Acne and Hormones




Have you ever noticed acne breakouts coming at weird times and wondered why? I know you’ve had them. We all have! They’re embarrassing, come at the worst time, and are hard to hide… and it may be due to your hormones.

Many people think it’s something that passes after the teen years but most of my clients are way past puberty and are still complaining about breakouts. It’s become the #1 skin problem in the United States..

Acne is not just a problem for teens. It affects more than 40 million people — over half of whom are women older than age 25. More than 4 out of 5 people between ages 12 and 24 develop acne at least once in their life.

Although acne is sometimes viewed as a superficial health concern, those of us who’ve had it know breakouts can cause permanent damage — physical and emotional — not to mention skin scarring and discoloration.

Acne is known as an inflammatory disease of the sebaceous glands and hair follicles of the skin, and, is marked by the eruption of pimples or pustules that can appear on the back, chest, arms, and commonly on the face.

An increase in oil secretions may build up beneath a blocked pore, allowing bacteria, including Propionibacterium acne (P. Acne), to proliferate. Conventional approaches to treating acne have a host of shortcomings, so it’s no surprise many people who use common medications are left feeling fed-up and helpless after trying them and not seeing results.

One of the main triggers for acne is from hormones, and that’s why we often see acne breakouts during puberty, starting/stopping birth control pills and around menopause.

But, have you noticed acne flare-ups when you’re stressed or when you eat the wrong foods? Did you know that can be hormonally related as well?

Here are the 3 hormones that are most connected to acne breakouts:


1. Androgens

In excess, androgens cause an increase in sebum which provokes acne breakouts. Androgens are made in the gonads and adrenal glands (in both men and women), and they also can be made locally in the sebaceous glands. Your body may be making these in excess and leading to acne.

Taking/using testosterone and DHEA increases the size and secretion of sebaceous glands, so if your doctor has prescribed these for you and you have acne, be sure to check with him or her to ensure you’re on the correct treatment regime.

2. Cortisol

High cortisol leads to more sebum production and inflammation which, again, triggers acne. When we’re stressed, cortisol goes up and that leads to this cascade. Cortisol is great to help us respond to stressful situations or get us going in the morning, but cortisol levels should taper off as the day progresses so we can relax and fall asleep at bedtime.

If we continue to be stressed without relief, then our adrenal glands that release cortisol get tired or confused and don’t work normally. That’s one of the ways we end up with high cortisol. As we age, we tend to have higher cortisol as well.

3. Insulin

High insulin has been shown to stimulate sebum production and androgen activity. When we get excess amounts of sugar in our diet or have high blood sugar levels, our insulin kicks in, which can lead to the acne cascade.

Insulin resistance, the inevitable result of chronically elevated insulin levels, becomes bad news. It leads to hair growth on the face and body and loss of hair on the head in women. Many women also get acne and irregular menstrual cycles. For some, it manifests as polycystic ovary syndrome (PCOS), primarily caused by too much sugar, which becomes associated with acne among other problems.

While pimples are not as simple as too much milk or sugar, both have a significant impact on acne. The biggest factor affecting your hormones is the glycemic load of your diet (how quickly the food increases your blood sugar and insulin levels).

To reverse insulin resistance, inflammation and other acne triggers, you’ll want to eat a diet rich in omega-3 fats and fiber (to reduce testosterone in women), cut out sugar (to reduce insulin).

Gut health certainly plays a role in skin health: Foods like gluten, dairy, yeast, and eggs can be problems if you have a leaky gut.

But many of these conditions trigger or exacerbate elevated insulin levels, knocking other hormones out of balance and contribute to inflammation, metabolic havoc and conditions like acne.

Simply put, to get your acne under control, get your insulin levels under control.
Sugar, in some form or fashion, will alter your blood sugar levels. Anytime you eat a food high in sugar, your blood sugar rises rapidly, and then falls shortly after insulin is released into your cells. This creates a huge drop in blood sugar that can make you shaky, hungry and moody. Anytime this happens, your body creates internal stress, which can also lead to breakouts.

What do we do about hormonal acne? Heal acne from the inside and out…

1. Heal the gut

It may seem strange to talk about the digestive tract when we’re discussing hormones, but the gut microbiome (the balance of micro-organisms like the good bacteria found in yogurt cultures) plays a role in balancing hormones.

