Hormonal shifts throughout the month come with their own host of side effects. Moodiness, fatigue, headaches, irritability, and of course, acne.
Research shows that 65% of women report an increase in acne before and during menstruation[1]. What makes hormonal acne particularly frustrating is that it isn’t just something you can fix with a topical cream — the source comes from internal imbalances.
In this article, we’ll discuss:
- What causes hormonal acne
- How acne medications can make things worse
- The top 3 hormonal acne supplements you need
- Other tips for fighting hormonal acne
What Causes Hormonal Acne?
Hormonal acne is caused by imbalances in male and female sex hormones. When male sex hormones rise or female sex hormones fall, it can set the stage for acne progression. While it’s normal and actually quite important that we have fluctuations in these hormones throughout the month, there is a tipping point where hormonal shifts can create the perfect environment for the development of acne.
Many women notice that they start spotting acne right before their period while they move from ovulation to pre-menstruation. During this time, the female sex hormones estrogen and progesterone naturally start to fall, giving more prevalence to the male androgen sex hormones.
Androgens stimulate the production of sebum in your sebaceous glands. When in balance, this helps to lubricate your skin and protect it from moisture loss. When androgens are out of balance, however, it can overstimulate the production of sebum resulting in accumulation in the glands of your skin. This also provides an ideal environment for the growth of the bacteria Propionibacterium acnes[1].
Research shows that your sebaceous glands not only respond to high levels of androgens in your blood, but they may also produce their own androgens. This process, known as intricate secretion, means that your skin cells can produce the very hormones that will stimulate the onset of acne.
Interestingly, this intracrine function is regulated by a hormone called corticotropin-releasing hormone (CRH). In addition to androgens, stress can also increase CRH, which is why some people find that they break out when they’re under a lot of stress[2].
In addition to sex hormone fluctuations throughout the month due to the menstrual cycle, diet may also contribute to hormonal acne.
Insulin and insulin-like growth factor (IGF-1) are two hormones that help to control blood sugar. When you consume a balanced amount of carbohydrates, these two hormones work in your blood to shuttle glucose into your cells to be used for energy or stored for later. Once their job is done, the levels of these hormones drop down to baseline. However, if your diet is rich in simple carbohydrates, insulin and insulin-like growth factor levels can rise and increase the production of androgen hormones[3].
What’s more, just like androgens, IGF-1 can increase sebum production in your glands while also initiating inflammation — the perfect recipe for acne[4].
The Problem With Acne Medication
If you struggle with hormonal acne, you’ve likely taken, or are considering taking, acne medication. Unfortunately, acne medication either doesn’t work for many people, or it comes with devastating side effects.
For instance, birth control pills are a very common go-to for managing hormonal acne. Birth control works by altering your hormones, helping to balance androgen production. While many people do see benefits for acne, they also experience side effects like fatigue, weight gain, headache, nausea, bloating, irritability, and hair loss — to name a few[5][6].
Furthermore, many women experience even greater fluctuations and side effects when they finally get off birth control.
Then there are drugs that are specifically designed to treat acne, like Accutane. Accutane may directly target your skin, but the effects of this medication are wide-reaching. Along with dry and itchy skin, decreased night vision, sun sensitivity, and depression, this medication can also cause congenital disabilities in the fetuses of women taking Accutane. For this reason, women are required to take birth control while taking this particular acne medication[7].
Dermatologists may also recommend antibiotics or antibacterials, which will give you short-term relief from acne but don’t get to the root cause of your acne issues.
Long-term antibiotics can also create issues with gut health by killing off your good bacteria and creating dysbiosis. Over time this could instigate a leaky gut, which can set the stage for autoimmune disease[8].
Top 3 Hormonal Acne Supplements
Instead of taking your chances with acne medications and drugs that impact your hormones, your best bet is to go the natural way and get to the root of your acne issues.
#1 Red Reishi
Reishi mushrooms have been revered for their health benefits like reducing stress, improving immunity, and enhancing energy for thousands of years.
Red reishi is a species of reishi mushroom that helps with acne by specifically targeting androgen hormones.
Research shows that red reishi can inhibit the activity of an enzyme called 5-alpha reductase, which is responsible for converting testosterone into the compound DHT. DHT is directly involved in signaling the sebaceous glands to produce sebum. Therefore, by inhibiting 5-alpha reductase, red reishi helps to fight against the progression of acne[9].
#2 Omega-3 Fatty Acids
Omega-3 fatty acids are one of the most well-researched supplements for inflammatory conditions. At its core, acne is considered an inflammatory skin disease, making nutrients that can calm inflammation an essential piece of the acne-fighting puzzle.
Interestingly, research shows that acne is very rare in countries where omega-3 intake is high[10].
Omega-3 fats fight inflammation by reducing the production of inflammatory chemicals, such as eicosanoids and cytokines. By calming the inflammatory process in your body, these fats eliminate one of the central players in the progression of acne[11].
