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Hormonal acne, also called adult acne, refers to a skin condition triggered by hormonal abnormalities. When there are hormonal changes during pregnancy or throughout puberty, it frequently happens. Adult female acne (AFA) is more common and affects women over the age of 25. They may develop for the first time during adolescence and persist continuously or intermittently from this period. So, if you notice deep, painful cysts or nodules form on the chin, jawline, and cheeks – that may be hormonal acne. Hormonal acne can create a lot of discomfort and leave scarring on the face having a psychological impact and you may need to see a dermatologist to treat it early.
Key Symptoms of Hormonal Acne
Hormonal acne, a kind of acne caused mainly by hormonal imbalance, can present in various ways. Understanding the clinical symptoms of hormonal acne is critical for correct diagnosis and appropriate therapy.
Below are some of the most common clinical signs of hormonal acne:
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Persistent
Hormonal acne doesn’t go away easily. It might respond poorly to standard over-the-counter remedies or prescription drugs.
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Resistant to Treatment
Topical drugs alone may not be effective on hormonal acne since they might be tenacious. A complete treatment strategy targeting the underlying hormonal variables may be required.
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Painful Nodules
Hormonal acne often presents as painful nodules or cysts which may be inflamed and sensitive and cause discomfort or pain.
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Scarring
Deep, inflammatory nodules and cysts can leave lasting skin marks such as pitted scars or dark patches.
The Lower Part of the Face, Jawline, and Chin are mostly affected. This distribution pattern results from the high density of oil glands in this location, primarily affected by hormonal fluctuations.
What Causes Hormonal Acne Among Adults?
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Pore blockages are the root cause of acne
Hormonal acne occurs when your skin generates more oil due to hormonal fluctuations. Acne is caused by the interaction of this oil with bacteria on your skin's pores or hair follicles, where hair grows.
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Stress
Stress can cause hormonal abnormalities in the body, including an increase in the synthesis of stress hormones like cortisol. High cortisol levels can exacerbate hormonal acne by activating the sebaceous glands, which produce too much sebum and clog the pores.
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Genetics
The tendency to develop hormonal acne might be inherited. A hereditary predisposition to hormonal acne may exist if your parents or other close family members have a history of the condition. Some people are more prone to developing acne due to genetic variances that affect how hormones are regulated, how much sebum is produced, and how inflamed their skin is.
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Hormones
Hormonal changes strongly influence the emergence of hormonal acne. Androgens, such as testosterone, can activate the sebaceous glands, producing excessive sebum. Acne lesions can develop due to combining this extra oil with bacteria, dead skin cells, and other contaminants that clog pores and cause irritation.
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Diet
Even though diet’s impact on hormonal acne is still debatable, certain dietary factors may contribute to its development. Consumption of high glycemic index foods, dairy products, and foods rich in saturated fats may trigger hormonal changes and inflammation in the body, potentially worsening acne symptoms.
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Endocrine Disorders - PCOS
Polycystic Ovary Syndrome (PCOS) is an endocrine disorder characterised by hormonal imbalances, including elevated androgen levels. These hormonal disruptions can lead to increased sebum production and the development of hormonal acne.
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Drugs
Specific treatments and medications can sometimes cause hormonal acne. Corticosteroids, anticonvulsants, and hormonal therapies like birth control pills or hormone replacement therapy are a few examples.
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Lab Investigations
In the presence of other clinical signs of hyperandrogenism, most doctors suggest plasma concentrations of free and total testosterone, S-DHEA, Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), and, in some cases, when suspecting POS, and ultrasound for visualization of the ovaries.
Treatment of Hormonal Acne
Over-the-counter (OTC) products are usually ineffective unless your hormonal acne is mild. Cyst bumps are the most common manifestation of hormonal acne. Most topical treatments are ineffective against these pimples because they originate deep beneath the skin. The hormone balance and skin-clearing effects of oral drugs can be felt from the inside.
Topical Treatment for Hormonal Acne
Topical treatments are commonly used to manage and treat hormonal acne. Here's an explanation of some commonly used topical treatments:
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Retinoids
Treating hormonal acne using retinoids, vitamin A compounds, is thriving. They unclog pores, decrease inflammation, boost cell turnover, and prevent future acne breakouts.