Research indicates addressing the gut microbiome is important in addressing acne, and probiotics can help restore a healthy gut flora and help balance hormones. Taking probiotics (such as lactobacillus), prebiotics, and digestive enzymes can improve acne. Work with an integrative physician to correct leaky gut and other gut issues. I have seen serious cystic acne resulting from gut imbalances and parasites that resolve when the gut is fixed. I recommend Strengtia from Apex Energetics or Premier Research Labs Probiotics.

2. Manage Stress

Stress, especially in combination with digestive and gut microbiome imbalances and poor diet, triggers inflammation, oxidative damage, and high cortisol. None of this is good for the skin. Whether it’s a warm bath with a few drops of lavender essential oil, restorative yoga classes, listening to soothing music, a stroll thru nature or some other way to calm your mind and soul, pick one to do every day. Chronic stress causes acne flare-ups by increasing inflammation and oxidative stress, raising cortisol and depleting zinc, magnesium, and selenium, which help control acne. Stress also causes poor dietary choices. You can manage stress through meditation, yoga, saunas, massage, biofeedback, aromatherapy, and more. Relaxing is anti-inflammatory. .

3. Improve detoxification

One of our liver’s jobs is metabolizing hormones, and when our detoxification pathways are suboptimal, we can end up with imbalances in hormones and their metabolites. A well designed cleanse program can enhance liver detoxification. The amino acid glutathione (also a potent antioxidant) is lower in the skin of acne patients compared to people without acne. Certain nutrients such as N-Acetyl Cysteine and Vitamin C can boost glutathione and support detoxification.

4. Balance hormones naturally

Chasteberry, or vitex, can be helpful for women when hormonal imbalance is the underlying trigger for skin problems. It is reported to have hormonal effects similar to progesterone in the body, and research shows it can relieve acne symptoms.

For men or women with excess testosterone, the supplement Saw Palmetto may help curb the excess. Saw palmetto, most often used for prostate health, can reduce facial hair and acne in women. Take 320 mg twice a day, once with breakfast and once with dinner. Hormones can be confusing, so if yours are out of balance, it’s best to work with a naturopathic physician or functional medicine doctor who really knows how to balance hormones naturally.

5. Reduce sugar

When you reduce your sugar intake, it’s easier to manage your blood sugar and insulin levels. Sugar is hidden in many foods, so in addition to avoiding sugary treats and sodas, read ingredient labels for sugar in popular packaged foods like breads, crackers, juice, smoothies, dressings, and condiments. And, remember, many other foods turn into sugar in the body like breads, pastas, and other high carbohydrate foods.

In addition to reducing sugar, be sure to eat plenty of fiber, protein, and healthy fats at your meals to prevent the spikes and crashes. If your blood sugar runs high or you’re not sure, talk with your doctor to have your levels tested.
Sugar (including flour). Sugar raises insulin levels, which promotes the production of testosterone in women, and inflammation in general, causing acne. Large randomized prospective controlled trials (the gold standard of medical research) found people who had higher sugar intake and a high glycemic load diets (more bread, rice, cereal, pasta, sugar and flour products of all kinds) had significantly more acne.

Dairy consumption. Hormones (including growth hormones) in dairy contribute to acne. Two large controlled trials found cow’s milk increased both the number of people who got acne and its severity.

Other acne-triggering dietary culprits include processed fats like trans fats, which increase arachidonic acid levels and compete with omega-3 fats in the body, leading to more inflammation and acne.

But the big two – dairy and sugar (in all its blood sugar-raising forms) – cause spikes in certain pimple-producing hormones. Dairy boosts male sex hormones (various forms of testosterone or androgens) and increases insulin levels, very similarly to sugar and starchy carbs, which quickly raise blood sugar and spike insulin.

What you eat becomes the root cause of most acne. Along with a high-processed, high-sugar, high-dairy diet, studies show nutrition-related lifestyle factors can contribute to and exacerbate acne.

The reason why most home remedies for acne don’t work is simple. They focus primarily on topical treatments, when the root cause is actually an internal problem.

In my practice, I’ve seen numerous patients struggle with acne and other skin problems. Almost always remedy the issue without resorting to harmful antibiotics and other conventional therapies

Beauty is an Inside Job. Make a Promise to your Skin Today!

Karen Johnson is a Naturopathic Doctor and a Licensed Esthetician. She has helped many clients with acne and digestive disorders naturally. If you have any questions and would like to schedule a consultation contact Karen at 949-400-5455 or go to