When our hormones are helter-skelter, it can frustratingly present itself in the skin.
Understanding the complex role they play, will help considerably.
Here at the NC, there are several questions we regularly get asked about hormonal acne.
So we thought we’d put together this little Q and A for our readers.
To help you to get to the bottom of your hormonal skin.
Why does acne start at puberty?
As young adults, we develop sex hormones.
The testes produce male hormones known as androgens in men and the adrenal gland in women.
Androgen is an endocrine hormone, which means it flows directly into the bloodstream, one of its functions is a stimulant for a sebaceous gland.
When we reach puberty, androgens first start affecting our skin; pores start appearing 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 bloodstream. 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. acne bacteria love.
What exactly 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; this is why fluctuations are seen during 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 to achieve this process, which stimulates the sebaceous glands, causing surges in the sebum in the follicle, leading to pimples.
Does stress cause acne?
Much of the androgen hormone is produced in the adrenal gland which produces adrenaline, which copes with stress.
When it is in overdrive in a stressful situation, androgens are produced in larger quantities, making it likely for sebaceous glands to be produced in larger quantities, stimulating the flow of sebum 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 may be the cause of your acne, seek medical advice from a doctor or dermatologist, who will be able to assess your skin and give you the best hormonal acne treatment for your particular condition.
Let’s dig a little deeper and look at the types of hormones that influence acne for those keen.
Hormones in the body
Hormones are molecules involved in just about every biological process in the body:
- Immune function
- Menstrual cycles
- Muscle growth
- Organ and cellular growth
- Controlling energy levels
Hormones work in minimal concentrations, carrying instructions from many different endocrine glands, tissues, and cells all over the body.
They are released by one of about a dozen glands that travel throughout the body, either in the bloodstream 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 multiply, the protein receptor reads the hormone’s message. It 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.
The types of hormones
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.
Oestrogen is 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.
The adrenal glands and ovaries make this 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.
These are sex hormones 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 and an increase in both facial and body hair and acne in some cases.
Androgens are a group of three hormones, known as testosterone, DHEA and androstenedione.
Also known as DHEA, it is the principal 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.
This is a metabolite of DHEA and serves as a direct precursor in the biosynthesis of testosterone.
This is the most potent type of naturally occurring androgens; they are the main hormone responsible for male characteristics.
Testosterone is usually addressed through hormonal treatment.
This is because it stimulates 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 too 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 women make too little estrogen to mask the testosterone, they can also develop a genetic disposition towards susceptible skin.
Testosterone arises from the circulation and is converted to its more potent reduced form, dihydrotestosterone (DHT) by the enzyme 5A reductase.
There are two different forms of reductase, type1, and type2, which are both very active in different body regions.
Reductase is responsible for converting dihydrotestosterone; this disperses throughout the body where it can erupt and affect 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
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, leading to oily skin.
As follicles become filled with excess oil, cutibacterium acne become active and block them, which leads to comedones and acne breakouts.