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Antibiotics
Acne-causing germs on the skin are commonly reduced using topical antibiotics. Inflammation is lessened, and acne lesions are under control. Topical antibiotics are frequently used with other treatments since prolonged use may increase antibiotic resistance.
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Benzoyl Peroxide
Hormonal acne is commonly treated topically with benzoyl peroxide, which is widely available over the counter. It eliminates acne-causing germs while also decreasing inflammation and unclogging pores. Benzoyl peroxide is frequently used as a first-line treatment for mild to moderate acne. It has various strengths and formulations (gel, cream, or wash).
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Azelaic Acid
It has antibacterial and anti-inflammatory characteristics and is helpful in the treatment of acne lesions. Azelaic acid is effective in treating post-inflammatory hyperpigmentation since it aids in pore clearing, lowers keratin synthesis, and perhaps lightens skin.
It is critical to note that the severity of acne, a person's specific skin type, and other factors all influence the choice of topical therapies. The best dermatologist in Bangalore can assess a patient's particular requirements and provide the best topical therapy or regimen of medications for hormonal acne.
Oral Medications for Hormonal Acne
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Isotretinoin
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OCPS and anti-androgens.
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Low doses of corticosteroids.
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Insulin sensitising agents- Metformin.
Adjuvants to Treat Hormonal Adult Acne
Adjuvants are additional treatments or procedures that can be used with topical treatments to enhance their effectiveness in managing hormonal acne. Here are a few examples of adjuvants commonly used in acne treatment:
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Chemical Peels
A chemical solution is applied to the skin in a chemical peel, removing the top layer of dead skin cells. This method can aid in the unclogging of pores, the improvement of skin texture, and the reduction of acne lesions. Ingredients with exfoliating and anti-inflammatory effects, such as salicylic acid, beta-hydroxy acids, and AHAs, may be used in chemical peels.
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Photodynamic Therapy (PDT)
PDT is a treatment that combines the application of a photosensitising agent to the skin, followed by exposure to a specific wavelength of light. This activates the photosensitising agent, targeting and destroying acne-causing bacteria and reducing inflammation. PDT can effectively manage moderate to severe acne.
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Microdermabrasion
A device is used during the non-invasive microdermabrasion technique to gently exfoliate the skin, eliminating dead skin cells and clearing pores. It can treat acne-prone skin by minimising the appearance of acne lesions, improving the skin's texture, and stimulating cell turnover.
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Laser Therapy
Laser therapy involves using laser devices to target and reduce the activity of sebaceous glands, kill acne-causing bacteria, and promote collagen production. Different types of lasers, such as pulsed dye lasers or fractional lasers, may be used depending on the specific acne concerns.
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Extraction and Comedone Removal
Manual extraction of comedones (blackheads and whiteheads) by a dermatologist or esthetician can be an effective adjuvant treatment for acne. This process involves carefully removing comedones using sterile instruments, reducing pore blockage and inflammation.
Hormonal acne is a specific type of acne primarily caused by hormonal imbalances in the body. By staying informed about the causes, manifestations, and treatment options for hormonal acne, you can manage adult acne and achieve more transparent, healthier skin. Remember, managing hormonal acne is a journey, and with the right strategies and support from an experienced dermatologist in the best skin hospital in Bangalore, it is possible to regain confidence and enjoy clearer skin.
Frequently Asked Questions (FAQs)
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Can hormonal acne only occur during puberty?
Hormonal acne can occur during various stages of life, including puberty, pregnancy, and hormonal imbalances caused by conditions like PCOS. While it is commonly associated with puberty, hormonal acne can persist into adulthood and affect individuals of any age.
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Can lifestyle changes help in managing hormonal acne?
Certain lifestyle adjustments can aid in managing hormonal acne. Maintaining a nutritious diet, managing stress, adopting good skin care habits, avoiding harsh or pore-clogging products, and exercising are all examples.
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How long does it take for hormonal acne to improve with treatment?
The improvement time depends on the acne's severity, chosen treatment method, and personal circumstances. For the condition to significantly improve after treatment, it could take weeks or months.
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