What is hormonal acne?

Most of the acne we are familiar with is hormonal acne, also known as acne vulgaris. Most simply, it is acne that develops due to hormonal changes and imbalance, usually as a result of there being too much male hormone, or testosterone. Testosterone increases how much oil the skin secretes, which can lead to clogged pores. These can then be colonised by a bacteria known as Cutibacterium acnes, irritating the skin cells and leading to inflammation.

Hormonal acne is most common in teenage years when our bodies are undergoing many changes, but can arise at any time in your life.

Is there a difference between acne, hormonal acne, acne during puberty and acne vulgaris or are they all the same thing?

While the reasons for someone getting acne might differ, all acne is caused by excessive oiliness of the skin. While some people may normally have oilier skin, unexplained and regular bouts of acne all point to the same underlying causes – insulin resistance and hormonal imbalance. So while you have heard of different names, these acnes are actually the same. It should be noted, though, that hormonal change at certain times of one’s life, like puberty, is normal, even if uncomfortable, while at other times may point to a bigger problem.

How are acne, insulin and my hormones linked?

Insulin and hormone balance are tightly connected. When insulin becomes too high, it is able to suppress the action of female hormones, and enhance that of male hormones. At the same time, male hormones, like testosterone, are able to cause insulin resistance. What this leads to is a snowball effect where hormones become more imbalanced and insulin resistance increases.

Male hormones are also responsible for causing higher amounts of oil, or sebum, production in the skin, especially on the face. This leads to blocking of pores and the development of acne.

I’ve already undergone puberty or am an older adult, what does it mean if I still suffer from acne break-outs?

Experiencing acne past puberty is not so rare that you should be worried, especially if you only get a few spots every now and then. Acne can be caused by many things, and you should try and figure out what is associated with spots. If you’ve tried your best, however, and either can’t find any link, or your acne is persistent, it may be worth considering that underlying hormonal imbalance or insulin resistance may be the cause.

I only get acne a few times a year, should I be worried about PCOS, insulin resistance or hormonal imbalance?

If your acne occurs only intermittently, without any other symptoms, it is not likely caused by chronic insulin resistance or hormonal imbalance but more likely some lifestyle factor like stress or a poor diet during the holidays. That even intermittent acne might be a sign of some underlying condition, however, should not be ruled out. This is especially the case if you experience any of the other symptoms of insulin resistance or hormone imbalance.

What are some symptoms of insulin resistance or hormonal imbalance that I should be especially aware of?

Insulin resistance and hormonal imbalances go hand-in-hand, and so signs of symptoms of the one can point to the other. If you experience any of the below, especially in combination with acne, it may be prudent to consult with your doctor:

  • Difficulty losing weight or weight gain
  • A waist measurement over 88cm for a woman or more than 102 for a man
  • Always hungry or thirsty
  • Excessive urination
  • Hair loss or growth
  • Emotional changes
  • Infrequent, irregular or prolonged menstrual cycles and/or infertility.

How can I address my acne and what are the treatments?

Acne can be caused by many things, but ultimately is a result of excessive oiliness of the skin leading to blocked pores, invasion by the bacteria C. acnes, and ultimately, inflammation. Treatment for acne should therefore be multi-layered, focussing on the underlying cause of oily skin, prevention of pore blockage and suppressing inflammation in the skin. In any of these cases, however, the over-bearing evidence is that acne can be significantly reduced by adopting positive lifestyle modifications.

  • Maintaining a healthy weight. Weight loss can reduce insulin and androgen levels and may restore ovulation. Even slight reductions (as little as 5%) can make a difference and improve fertility.
  • Avoidance of processed, high-carbohydrate foods. Diet should be centred upon plant-based, minimally processed foods comprising complex carbohydrates, healthy fats and proteins.
  • Staying active. Exercise helps lower blood sugar levels, reduce inflammation and improve hormonal regulation.
  • Avoiding toxic substances, such as tobacco and alcohol. Not only can these cause direct damage via oxidative stress, but also affect hormonal regulation and inflammation.
  • Practising a good skin care routine.
  • Avoiding dairy if it appears to make your acne worse.
  • Taking supplements like SkinVance+Zinc™, aimed at improving insulin sensitivity, hormonal balance and reducing inflammation.