Woman with oily skin and acne scars

Woman with oily skin and acne scars

When our hormones are helter skelter

Like during puberty or pregnancy.

It can frustratingly present itself in the skin.

If your suffering from hormonal acne, understanding the complex role they play, will help considerably.

HORMONES

Hormones are molecules involved in just about every biological process in the body:

  • Immune function
  • Menstrual cycles
  • Reproduction
  • Muscle growth
  • Organ and cellular growth
  • Controlling energy levels

Hormones work in very small concentrations, carrying instructions from more than a dozen endocrine glands, tissues and cells to all over the body.

They are released by one of about a dozen glands that travel throughout the body, either in the blood stream or in the fluid around the cells, looking for target cells with a receptor that fits.

Once they bind with a receptor, they specifically change the cells activity, sending a signal to the cell to produce a certain protein or to multiply.

The protein receptor reads the hormones message and carries out the instructions, either by influencing gene expression, or altering cellular protein activity.

These actions produce a variety of rapid responses in the body.

TYPES OF HORMONES

Estrogen

There is no one hormone called estrogen, it is the name given to a class of hormones.

The three major types of hormones produced by women are estriol, estradiol and estrone.

Estrogen is known as a female hormone, because it plays a key role in shaping the female body, preparing it for uniquely female metabolic processes and functions, such as pregnancy.

This article does a great job of explaining how hormones influence acne in women.

Progesterone

This is made by the adrenal glands and ovaries during ovulation, it is recognised as one of the important types of hormones in women.

It is the precursor to estrogen, testosterone and all of the steroid hormones.

The most important role of progesterone is to counter the effects of estrogen, and help provide an environment for a successful pregnancy,

It does also have other functions including improved sleep, balancing body fluids and improving fat metabolism.

Progesterone deficiency is responsible for many of the symptoms associated with menopause.

Androgens

These are sex hormones that are produced by the ovaries and adrenal glands in women, and by the testes in men.

This family of androgens is responsible for masculine qualities such as hair loss as well as an increase in both facial and body hair as well as acne in some cases.

Androgens are a group of three hormones, known as testosterone, DHEA and androstenedione.

Dehydrospiandrosterone

Also known as DHEA, it is the principle androgen steroid hormone, found in both men and women.

It is produced in the adrenal cortex and converted into estrogen and the androgen type metabolites, a substance produced by biologically processes found only in the skin.

Androstenedione

This is a metabolite of DHEA and serves as a direct precursor in the bio-synthesis of testosterone.

Testosterone

This are the most potent types of hormones, that are naturally occurring androgens, they are the main hormone responsible for male characteristics.

Testosterone is usually addressed through hormonal treatment.

This is due to the fact that it works to stimulate sebaceous oil gland activity, creating an oily skin that is easily susceptible to breakouts.

Although testosterone is often thought of as a male hormone, women also require it in small amounts.

Problems occur, if women start to produce to much testosterone, which can cause polycystic ovary syndrome.

The other cysts created by this condition are often responsible for the angry inflamed pustules, breakouts and acne scars that are associated with hormonal breakouts.

If a women makes too little estrogen to mask the testosterone, they can also develop a genetic disposition towards highly sensitive skin.

Testosterone arises from the circulation and is converted to its more potent reduced form, dihydrotestosterone (DHT) by the enzyme 5A reductase.

5a Reductase

There are two different forms of reductase, type1 and type2, which are both very active in different regions of the body.

Reductase is responsible for converting dihydrotestosterone, this disperses throughout the body where it can erupt and effect other organs.

Type 1: Predominates in sebaceous glands, influencing sebum production.

It is Type 1 that is important when understanding and establishing the cause of female hormonal acne.

Type 2: An enzyme that is restricted to certain sites including the hair follicle, prostate and other tissues involved in sexual differentiation

Dihydrotestosterone

Otherwise known as DHT, 5a reductase is the enzyme that converts the male hormone testosterone, into the more potent hormone DHT.

This stimulates the sebaceous glands, causing an increase in sebum production, which can lead to an oily skin.

As follicles become filled with excess oil, which oil loving P,Acnes love, they become blocked.

It is this blockage that creates comedones and acne breakouts.

HORMONAL ACNE QUESTIONS

WHY DOES ACNE START AT PUBERTY?
As young adults we develop sex hormones.

Male hormones known as androgens are produced by the testes in men and adrenal gland in women.

Androgen is an endocrine hormone, which simply means it flows directly into the blood stream, one of it’s functions is a stimulant for a sebaceous gland.

When we reach puberty, androgens first start affecting our skin, pores start appearing which is due to the follicle being dilated from oil flowing to the surface, these pores spread across the nose, cheeks and chin.

The androgens switch on our oily sebaceous glands, they go about their business flowing through the blood stream, and when they come into contact with a sebaceous cell, they start to produce oil.

They coat the cell and if they build up it can block the pore creating pimples, an oil rich environment that p.acnes bacteria love.

WHAT IS ADULT ACNE ?
Whilst this could be to do with genetics it is mostly hormonal

Because more women have intricate hormonal processes in their body, glands secrete different hormones at different times during the cycle.

Which is why fluctuations are seen at such things as birth control, pregnancy and illness,

WHY DO WE GET PRE-PERIOD BREAKOUTS?

Around 8-10 days before a period, the body realises the cycles egg will not be used, this begins a hormonal process to start the period.

There are a series of hormonal reactions that take place to achieve this process, which stimulates the sebaceous glands, causing surges in the sebum in the follicle, that leads to breakouts.

DOES STRESS CAUSE ACNE?

Much of the androgen hormone is produced in the adrenal gland which produces adrenaline, the hormone that copes with stress.

When it is in over drive in a stressful situation, androgens are produced in larger quantities, making it likely for sebaceous glands to be produced in larger quantities, this stimulates the flow of sebum, more follicles become impacted, resulting in a breakout.

As you can see, the relationship between the types of hormones and acne is very complicated.

If you are concerned hormones maybe the cause of your acne, seek medical advise from a doctor or dermatologist, who will be able to assess your skin and give you the best acne treatment for your particular condition.

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