Comment atténuer l'acné hormonale ?

How To Treat Hormonal Acne?

It is possible for acne to persist into adulthood. It is no longer just a typical problem of teenagers: about 40% of adults are said to still suffer from acne, including more than a quarter of adult women. As the name suggests, hormonal acne is related to fluctuations in hormone production. It is the most common form of acne that occurs in adult women in connection with the menstrual cycle, pregnancy, or menopause. But how do you get rid of it?

Summary
Published November 17, 2021, updated on March 11, 2024, by Stéphanie, PhD, Doctorate in Life and Health Sciences — 15 min read

Hormonal Acne: What Is It?

Even though hormonal acne is the result of the activity of male sex hormones (androgens), it more accurately refers to acne in adult women. While hormone levels stabilize after puberty in men, they still fluctuate in women. Although up to 40% of adults aged 25 and older are affected by this skin problem, 75-80% of women between the ages of 25 and 40 are particularly likely to suffer from this type of acne.

Acne is the appearance of different types of pimples on the face at certain times, such as during the menstrual cycle (before or during the period), during pregnancy, sometimes during menopause or in times of stress. This term is therefore less commonly used in men, as they are not exposed to as many hormonal changes throughout their lives.

How can I tell if I have hormonal acne?

You may be suffering from hormonal acne.

  • If the pimples are clustered in the lower face area, around the jaw, chin, and neck;

  • If you have blemishes such as red pimples (papules), white pimples (pustules), nodules, or painful microcysts caused by skin inflammation.

If the pimple outbreaks occur cyclically or due to a known hormonal change, i.e., the skin rashes are triggered or intensified during the premenstrual phase and menstruation, as opposed to juvenile acne, which disappears after puberty is over. It can also occur during special events, such as pregnancy, menopause, or when you stop taking birth control pills.

Why do I have hormonal acne?

Acne breakouts can be related to several factors, including hormonal changes. This is because changes in the production of certain hormones stimulate the sebaceous glands to produce extra sebum (seborrhea). This imbalance in the skin is an ideal place for the growth of Propionibacterium acnes, which causes inflammation of the hair follicle and the surrounding dermis.

An excess of androgenic hormones circulating in the blood – male sex hormones, the most important of which are testosterone and dihydrotestosterone (DHT) – is significant in the development of hormonal acne. These are, in fact, the main hormones that control the activity of the sebaceous glands on the entire surface of the skin. In women, androgens are secreted in small doses. However, in certain situations, excessive androgen production occurs:

  • Discontinuation of birth control pills: certain types of oral contraceptives are sometimes used to improve acne because they can reduce acne breakouts. This is especially true of estrogen-progestin pills (or combinations of pills), which block ovulation by replacing hormones produced naturally by the body. However, when ovulation does not occur, fewer androgenic hormones are produced, which also counterbalance the acne-promoting effects of progesterone. With the discontinuation of the pill, testosterone release in the body resumes on a large scale, accompanied by a hormonal acne outbreak several weeks to months after contraceptive discontinuation.

Note: Other progestin-type contraceptives may increase testosterone levels, thereby promoting acne.

  • Menstrual cycle: if there is a time when skin problems are particularly severe, it is just before or during menstruation, when estrogen and progesterone levels are at their lowest and testosterone, even if in small amounts, reaches higher levels than female hormones. Now, estrogen is known to prevent sebum production when produced in sufficient doses by directly targeting testosterone or inhibiting its secretion. When present in small amounts, estrogen and progesterone cannot exert their “anti-sebum” effects.

  • Pregnancy: Another time when women experience a hormonal change is pregnancy. Estrogen and progesterone levels rise sharply. However, these can lead to overactivity of the sebaceous glands and thus to an overproduction of sebum. Particularly in the first trimester, women are more prone to developing hormonally induced acne.

  • Menopause: This physiological phenomenon is characterized by a regular hormonal change. It occurs because the synthesis of the two reproductive hormones estrogen and progesterone gradually and drastically decreases as the ovaries stop producing them. In contrast, during menopause, testosterone levels rise and overtake female hormones. This increase in male hormones is the reason for the development of acne in some people.

  • Stress: stress plays an important role in the balance of hormones and thus in the amplification and frequency of acne breakouts. In times of stress, cortisol is released in large amounts. This hormone affects the skin by stimulating the adrenal glands, which are responsible for producing androgens, which in turn regulate sebum production by the sebaceous glands.

Hormonal acne can also be due to a genetic predisposition. In fact, 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. Hypersensitivity of the sebaceous glands can also be a cause.

How To Stop Hormonal Acne?

If you suffer from severe acne in the first place, you should see a dermatologist for a professional opinion, who can help you with medications in addition to cosmetics. In any case, skin hygiene should be adapted to acne skin by using non-comedogenic cosmetics. Long-term care will help you minimize all the disturbing elements in hormonal acne. If you have mild acne, cosmetics will help reduce it. So include skincare products with the following ingredients in your daily skincare routine:

  • Salicylic acid is an organic compound in the BHA family that is commonly used to curb the growth of bacteria on the skin's surface that are involved in the formation of pimples. This family of acids is also recommended to reduce cohesion between epidermal cells to better remove the dead cells of the stratum corneum that clog pores (exfoliating effect). Unlike AHAs and PHAs, BHAs are fat soluble, which favors their deep penetration into the pores, making it easier to remove blackheads and pimples.

  • Green clay, extracted from sedimentary rocks, is rich in mineral salts and trace elements (calcium, magnesium, potassium, silicon...), each of which contributes to the health of the skin. Thanks to its lamellar structure, green clay has excellent absorbent properties: it regulates the secretion of sebum. Thus, green clay reduces impurities by drying pimples, preventing their formation and mattifying the skin. Likewise, it helps to refine the pores of the skin, has a healing effect to prevent acne-related marks, and soothes skin inflammation.

  • Bakuchiol, a chemical compound of plant origin, is valued for its anti-inflammatory and antibacterial properties. In fact, studies have shown that bakuchiol has a strong inhibitory effect against an enzyme that contributes to the formation of hormones that promote inflammation. It also has an exceptional inhibitory effect against P. acnes. This active ingredient also acts on sebum secretion by reducing the activity of an enzyme that converts testosterone to DHT. DHT binds to the androgen receptors of the sebaceous glands and leads to abnormal sebaceous secretion. