Salicylic Acid Is An All-Star When It Comes To Getting Rid Of Hormonal Acne
Think angry, red breakouts are only for pubescent teens? Think again. Acne doesn't discriminate by age—even adults, especially women (lucky us!), are prone to breakouts well into their 30s, 40s, and even 50s before the onset of menopause, according to the American Academy of Dermatology Association (AAD).
Even adults who never had pimples during their teen years can experience acne on any area of their face (jawline, around the mouth, or the forehead, for example) or on the body (the back or chest, for example). When this happens, dermatologists call the condition "adult-onset acne."
If you're an adult experiencing this annoying—and sometimes even painful—skin condition, experts say it's usually due to one of the following: stress, family history, hair and skincare products, medicinal side effects, an undiagnosed medical condition, or hormones.
The latter is one of the more common culprits, and the condition is typically referred to as hormonal acne.
Meet Our Experts: Michele Green, MD, a board-certified dermatologist in New York City
Sanusi Umar, MD, FAAD, a board-certified dermatologist and CEO and founder of the Dr. U Hair and Skin Clinic in Los Angeles
What is hormonal acne?
"Hormonal acne, as the name implies, is acne that is caused by an imbalance of hormones in the body," says Dr. Michele Green, a board-certified cosmetic dermatologist in New York City.
What causes hormonal acne?
As you might suspect: clogged pores, says Dr. Sanusi Umar, a board-certified dermatologist and CEO and founder of the Dr. U Hair and Skin Clinic in Los Angeles. Fluctuating hormones can cause excess or overproduction of sebum (the oily substance in skin glands), a buildup of dead skin cells, or an accumulation of bacteria, he explains.
"There are various conditions that may influence the presence of hormonal acne including puberty, polycystic ovarian syndrome, menopause, menstrual cycle, and increased androgen levels," says Green. "Stress and diet can also impact hormonal acne breakouts," she adds. Even pregnancy or beginning or discontinuing the use of birth control pills can cause pimples.
How do I know I have hormonal acne?
But how do you know if your red spots are caused by hormones or something else altogether? And why is that important? Pegging down the root cause of your acne can help inform an effective treatment plan. For example, if a product is causing breakouts, the answer could be as simple as discontinuing usage. On the other hand, if you're experiencing hormonal acne, treatment may be a little bit more complex.
Green says hormonal acne typically presents as cysts along the jawline and on the chin in adults and in the T-zone during puberty, but it can also present as whiteheads, blackheads, papules, and pustules, says Umar—and that's exactly why it's important to consult a board-certified dermatologist who can help you correctly identify your condition.
In the meantime, you can also look for patterns. "It is common for hormonal acne to reappear in the same areas in a cyclic fashion," she explains. "Many adult patients struggling with hormonal acne indicate that their breakouts are more pronounced for a certain period each month or when they have endured significantly more stress."
How do I treat hormonal acne?
Typically, treatment for hormonal acne is multi-pronged and includes the following, says Green:
Topical over-the-counter products: "Benzoyl peroxide is an excellent acne-fighting skincare ingredient that is commonly found in cleansers and spot treatments alike," says Green. "Benzoyl peroxide eliminates bacteria on the skin’s surface and reduces the amount of excess sebum in the pores, essentially drying up zits and controlling breakouts." Salicylic acid is another anti-inflammatory skincare ingredient that gently exfoliates the skin, she adds. "It penetrates deep into the pores to remove dead skin cells, debris, and sebum." Another popular remedy? Tea tree oil, which is a natural anti-inflammatory and anti-microbial. Some find success with green tea, too, says Umar. "It decreases inflammation in the body and can be consumed orally as tea or as part of a topical skin care regimen," he explains. "If using lotion or gel, use at least 2 percent green tea extract for best results."
Stress management: Finding ways to reduce stress, like regular exercise or meditation, can help control hormonal imbalances associated with the body's fight or flight response, says Green.
A change in diet: In attempt to naturally combat hormonal acne, patients can try to limit dairy and fatty foods. "Foods that have been linked to increasing levels of acne-causing hormones include dairy, trans and saturated fats, and high-glycemic carbs," says Green. Swap lean protein for red meats and including plenty of different colored fruits and vegetables into your diet.
Prescriptions: "Topical and oral antibiotics are also effective treatments for resolving acne breakouts," says Green. "Clindamycin and erythromycin are topical antibiotic treatments that reduce the number of acne-causing bacteria on the skin and minimize inflammation associated with breakouts. Oral antibiotics like doxycycline may be prescribed for infected acne breakouts that are often characterized by redness, inflammation, and tenderness to the touch." Of course, you'll need to see a board-certified dermatologist to discuss these options to find out whether or not they're right for you.
How long does it take for hormonal acne to clear up?
"Hormonal acne may resolve on its own once hormone levels in the body become balanced, though it is common to experience hormonal acne breakouts in cyclic episodes as hormones fluctuate overtime," says Green.
So while your pimples may disappear in as little as one week, Green says they're likely to return and can even cause permanent scarring if left untreated. "For patients who forgo evaluation and treatment with a dermatologist, their hormonal acne can last for years," she says.
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