What to do in case of hormonal acne?

Even though hormonal acne is the result of the action of male sex hormones (androgens), it more specifically refers to adult women's acne. While after puberty, hormone levels stabilize in men, they still fluctuate in women. Indeed, although this skin issue affects up to 40% of adults from the age of 25, 75 to 80% of women between 25 and 40 years old are particularly prone to this type of acne.

It is characterized by the appearance of various types of pimples on the face at specific times, particularly during the menstrual cycle (before or during menstruation), during pregnancy, sometimes at menopause, or even during periods of stress. Thus, this term is less commonly used in men, as they do not undergo numerous hormonal changes throughout their lives.

How can I tell if I have hormonal acne?

You may be suffering from hormonal-type acne:

• If pimples are concentrated on the lower area of the face, around the jawline, chin, and neck;

• If you are experiencing skin imperfections such as red bumps (papules), whiteheads (pustules), nodules or painful micro-cysts , caused by skin inflammation.

• If breakouts occur cyclically or following a known hormonal disturbance, that is, skin eruptions trigger or intensify during the premenstrual phase and menstruation, unlike juvenile acne which disappears once puberty is over. It can also occur during specific events, such as pregnancy, menopause, or when stopping birth control pills.

Why do I have hormonal acne?

Acne flare-ups can be linked to several factors, including hormonal fluctuations. Indeed, changes in the production of certain hormones stimulate the sebaceous glands to produce an excess amount of sebum (seborrhea). This skin imbalance creates an ideal environment for the growth of Propionibacterium acnes, which leads to inflammation of the hair follicle and the surrounding dermis.

An excess of androgen hormones circulating in the blood, male sex hormones of which the main ones are testosterone and dihydrotestosterone (DHT), plays a significant role in the onset of hormonal acne. Indeed, these are the primary hormones that control the activity of the sebaceous glands across the entire skin surface. In women, androgens are physiologically secreted in small doses. However, in certain situations, the production of androgen is excessive:

• Stopping Birth Control Pills: Some categories of oral contraceptives are sometimes used to improve acne, as they help to reduce acne flare-ups. This includes combined oral contraceptives (or combined pills) that block ovulation by substituting for the hormones naturally produced by the body. In the absence of ovulation, the production of androgen hormones decreases, in addition to counterbalancing the acne-boosting effect of progesterone. With the cessation of the pill, the secretion of testosterone in the body resumes on a large scale, accompanied by a surge of hormonal acne a few weeks to a few months after stopping contraception.

  Note : Other progestin-type contraceptives can increase testosterone levels and consequently promote acne.

• Menstrual Cycle: If there is a time when skin eruptions are particularly intense, it is just before the onset of menstruation or even during it, a time when estrogen and progesterone levels are at their lowest while testosterone, although in small amounts, reaches a level higher than feminizing hormones. Indeed, estrogen is known to prevent the production of sebum when produced in sufficient doses, by directly opposing testosterone or inhibiting its secretion. Present in small amounts, estrogen and progesterone cannot exert their "anti-sebum" effect.

• Pregnancy: Pregnancy is another time when women experience a real hormonal upheaval. Indeed, the levels of estrogen and progesterone increase significantly. These hormones can cause an overactivity of the sebaceous glands and therefore an overproduction of sebum. It is especially during the first trimester that women are more prone to developing hormonal acne.

• Menopause: This physiological phenomenon is marked by a significant hormonal upheaval. It occurs following a gradual and drastic drop in the synthesis of the two reproductive hormones: estrogen and progesterone, as the ovaries cease to produce them. Conversely, during menopause, the level of testosterone tends to increase and takes precedence over female hormones. However, this increase in male hormones is the cause of acne development in some individuals.

• Period of Stress: Stress plays a fundamental role in the balance of hormones, and therefore in the amplification and frequency of acne outbreaks. Indeed, during periods of stress, cortisol is secreted in large quantities. This hormone impacts the skin by stimulating the adrenal glands, which are responsible for the production of androgen hormones. These hormones, in turn, regulate the production of sebum by the sebaceous glands.

Hormonal acne can also result from a genetic predisposition. Indeed, the number, size, and activity of the sebaceous glands can be inherited. While the number of sebaceous glands remains stable throughout life, their size increases with age. A hypersensitivity of the sebaceous glands can also be a cause.

If you initially have severe acne, it is best to consult a dermatologist to get a professional's opinion who can assist you with medications that complement cosmetics. In any case, skin hygiene must be adapted to acne-prone skin with the use of non-comedogenic cosmetic products. Long-term care will help you minimize all the bothersome elements in hormonal acne. If you have mild acne, cosmetics will help reduce it. Thus, incorporate care containing the following ingredients into your daily skincare routine:

• Thesalicylic acid is an organic compound from the BHA family, frequently used to limit the proliferation of bacteria on the skin's surface involved in the appearance of pimples. This family of acids is also particularly recommended to decrease the cohesion between epidermal cells to promote the elimination of dead cells from the horny layer that clog the pores (exfoliating effect). Unlike AHA and PHA, BHAs are soluble in fat, which promotes their deep penetration into the pores to facilitate the evacuation of comedones and pimples.

• Thegreen clay, extracted from sedimentary rocks, is rich in mineral salts and trace elements (calcium, magnesium, potassium, silica...), each of which contributes to skin health. Thanks to its "lamellar" or layered structure, it has excellent absorbent properties: it helps regulate sebum secretion. Thus, green clay reduces imperfections by drying out pimples, prevents their occurrence, and mattifies the skin. Moreover, it helps tighten skin pores, has a healing action to prevent acne-related marks , and soothes skin inflammation.

