especially those that are “comedogenic” or pore-blocking
- Hair-care products, especially if you notice acne near the hairline
- Medications, in some circumstances
- Vitamin D deficiency: a 2016 study found that vitamin D deficiency was more common among acne sufferers. Though it doesn’t prove a causal link, it’s always a good idea to make sure your vitamin D levels are in check.
If you suspect your acne is hormonal in nature, it’s a good idea to rule these factors out while also making lifestyle changes and treating your breakouts. Paying attention to these factors may help you understand your own personal acne triggers.
The bottom line
Hormone imbalances can contribute to acne, and testosterone is no exception. While it is often called the male sex hormone, testosterone is also found in small quantities in women and can cause acne in both sexes. It increases the activity of oil glands in the skin, causing clogged pores.
If you suspect you are suffering from hormonal acne, it can be a good idea to speak to a dermatologist or endocrinologist. He or she can check your steroid hormonal profile with simple blood or urine tests and recommend lifestyle changes, medications, and/or topical treatments to help ease your symptoms. In addition, you can consider tweaking your diet and stress levels, to see if that helps. Hormonal acne is never easy to deal with, but with some trial and error you may be able to reduce it.