Stubborn Acne? Test These Parameters

Persistent acne can be due to hormonal imbalances. Understand how hormones can impact acne and what you should be on the lookout for.

By URLife Team
06 Jun 2024

Are you dealing with persistent acne despite having tried spot treatments, pimple patches, and anything with an “acne-fighting” label on it? If yes, then this is the sign to take a closer look at what’s going on beneath your skin. Acne can also be an indicator of hormonal imbalances.

The doctors mostly do not recommend a hormone test. This is because treatments like birth control pills and anti-androgen drugs are effective and work no matter what kind of hormone imbalance you have. These medications are powerful enough to override any hormonal imbalance. But the issue is, when you stop taking them, your hormonal imbalance and acne can return. To get rid of your acne for good, you need to balance your hormones.


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How To Know It Is Hormonal Acne?

Hormonal acne is associated with sex hormones that influence how much (or how little) sebum (oil) the sebaceous glands in your skin produce.To naturally solve hormonal acne, knowing your hormone levels is important. Testing helps you understand your hormone levels, allowing you to choose the right line of treatment, medications and supplements.

Oestrogen helps to regulate and lower sebum production, which can clog pores and cause acne. However, oestrogen levels naturally decrease during certain life phases, like menstruation and perimenopause (the years before menopause). On the other hand, progesterone, which increases during pregnancy and ovulation, can trigger more sebum production, leading to skin issues.

Androgens, especially testosterone, also stimulate oil glands, creating an ideal environment for acne-causing bacteria like Cutibacterium acnes to thrive. This is why breakouts are common in conditions like PCOS, which involves an imbalance in androgens.

Hormonal acne may be caused by imbalances of hormones from:

  • Menstruation
  • Polycystic ovarian syndrome (PCOS)
  • Menopause
  • Increased androgen levels
  • Pregnancy
  • Birth control pills
  • Stress

This can result in skin conditions such as:

  • Overall skin inflammation
  • Increased oil (sebum) production in the pores
  • Clogged skin cells in hair follicles
  • Production of acne-causing bacteria called Propionibacterium acnes (Cutibacterium acnes)
  • Enlarged pores
  • Increased sensitivity and redness
  • Development of cystic acne
  • Acne flare-ups along the jawline, chin, and neck
  • Dark spots and hyperpigmentation after breakouts
  • Slow healing of acne lesions


Related story: The Real Reason Behind Your Acne Breakout


Why Is It Important To Get Your Hormones Tested?

Without testing for hormonal imbalance, you're just guessing what you need. You might read about different supplements, vitamins, and minerals for hormonal acne, but without knowing your hormone levels, you're just assuming what will work for you.

The most important hormones to test for are male sex hormones (testosterone, DHEA, and androstenedione), female sex hormones (oestrogen, progesterone, luteinizing hormone, and follicle-stimulating hormone), and the stress hormone cortisol. These hormones interact with each other, so it's crucial to test all of them to understand what's happening in your body.

Testing male sex hormones is important because they affect skin pore size. Larger pores trap more dirt and dead skin cells, leading to more bacteria and infections. High levels of male sex hormones also increase oil production, which clogs pores and causes acne. If you are someone with unusual hair growth in certain areas like the beard line, chest, and around the nipples and navel, then it can be a sign for you to get the male sex hormones tested. If they are high, you might see more acne and hair growth in these areas. 

Additionally, high male sex hormones can lead to hair thinning, so if you notice this along with acne, it’s a sign that these hormones are out of balance.

Female sex hormones, especially oestrogen and progesterone, are also important to consider if you are getting your hormones tested . They help reduce pore size and oil production by counterbalancing male sex hormones. When female hormone levels are optimal, they dominate male hormones and prevent them from triggering extra oil production. Good levels of female hormones also reduce facial and body hair, boost energy, and balance your mood.

Another hormonal test is cortisol, the stress hormone. High cortisol levels can increase oil production and suppress female hormones. This allows male hormones to dominate, leading to more oil production and acne. This is why you can have normal testosterone levels on a blood test but still experience hormonal acne. It's not that your male hormones are too high, but they are high relative to your low female hormone levels. Also, if your cortisol is well below the normal range shows that there isn’t too much cortisol, but low cortisol isn’t good either. Low cortisol indicates there’s been long-term stress and the body’s gone into shutdown mode.This stage is more advanced than the initial stress response, where cortisol levels are high. If stress continues, cortisol levels eventually drop, and female hormones are definitely suppressed.


Related story: The Reasons Behind Your Body Acne And How To Get Rid of It


Does Treatment Vary for Different Hormonal Imbalances?

Yes, the treatment for hormonal acne can vary depending on the specific hormonal imbalance. Here’s how different imbalances might be addressed:

1. High Androgen Levels

  • Medications: Birth control pills, anti-androgen drugs 
  • Lifestyle Changes: Reducing sugar and refined carbs, managing stress
  • Supplements: Zinc, green tea extract, omega-3 fatty acids, spearmint tea

2. Polycystic Ovarian Syndrome (PCOS)

  • Medications: Birth control pills, metformin
  • Diet and Exercise: Low-glycemic diet, regular physical activity
  • Supplements: Inositol, chromium, omega-3 fatty acids


Related story: Guide on Managing Acne With PCOS


3. Menstruation

  • Birth Control Pills: To regulate hormone levels
  • Dietary Adjustments: Reducing dairy and high-glycemic foods
  • Supplements: Magnesium, vitamin B6


Related story: Are You Using Birth Control Correctly


4. Stress-Induced Hormonal Imbalance

  • Stress Management: Yoga, meditation, exercise
  • Adaptogens: Ashwagandha, rhodiola
  • Supplements: Magnesium, vitamin C


Related story: 5 Things To Stop To Reduce Acne


5. Female Sex Hormone Imbalance

  • Topical Treatments: Birth Control Pills, Progesterone Supplements
  • Dietary Adjustments: Phytoestrogens including foods like soy, flaxseeds, and legumes to naturally boost oestrogen levels.
  • Supplements: Vitamin B6, magnesium


Related story: Could One of These Habits Be Causing Acne


Testing these hormones provides insights into your body's internal environment, guiding treatment decisions. While conventional acne treatments address symptoms, targeting hormonal imbalances offers a more sustainable solution. Treatment strategies vary based on specific hormonal imbalances, emphasising medication, lifestyle modifications, supplements, and skincare tailored to restore hormonal harmony. By addressing the root cause of hormonal acne, you can achieve clearer, healthier skin in the long run. 


Need all your wellness solutions in one place? A whole new world awaits just a click away.


Regular blood tests are essential for everyone, but they are particularly important for individuals who are dealing with stubborn acne. These blood tests help to identify the root cause of the acne and address the same. Through UR.Life, book your blood tests today to get exclusive member discounts. 


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