Ask a Dermatologist: How to Tackle Hormonal Adult Acne

February 11, 2019

Acne: it’s something that’s often associated with teenage skin but adult acne is something that thousands of people deal with every single day.

Why? Because acne-causing factors like stress and your hormones are at play throughout your entire life— not just your teenage years.

Adult acne is especially common for women in their twenties and thirties, who may have masked any hormonal imbalances with hormonal contraceptives throughout their adolescent years. Once they stop using these methods of contraception, their hormone levels can take a while to re-regulate, which can cause spots to form.

Acne can be painful and even lead to anxiety, low-mood and depression. So we’ve asked some of the best dermatologists out there for their advice on dealing with hormonal adult acne…

Suffer from hormonal acne? Here’s what the dermatologists say…

What causes hormonal acne?

“Hormonal acne is due to fluctuations with your hormones,” says Stuart Kaplan, founder of Kaplan MD Skincare. “Up to 50% of women in their 20s, and 25% of women in their 40s suffer from hormonal acne. Menstruation and other hormonal imbalances can cause increased androgen levels, specifically testosterone. This causes increased oil (sebum) production in the pores, skin inflammation, clogged hair follicles, and increased bacteria in the pores. All of this leads to acne.” Kaplan says.

If you’re noticing problematic skin during your time of the month, it’s most likely a hormonal imbalance. During days 19–28 of your menstrual cycle (also known as the luteal phase), your oil production naturally increases.

“Oily skin has a hard time keeping up with shedding the dead skin cells, therefore, we get clogged pores which can cause spots to form. This spike in oil production can also feed existing bacteria that might be living on your skin, making our breakouts worse,” says Megan Felton, founder of Lion/ne, a London-based skincare consultancy firm.

If you’re finding that nonprescription, topical spot creams just aren’t working, you’re not alone. “This is because the deep cysts that form under the skin cannot be reached by most creams and washes,” says Kaplan. “Oral medications are more effective since they work from the inside. These include oral contraceptive pills, oral anti-androgen medications (such as spironolactone), and oral antibiotics. If your acne is severe or scarring, oral isotretinoin (Accutane) may be necessary. Whatever you do, do not squeeze or pick your pimples. This always makes it worse.”

But what if you don’t want to take medication? What’s next?

What if medication isn’t the answer?

We spoke to consultant dermatologist Justine Kluk, MD, who explained why coming off the pill could be having an effect on your skin, even months after. “The combined contraceptive pill contains both oestrogen and progesterone and can be an effective way of controlling breakouts by stabilising hormone levels and reducing androgen activity. After discontinuing the pill, some women will find that their spots start to flare within a few weeks, whilst many only start to notice the problem creeping back as long as six or even 12 months after they’ve come off it.”

So what topical treatments will work?

“If your skin is normally well behaved, it’s a good idea to up the BHA products in your regimen a week or so before your period is due,” says Felton. “This might mean switching your normal cleanser for a cleanser that’s formulated with salicylic acid, which is designed to go deeper into the pore and clean out excess oil and bacteria.”

It makes total sense to introduce spot-prone skincare and ingredients before breakouts appear rather than trying to target the cystic acne once it’s formed. But this doesn’t necessarily mean an overly complicated multi-step routine is best. Sam Bunting thinks that a simple, direct approach to skincare is the best way to target these kinds of breakouts.

“The best approach for most women is a product cull,” she tells us. “Simplify your regime, removing any irritants (like excessive use of exfoliators and overuse of foaming cleansers) and build a basic routine from non-comedogenic skincare brands instead.

I developed Flawless Cleanser and Moisturiser, the first two products in my skincare range, to meet the needs of adult skin without promoting blemishes.

“Then, depending on the severity of the condition, I will add in therapeutic products. Most acne sufferers will benefit from a retinoid (to prevent clogging) and an anti-inflammatory agent like salicylic acid or benzoyl peroxide.”

Kluk agrees that these are the key products to bring blemishes under control: “It’s important to stick to your skincare routine as much as possible, remembering to cleanse twice daily and only use non-comedogenic beauty products and makeup. Adding topical benzoyl peroxide, retinol or salicylic acid to your routine can help unblock pores by removing dead skin cells, decrease shine and reduce redness and inflammation.”

Quotes adapted and edited from Byrdie UK, 2018

One response to “Ask a Dermatologist: How to Tackle Hormonal Adult Acne”

  1. antonia_ says:

    Very interesting post and insightful! Great read

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