Hormonal Acne: Why It Happens & How to Prevent It

Period symptoms, including hormonal acne, don’t have to be a monthly reality. This article explains the leading theories about what causes hormonal acne, and how to prevent it. 
What causes hormonal acne? 

Scientists don’t yet know the exact cause of hormonal acne, but they suspect it involves fluctuating levels of reproductive hormones throughout the menstrual cycle. 

Estrogen and progesterone are the two main hormones that regulate the ebbs and flows of the menstrual cycle. In the first half of your cycle, following your period, estrogen steadily rises and falls leading up to ovulation—the release of an egg from an ovary. In the second half of your cycle, following ovulation, both progesterone and estrogen steadily rise and fall leading up to your period.

The dramatic drop in estrogen and progesterone right before your period starts is believed to be the culprit behind most PMS symptoms like mood swings, bloating, and headaches. 

But when it comes to hormonal acne, a third reproductive hormone may be mostly to blame: testosterone.  

Testosterone is one type of androgen—a group of hormones people think of as “male” hormones. Women make androgens, albeit in much smaller amounts compared to men. Testosterone levels remain low throughout most of the menstrual cycle, with a modest spike around ovulation. 

The body responds to hormones via receptors—binding sites where hormones attach. When a hormone binds to a receptor, it triggers a response in whichever tissue that receptor is located.

We have estrogen and progesterone receptors throughout our bodies, which explains why PMS symptoms can arise anywhere from the brain and breasts to the gut and muscles. Testosterone receptors are located on the skin, which explains the testosterone-acne connection. 

When testosterone binds to receptors on the skin, it stimulates oil glands to make more oil. Increased oil production increases risk of clogged pores, which harbor bacteria that cause inflammation and breakouts.

The more testosterone that binds to receptors, the more oil is produced, and the more breakouts ensue. That’s why acne is a common symptom of Polycystic Ovary Syndrome (PCOS)—a condition in which testosterone and other androgen hormones are overproduced. 

Some researchers think estrogen and progesterone may still play a role in hormonal acne. 

High levels of estrogen and progesterone prevent androgens like testosterone from binding to receptors and increasing oil production. When estrogen and progesterone levels plummet at the end of your cycle, however, there isn’t enough of them to block oil-producing androgens, leading to breakouts before and during your period. 

How to prevent hormonal acne: 
Clean and consistent skincare 

Healthy skin starts with healthy habits. Using high-quality, thoughtfully-formulated skincare like Dr. Elsa Jungman consistently can do wonders for soothing erratic skin. Hormones will fluctuate, but the best skincare routines are steady as she goes. 

Stress management 

Stress is one of the biggest causes of hormonal imbalances in women. Stress management isn’t easy, so be patient with yourself and try minimizing just one stressor at a time. Common stressors are lack of sleep, too much sugar, caffeine, alcohol, or screen time, and toxic people in your life. If your period is stressing you out, De Lune Steady Mood is a daily supplement that can help relieve mood swings, bloating, cravings, and other problems with stress-busting nutrients and adaptogens. 

Anti-inflammatory foods

Inflammation is a major driver of acne, so choosing anti-inflammatory foods can help quell irritation and prevent future breakouts. Anti-inflammatory diets tend to be rich in whole foods and plant-based dishes. Brightly-colored fruits and vegetables and sources of omega-3 fatty acids like salmon, tuna, chia seeds, and flax seeds are great choices. 

Zinc supplements 

An anti-inflammatory nutrient, numerous clinical studies show that zinc supplements can significantly improve all types of acne, including hormonal acne. De Lune Steady Mood offers a potent daily dose of zinc along with other anti-inflammatory ingredients. 

Hormonal birth control 

Birth control pills can be another option if the strategies above aren’t successful. Some types of progestins—the pill’s synthetic version of the body’s natural progesterone—help control breakouts by reducing oil production. But other types of progestins may make acne worse.  Always ask your doctor about all possible side effects of any new medication, especially hormonal birth control. 

Your Microbiome

If you are suffering from consistent acne and upset skin, it may be a good time to check in on the state of your microbiome. Trillions of bacteria + fungi call your skin surface home. An unbalanced microbiome could be the cause of your skin health issues, the only way to know is to test. See here to learn more about our Skin Microbiome Kit and how testing your microbiome could be the key to understanding your skin. 

About the author 
Courtney Mayszak, RDN, LDN, is a Registered Dietitian Nutritionist and the co-founder and CPO of De Lune—a menstrual health company on a mission to lift the period burden with natural, research-backed solutions for cramps and PMS. It’s your period, not a problem.


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