12 Hormonal Acne Causes
In each pore of our skin, we have sebaceous glands that produce sebum, an oil-like liquid, which helps to moisturize and protect our skin. When too many dead skin cells collect on the top of the skin in conjunction with high amounts of sebum, this can create a clog in our sebaceous glands and will result in inflammation. Our body will respond to this inflammation by sending white blood cells to the site of the clog which forms the white-headed pimples called acne. So, what are some hormonal acne causes?
Sources: NIH
1. Estrogen Dominance
Balanced estrogen is found to be beneficial for inhibiting the androgen activity with sebaceous glands and additionally can have regulatory effects on the genes that function in negative acne production. Due to this, one of the hormonal acne causes can be estrogen dominance. When estrogen is produced too much, you can develop overly dry skin, which causes inflammation, irritation and the sebaceous glands will respond by producing more oil.
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2. Poor Estrogen Detox
Estrogen dominance can be caused from poor estrogen detox which we know is also one of the hormonal acne causes. Estrogen gets eliminated through the 3 step detoxification process. There are 3 main steps to the detoxification. First, the estrogen is converted into another compound, next, that compound is packaged up with the help of a nutrient like amino acid, and finally, that new compound is excreted from the body. When one of these steps isn’t fulfilled, estrogen will not be eliminated and will recirculate in the body.
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3. Elevated Testosterone
Elevated testosterone levels can be one of the hormonal acne causes. Testosterone gets converted into DHT and this is what causes the increase in sebum in the sebaceous glands to further produce acne. Noticing when breakouts occur on your skin is important too. This is because females naturally have an increase in testosterone around ovulation which causes an increase in libido. If you are noticing acne specifically during ovulation this may not be from high testosterone, but if the acne is occurring throughout any time of the cycle then it probably is one of the symptoms of high testosterone.
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4. Elevated DHEA
Another one of the hormonal acne causes is elevated dehydroepiandrosterone (DHEA) levels. Dihydrotestosterone or DHT is made from a reaction between testosterone and an enzyme called DHEA. DHT is what causes an increase in sebum in the sebaceous glands. So this is why elevated DHEA is another one of the hormonal acne causes. Certain acne medications are made to inhibit the DHEA which subsequently will reduce testosterone and sebum production which will cause an overall decrease in hormonal acne.
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5. Favoring the 5-Alpha Reductase Pathway
The 5 alpha-reductase pathway is an enzyme that helps to convert testosterone into DHT which is an active form that causes acne production. This specific pathway is not the only way to produce DHT because the 5-beta pathway can be up to 3x less symptomatic for acne. There are also two forms of the 5 alpha-reductase pathway, type 1 and type 2. A study has found that the inhibition of type 1 5 alpha-reductase pathway is beneficial to reduce sebum production and hormonal acne.
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6. Dehydration
Dehydration is another one of the hormonal acne causes. Water is essential for skin functionality and a study has found that increasing consumption of water has beneficial effects on reducing acne. When we are dehydrated, there is not enough water to circulate the body, the organs will use up the water first to maintain their function, and the skin will receive the least. This causes the skin to ‘dry up’, and as a response, the sebaceous glands will produce more sebum in order to counteract this. This is why dehydration is one of the hormonal acne causes because the skin can not properly determine how much sebum is too much in this situation of dehydration, overproduction can occur.
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7. Low Zinc
Another one of the hormonal acne causes is low zinc consumption. Zinc is a great mineral that can be used for a lot of health benefits, but it specifically can be beneficial for enhancing skin appearance and decreasing acne. A mechanism for this can be that zinc has anti-inflammatory properties and it also can effectively reduce cutibacterium acnes which is a bacteria linked to acne production in the skin. Additionally, zinc can inhibit sebum secretion and production by its anti-androgenic property.
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8. Low Healthy Fats
If you don’t eat enough healthy fats, this can be one of the hormonal acne causes. Healthy fats are unsaturated which means they have at least one double bond in the fatty acid chain. Polyunsaturated fats are fatty acids that contain at least 2 double bonds in the structure. Two types of polyunsaturated fats are omega 3 and omega 6. Most western diets consume a ratio of 1:20 of omega 3 to omega 6 when it should be 1:3. This evidence is correlated with acne incidence, showing that omega 6’s are pro-inflammatory and cause acne while omega 3’s have protective effects to decrease acne. Omega 6 sources include soybeans corn, safflower, sunflower oils, nuts, meat, poultry, and eggs. Omega 3 sources include oily fish such as salmon, herring, mackerel, and sardines; fish oil and flaxseed oil; flaxseeds, walnuts, and chia seeds.
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9. Blood Sugar Imbalances
Blood sugar imbalances can lead to insulin resistance which is another one of the hormonal acne causes. Insulin is a hormone released from the pancreas when you eat food, and its job is to take sugar into cells for energy. Think of it like the cell accepting the sugar is a lock and insulin is the key. When you are insulin resistant the cells deny the insulin with the sugar, so your blood sugar rises along with insulin levels. This would mean that the cell or “lock” changes so that the insulin or “key” no longer fits.
Insulin resistance causes high levels of testosterone because when insulin levels are high in the blood, it will stimulate an enzyme called 17-hydroxylase which will help the ovaries to become stimulated to make more testosterone. Additionally, this process will inhibit the synthesis of a binding protein to testosterone which increases the abundance of free testosterone in the blood. This process results in an increase of DHT which can be one of the hormonal acne causes.
10. Gut Imbalances
Another one of the hormonal acne causes is gut imbalances. The gut contains a large diversity of bacteria that aids us in regular bowel movements and digestion. When this bacteria is reduced or overpopulated, it can cause issues, one of these being acne. Studies have found that the gut microbiota or bacteria have a connection to acne production due to the inflammatory response it results in. In addition, studies have shown that gut flora can transport excess microbiota to the skin directly. This is because when the intestinal wall becomes permeable, the bacteria can enter the bloodstream and collect in the skin which can clog the pores to create acne.
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11. Stress
Stress can have an effect on acne similar to how the gut affects it, and this is why stress is another one of the hormonal acne causes. Emotions that come with stress are anxiety, anger, and depression, and these have been predicted to change the gut bacteria balance which will increase inflammation and lead to irritation to the acne. Other studies have looked at different mechanisms for why stress correlates positively with acne severity. One is that stress can increase the androgen secretion from the adrenal glands which cause the sebaceous glands to grow larger. Additionally, the stress response leads to a release of Corticotropin-releasing hormone which is a derivative of cortisol, and this hormone leads to excess lipid production in the sebaceous glands. This is why stress is one of the main hormonal acne causes.
12. Harsh Skincare Products
Harsh skin care products can also be one of the hormonal acne causes. This is because many skincare products contain chemicals that reduce transepidermal water loss, which is the moisture level in the outermost layer of skin. This layer of skin needs to be moisturized or else it can cause inflammation and irritation resulting in an overproduction of oil. Examples of some harsh chemicals to watch out for are benzoyl peroxide, salicylic acid, and retinoids. They are found in moisturizers, facewashes, and daily creams ‘recommended for acne’.
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Take away message:
There are several possible hormonal acne causes. If you’re looking to understand what is driving your hormonal acne, check out my hormone testing packages HERE.
Be sure to check out my FREE hormone guide & 5-day meal plan below for more hormone balancing tips. And my online course Heal Your Period: Everything you need to know to achieve a regular, pain-free period.
