Skin Care Tips- Treating HORMONAL ACNE
Dr Davin Lim Dr Davin Lim
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 Published On May 19, 2018

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Skin Care Tips- Treating hormonal acne

Hormonal acne is extremely common and affects one in four Australian women.
Before going into treatment, lets explore how to tell if you suffer from hormonal acne.
1. You are no longer a teenager. While we’d love to leave acne behind once we enter our 20s, the reality is flare-ups are possible at any time. Hormonal acne is the type that’s most likely to present in your 20-something years – all the way to your late20s. That because those are the years when women are most hormonally active. Your 20s is often peak childbearing age, making women more prone to the intense hormonal fluctuations conditions such as polycystic ovarian syndrome, childbirth, pregnancy and breastfeeding. Age alone won't determine whether or not you will suffer from adult acne. Genetics can dictate when hormonal breakouts start and stop. This is modified by diet, stress and the products you use.

2. One of the telltale signs of a hormonal breakout is its location on the face. If you’re noticing inflamed cysts around your lower face—especially your chin and jawline area—you can bet your bottom dollar that it’s probably hormonal. This is due to the fact that acne glands, known as sebaceous glands are concentrated in this area.

3. Period cycles and patterns. Adult hormonal acne often occurs in a cyclical pattern, much like women’s menstrual cycles. This is true even in postmenopausal women, because these women still experience monthly fluctuations in their estrogen and progesterone levels, albeit lower than pre-menopausal women. Adult hormonal acne tend to occur in the same place each month.

4. Stressors play a major role in adult acne. With our stressful jobs, cortisol or cortisone levels rise, this in turn stimulates the oil gland to enlarge and produce more sebum, clogging the oil gland to produce painful cysts. That is why taking a vacation resets our cortisol patterns and acne usually improves.

5. Deep painful cysts are the predominant lesion of adult acne, with very little in the way of zits, and blackheads. These painful cysts manifest as deeper bumps that are under the skin’s surface and cannot be extracted with normal manual extraction.

How to treat? Here is the truth- this form of acne is one of the hardest DIY acne sub types to treat. Why? Because cysts lie deep in the dermal layers of your skin, beyond normal therapies such as creams, chemical peels and even laser light! Try these hints before seeing a dermatologist.
Firstly review your skin care- use a simple cleanser, and non-comedogenic products. This goes across the board from your vitamin A, B, C creams and serums, sunscreen, moisturiser to your make up range. Mineral make up is considered the best for any form of acne, including hormonal acne.

Secondly identify and rectify your flare up factors. Flare factors include foods such as dairy and refined foods high in sugars. Eat a balanced diet, and supplement this with zinc.
Thirdly add vitamin A creams. In Australia buy a high strength retinol serum or cream and apply nightly to acne prone areas. In the US you can buy Differin. The trick is to constantly use this retinoid- its designed to prevent acne and not to be used as a spot treatment. If you after a natural solution- tea tree oil may help.
The use of anti-inflammatory antibiotics may help some patients. Additionally the use of BHA or AHA peels and Blue/ Red light one week before breakouts can help some patients. Kleserca can be successful in some cases.
So, how do medical dermatologist treat hormonal acne? Firstly they may investigate your condition and conduct a full hormone profile. Secondly they may treat you with the pill. OCP or oral contraceptive pills such as Diane, Estelle, Yaz or Yazaim may help. It often takes 3 period cycles to gain hormonal control. Medication such as spironolactone or cyperterone acetate are highly effective, and in my option are much safer than Accutane or Oratane. Oral retinoids are the last line of defense in the fight to control adult hormonal acne, they have many side effects and regular blood tests are required.
Thanks for watching, one video every week, Saturday morning Brisbane time. Dr Davin Lim, Laser and aesthetic dermatologist.

Disclaimer- I do not treat acne, as I am a procedural dermatologist and laser dermatologist, I can however assist in referring you to colleagues who treat hormonal acne with medication.

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