Omega-3 fatty acids have also been shown to improve overall skin health by protecting against UV radiation (sun damage), improving skin hydration, and supporting wound healing[12][13][14].
#3 Zinc
Zinc is well-known for its ability to support immunity and decrease inflammation. Along with sebum production and bacteria, inflammation plays a central role in the progression of acne.
Research shows that both topical and oral forms of zinc can help to treat moderate to severe acne. With that being said, oral supplementation seems to work best, especially in more severe cases[15].
Zinc exhibits anti-inflammatory activity by decreasing inflammatory mediators and also combating oxidative stress. Along with inflammation, oxidative damage can contribute to skin issues via damage to your skin cells and tissue[16][17].
In addition to its anti-inflammatory and antioxidant activity, zinc may also decrease oil production in your skin by modulating androgen levels, specifically targeting DHT[18].
Other Ways To Reduce Acne
In addition to taking targeted supplements, a few lifestyle factors contribute to the progression of hormonal acne that you should keep in mind. Changes in these areas can make a significant difference in the way your body handles both your hormones and the onset of acne.
Diet
When it comes to anything happening in your body, diet almost certainly plays a role. In the case of hormonal acne, this is especially true.
As mentioned previously, inflammation is a key player in the progression of acne. Nine times out of ten, if you have excess inflammation in your body, it’s due to poor diet choices. Avoiding inflammatory foods can make a big difference in the health of your skin and every other tissue or organ in your body, for that matter.
Highly inflammatory foods include sugar and high-fructose corn syrup, trans fats and vegetable oils, refined carbohydrates, alcohol, and low-quality meat. Avoiding processed foods and foods that are high in sugar is always a fail-safe if you’re trying to lower your inflammatory load.
Sugar, in particular, should be avoided if you’re trying to fight acne. When you consume sugar, it signals insulin and IGF-1 to increase; in excess, these hormones stimulate androgen, inflammation, and sebum production[19].
Support Your Liver
Your liver plays a crucial role in supporting hormone balance. When hormones are too high, it’s your liver’s job to clear them from your blood and get you back into homeostasis.
Unfortunately, with the number of toxins in our environment today, many people’s livers are completely taxed. This organ is so busy trying to clear your body of heavy metals and other pollutants that hormones end up building up.
When you support the health of your liver, you provide it with the building blocks it needs to keep functioning optimally. To keep the flow of toxins moving out of your body, along with endogenously produced compounds like sex hormones, you must provide your liver with nutrients that keep the system moving.
I take Daily Detox every morning to offer support to my liver, along with metabolic, anti-aging, immune, and digestive support for my body.
Manage Stress
Stress can activate the same pathway that androgen hormones do in the initiation of sebum production. As mentioned earlier, the intracrine function of your sebaceous glands is regulated by the hormone corticotropin-releasing hormone (CRH), which can be modulated by stress[20].
Managing stress may sound simple, but unless you have the correct tools in place, it can be a tall order. Some of the most well-researched stress reduction activities include:
- Yoga
- Breathing exercises
- Physical activity
- Meditation
- Journaling
- Connecting with friends and loved ones
- Spending time in nature
- Engaging in a creative outlet
You may want to try a handful of techniques to find which one works best for you. In general, a stress-reduction activity doesn’t necessarily remove the stressor from your life but rather helps you get emotional and mental space from it so you can handle it from a more grounded perspective. In this way, stress reduction strengthens your state of mind so you can handle stressors with more ease.
Skincare
Of course, when it comes to managing acne, taking a look at your skincare routine is essential.
Some obvious steps to take include washing your face after workouts, before bed, and in the morning. It’s important to find the cleaners that will work for your skin type. If you have sensitive skin, washing with a more aggressive cleanser will only make matters worse.
You’ll also want to stay on top of switching out your face towel. Make sure to use a new towel every couple of days to avoid bacteria buildup on the towel.
And finally, choose makeup and skincare products that are natural and free of harmful chemicals. The Environmental Working Group (EWG) has a database called Skin Deep that can help you choose which products and brands are right for you. All of the products are graded for their individual ingredients regarding safety and purity. What you put directly on your skin can have a significant impact on the health of your skin cells — so make sure your beauty products are top-notch.
Takeaway
Whether you’ve just begun to notice hormonal acne, or it’s something you’ve struggled with for years on end, the good news is there is a way to fight it. Hormonal acne is like the canary in the coal mine, signaling to you that something is out of balance with your hormones.
Combating this type of acne comes from a two-fold approach:
- Manage the hormonal component
- Manage the general factors that increase acne progression
By tackling your hormonal imbalances with nutrition, supplements, and lifestyle, you’ll get to the root of your acne issues. Meanwhile, address some of the other underlying causes of acne-like inflammation and general skincare to ensure that your skin environment is primed for health instead of setting the stage for breakouts.
Whatever you do, try to avoid prescription acne medication and hormonal treatments like birth control. These tactics not only ignore the root cause of your hormonal acne, but they can produce an array of unwanted side effects that will only make matters worse.
