You thought you’d be done battling breakouts once you left your teens. Wrong! For some adults, acne continues well into their 20s and 30s, whether it’s an occasional zit or breakout or a crop of deep, painful cyst-like pimples on the cheeks and jaw. If that’s what you’re seeing in the mirror, you could be dealing with hormonal acne.
Hormonal acne mainly affects women and can be a bit trickier and more frustrating to deal with than a regular breakout. But don’t lose hope! There are ways to treat hormonal acne for more balanced, happy skin.
“Hormonal acne most commonly appears on the jaw, chin, and lower cheeks, but can also show up on the neck, shoulders, back, and chest. Spots can look like papules, cysts, and nodules.”
– Dr. Mohiba Tareen / Tareen Dermatology
“Studies show that about half of the women population between ages 20 and 29 struggle with acne, and 25 percent of women between 40 and 49 also deal with it,” says Dr. Mohiba Tareen, board-certified dermatologist and medical director at Tareen Dermatology. “Women tend to have more hormonal fluctuations [throughout the month] compared to men due to puberty, menstruation cycles, pregnancy, and menopause.” These types of hormonal fluctuations can lead to increased acne.
“Hormonal imbalances can also result in jawline acne, which is thought to be caused by an increase in androgen levels,” Tareen explains. “Androgens are male hormones, which can result in increased oil gland production, causing clogged pores and acne.” According to Tareen, hormonal acne can be caused in part by genetics; some people have a higher propensity for higher levels of hormones.
When hormones are out of balance, your body makes more sebum, which can lead to inflammation and changes in skin cell activity. “With this combination, acne starts to appear,” Tareen explains, adding that medications, antibiotics, depression, specific foods, stress, and anxiety can contribute to flare-ups. Hormonal acne most commonly appears on the jaw, chin, and lower cheeks but can also show up on the neck, shoulders, back, and chest. “These acne spots can look like papules, pustules, cysts, and nodules,” she says, “and range from mild to severe acne.”
You can treat hormonal acne in a few different ways, but if your acne isn’t responding to oral antibiotics or prescription topicals, you may want to consider talking to your derm about other options. “In this case, your dermatologist may recommend an anti-androgen drug such as spironolactone,” Tareen says. “Anti-androgen drugs suppress the male hormone androgen, which lowers oil production and secretion. Historically, doctors have prescribed spironolactone to treat high blood pressure. It’s also prescribed for people who are retaining too much fluid.”
“Hormonal imbalances can also result in jawline acne, which is thought to be caused by an increase in androgen levels … Androgens are male hormones, which can result in increased oil gland production.”
– Dr. Mohiba Tareen / Tareen Dermatology
Dermatologists have used spironolactone to treat acne and excess hair growth in women; it takes a few months to work but can effectively treat hormonal acne. (Important to note: be sure to tell your healthcare provider if you are pregnant or plan to become pregnant.) A retinoid (vitamin A) may also help prevent clogged pores and boost collagen production.
Outside of taking a prescription medication or using a topical, Tareen recommends sticking to a simple skin care routine, getting quality sleep, and staying hydrated to give your skin extra TLC. Consider reducing your sugar and dairy intake to see if that has an impact on acne. Tareen recommends a Mediterranean diet with lots of fatty fish for those delicious and nutritious omega-3s.
And don’t forget: You’re far from alone in your acne journey, even if it doesn’t feel like it.
Read more from our Annual Health Guide in the November issue of Mpls.St.Paul Magazine or here.