Acne is one of the most common skin conditions, affecting people of all ages. It’s multifactorial with four main causes:
1) Overproduction of sebum (oil) caused by excess hormones stimulating the sebaceous (oil) glands
2) Clogged pores from the abnormal shedding of skin cells, leading to blackheads and whiteheads
3) Bacterial growth of Propionibacterium acnes within the pores
4) Inflammation in the skin and around the clogged follicles
Often it’s a combination of the above that leads to persistent acne. But, hormones are one of the big players, and understanding how hormones can influence your skin is key to managing acne effectively.
First up… what are hormones?
Hormones are chemical messengers, produced by glands in your body, that regulate many of your body’s functions, including skin health. They travel through the bloodstream to tissues and organs and deliver messages that influence growth, metabolism, mood and reproduction.
Even the smallest of imbalances can have a significant impact on how you feel and function.
The key hormones involved in acne are:
1. Androgens: The Sex Hormone
Is your acne deep cystic acne rather than surface-level blackheads or whiteheads? And is it concentrated around your jawline, chin and neck? Then it could be androgen-driven acne.
We typically think of testosterone as being a male hormone. But women have it, and need it, too. It supports our muscle mass and bone density, helps us feel more energised, increases our libido and positively influences our mood and cognitive function. However, in excess, it can cause unwanted symptoms. One of which is acne.
Testosterone-driven acne is most common in puberty. Levels of this hormone surge and stimulate the sebaceous glands in the skin leading them to produce excess sebum. This oily sebum combines with dead skin cells and clogs pores leading to acne.
But hormonal fluctuations during the menstrual cycle, pregnancy or menopause can also increase androgen activity, leading to breakouts.
2. Oestrogen and Progesterone: The Female Hormones
Does your acne tend to appear at certain stages of your menstrual cycle? It’s probably an imbalance between your two main female hormones. Oestrogen and progesterone are dominant female hormones that fluctuate throughout the menstrual cycle. The balance between these hormones influences acne in the following ways:
Oestrogen: Often referred to as the "anti-acne" hormone, oestrogen helps regulate sebum production and promotes skin healing. When oestrogen levels are low, this regulation is not there and so testosterone can become more dominant, leading to excess oil production, clogged pores and acne. Low oestrogen can also weaken the skin barrier, making it more prone to inflammation and less able to recover from breakouts.
Progesterone: This hormone rises in the luteal phase of the menstrual cycle (after ovulation) and can cause water retention and skin inflammation. This narrows the pores making them more susceptible to being clogged. Progesterone can also, like testosterone, stimulate the sebaceous glands to release sebum.
3. Cortisol: The Stress Hormone
Does your acne worsen when you are stressed, or lacking in good quality sleep? It could be thanks to cortisol. The hormone cortisol is released during stress and can exacerbate acne in a number of ways:
Keeps insulin levels raised, which in turn leads to high testosterone
Negatively alters the gut microbiome leading to increased inflammation
Slows down our digestion leaving us unable to properly digest food and absorb the nutrients our skin needs to repair
Disrupts the balance between oestrogen and progesterone
4. Insulin: The Blood Sugar Hormone
Insulin is the hormone which regulates our blood sugar. When levels are elevated, or poorly controlled, it can lead to, or worsen, acne by:
Stimulating the production of testosterone, which as we’ve seen can increase sebum production
Promoting the production of the hormone insulin-like growth factor 1 (IGF-1) which accelerates the turnover of skin cells, which, in combination with excess sebum, is the perfect mix for acne development
Increasing inflammation, which can make existing acne redder, more swollen and harder to heal
Strategies to Balance Hormones and Combat Acne
1. Prioritize Anti-Inflammatory Foods
Chronic inflammation worsens hormonal imbalances and acne. Incorporate anti-inflammatory foods such as:
Fatty fish (salmon, mackerel and sardines) which are rich in omega-3s
Leafy greens like spinach and kale
Colourful fruits and vegetables which are high in antioxidants
2. Regulate Blood Sugar Levels
Spikes in blood sugar lead to insulin surges, which can increase androgen levels. Tips to stabilize blood sugar include:
Choose wholefoods and avoid refined sugars and processed foods
Include a palm-sized serving of protein with every meal
Fill up with fibre from vegetables, fruits, nuts, seeds, lentils and beans
3. Support the Liver
The liver plays a crucial role in detoxifying excess hormones. Help your liver with:
Cruciferous vegetables (broccoli, cauliflower, kale, Brussels sprouts)
Adequate hydration
Herbal teas like dandelion root or milk thistle
4. Incorporate Zinc Rich Foods
Zinc helps to reduce inflammation, regulate sebum production, inhibits the growth of Propionibacterium acnes and supports skin healing. You can get plenty of zinc through your diet by consuming nuts, seeds, legumes, wholegrains and shellfish.
5. Optimise Sleep
Poor sleep increases inflammation, disrupts hormone regulation, weakens the skin barrier and increases stress. All of which can exacerbate acne.
Maintain a regular sleep schedule, even at weekends
Aim for 7-8 hours of restful sleep
Limit caffeine in the afternoon and screen time before bed
6. Mindful Skincare
Use non-comedogenic products and avoid over-exfoliating, which can irritate acne-prone skin. Look for products that are certified organic or use organic ingredients. Avoid preservatives and artificial fragrances and go for brands that are transparent about their ingredient lists, sourcing and sustainability. Some of my favourite brands are:
Antipodes - New Zealand-based skincare brand whose products are free from toxic ingredients
Moo Goo
Natural skin care products with fragrance-free options, fluoride free toothpaste and options for those with skin conditions
Weleda
B-Corp certified organic skin and body care products
MÁDARA
Organic skincare and make-up brand
Trilogy
Natural skincare and anti-ageing products based on organic rosehip oil
If you want to investigate how your hormones are affecting your acne pop me an email louise@louisegouldingnutrition.co.uk
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