New research offers insights
For millions of women, it happens every month. Cramping, bloating, mood swings . . . and acne. Experts have always known there was some sort of link between hormones and acne, but few did research on "women's issues" in this area-until now. A recent study conducted by dermatologist Alan Shalita, MD, confirmed that nearly half of all women experience acne flare-ups during the week preceding their period.1 So if you get it, you're not the only one.
The question is, do you have hormonal acne or is something else going on? It's important to know because hormone-related acne may not respond to traditional therapies, such as topical retinoids, systemic or topical antibiotics.
Several clues can help you and your doctor identify whether hormones are causing your acne:
*Sudden adult-onset acne breakouts that appear for the first time
*Acne flare-ups that precede your menstrual cycle
*A history of irregular menstrual cycles
*Increased facial oiliness
*Hirsutism (excessive growth of hair, or hair in unusual places)
*Elevated levels of certain androgens in the blood stream
While hormonal acne typically begins around age 20-25, it can strike teens and mature women as well, and is most persistent in women over the age of 30. Surprised? A lot of people are.
If you have it, you'll usually experience lesions on the lower face, especially the chin and jaw line. While some breakouts may occur on the chest and back, most blemishes will show up exclusively on the face. Hormonal acne is typically moderate and limited to inflammatory papules, small inflammatory nodules and occasional comedones (whiteheads, blackheads).
But how does it start?
Puberty: Where it all begins. Starting sometime before adolescence (around the age of nine or ten) your adrenal glands begin to produce dihydroepiandrosterone sulfate (DHEAS), an androgen. Other androgens - the male hormones at work in a woman's body - such as testosterone and dehydrotestosterone (DHT), join in at the onset of puberty. All of these hormones stimulate your sebaceous glands to secrete more of the skin's natural oil, or sebum. This is why oily skin and acne are so prevalent among teenagers. Naturally, since boys have more male hormones, teen acne tends to be more severe in males.
A vicious cycle. Many women pass into adulthood without outgrowing their acne. Others may not develop it until their 20s or 30s, experiencing persistent breakouts the week before their period. Why? During the course of a normal menstrual cycle, your estrogen levels peak at mid-cycle, then decline as you approach your period. After ovulation, your ovaries begin to produce progesterone, another hormone that stimulates the sebaceous glands. And with the extra oil comes acne.
Pregnancy. Hormones are also responsible for acne in a percentage of pregnant women. During pregnancy, your sebaceous glands go into high gear causing oily skin ( probably not the "glow" you were looking for) and in many cases, acne. Acne during pregnancy isn't limited to the face either, many pregnant women experience breakouts on the chest and back, as well. While acne during your pregnancy may be distressing, it is very important that you speak to your physician or a dermatologist before you apply any medication or home remedy to your skin. Ask your doctor what the safest course is for you and your baby.
Menopause. Some women even experience acne after menopause, when estrogen levels begin to taper off and testosterone becomes the dominant hormone. Again, if this is happening to you it's not uncommon. That said, it's still best to consult your dermatologist prior to beginning any treatment or regimen.
If you think you have hormonal acne, regardless of your stage of life, it's always best to consult your dermatologist first.
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- Did you know antibiotics can be prescribed for acne? learn more