• The bakuchiol, a plant-derived chemical compound, is valued for its anti-inflammatory and antibacterial properties. Indeed, studies have shown that bakuchiol has a strong inhibitory activity against an enzyme that contributes to the formation of inflammation-mediating hormones, in addition to exhibiting excellent inhibitory activity against P. acnes. This active ingredient also acts on sebum secretion by reducing the activity of an enzyme that converts testosterone into DHT. This latter binds to the androgen receptors of the sebaceous glands and causes abnormal sebum secretion. Finally, its soothing virtues also make it an interesting ingredient for acne-prone skin.

• The activated charcoal, highly concentrated in pure carbon, has a powerful absorption capacity due to its porous material that captures pollutants, excess sebum, bacteria, and other impurities on the skin's surface, which are responsible for skin shine and the appearance of pimples, thus facilitating their elimination. It deeply cleanses the pores, thereby fighting against pore blockage and the development of bacteria caused by sebum production.

• Niacinamide is a comprehensive anti-blemish active ingredient that works both before the formation of pimples and afterwards to reduce any potential marks and scars. Upstream, this vitamin regulates the sebum level on the skin's surface, thereby preventing the pore obstruction that leads to the appearance of comedones and pimples. Additionally, it performs an effective anti-bacterial function against the microorganisms responsible for the inflammatory reactions of acne such as P. acnes. Downstream, its soothing virtues help to decrease inflammation and thus reduce the redness associated with blemishes.

• The retinoids group includes vitamin A, its metabolites, as well as its natural and synthetic derivatives such as the retinol, retinoid esters (retinyl acetate, retinyl propionate...) or retinal. Their beneficial effect on acne is attributed to their desquamating action and the increase in the cellular renewal of the epidermis, which prevents the formation of pimples. They promote the elimination of pimples, and also help to decrease the activity of the sebaceous glands, contrary to the production of sebum, and to reduce their size.

• The zinc is a powerful ally in combating skin problems. This trace element reduces sebum secretion. When paired with PCA, it promotes the strengthening of the skin's barrier function. It also targets the microorganisms responsible for the formation of pimples and inflammatory reactions. Zinc also helps to clear the pores of impurities and soothe irritations.

What skincare routine should be adopted in case of hormonal acne?

1. Morning and evening, cleanse your skin with a gentle cleanser suitable for skin prone to blemishes to eliminate excess sebum, bacteria, dust, or pollutants accumulated throughout the day, while protecting the hydrolipidic film. The skin will then be in better conditions to heal properly.

   For instance, you might choose the exfoliating cleansing gel concentrated in gluconolactone (PHA), which additionally micro-exfoliates the epidermis to smooth the skin texture and deeply unclog the pores. The cleansing gel also contains aloe vera and inulin with moisturizing, soothing, and repairing properties to calm inflamed skin and rebalance the disrupted skin microbiota.

2. Enhance the action of the cleansing gel and conclude your makeup removal routine with a toner rich in purifying and antibacterial active ingredients such as the 1% salicylic acid toner for a balanced skin and strengthened natural defenses. This alcohol-free liquid moisturizer targets the outer layer of the skin, particularly by tightening enlarged pores, reducing excess sebum, and minimizing the development of microorganisms. The purifying toner is also enriched with centifolia rose hydrosol, a perfect complement to salicylic acid, due to its soothing properties. Zinc is also present in the formula.

3. Incorporate into your beauty routine a rebalancing anti-blemish treatment to prevent and protect the skin from the appearance of blemishes. Concentrated at 1% of bakuchiol, our serum helps to neutralize unsightly pimples and the oily skin effect. Antibacterial and anti-inflammatory, this active ingredient helps to limit blemishes sustainably and deeply, to rebalance sebum and to limit the production of pro-inflammatory molecules.

   This water-free formulated care for optimal effectiveness also containshazelnut oil, known for regulating sebum production and rebalancing the hydrolipidic film due to its natural composition rich in vitamin E, omega-6, and oleic acid. It easily penetrates the skin to act on the hydrolipidic film and the epidermis, while leaving a protective film on the surface.

   Note : A range of 4 periodic serums has been developed at Typology to meet the needs of your skin for each week of your menstrual cycle.

4. Hydrate your skin with a purifying face cream specifically designed to meet the needs of acne-prone skin. Indeed, the active ingredients in this non-comedogenic cream (zinc PCA, bamboo extract) will moisturize the epidermis, while promoting the reduction of blemishes, regulating sebum secretion, reducing skin shine by absorbing excess sebum, and alleviating inflammation;

5. In the evening, use a salicylic acid spot treatment to speed up the healing of acne lesions, halt bacterial proliferation, soothe inflammation, and prevent acne scars. It should be applied directly to each pimple, before the moisturizing cream;

6. Once a week, apply a purifying face mask made from detoxifying green clay, mattifying pine charcoal, and stinging nettle which regulates sebum production. This will deeply cleanse the skin of impurities without leaving signs of skin dehydration, thanks to its creamy texture;

7. During the day, don't forget to apply a sunscreen to prevent the appearance of post-inflammatory hyperpigmentation dark spots . Contrary to popular belief, sun exposure can actually promote long-term acne. Additionally, some acne treatments are not compatible with sun exposure.

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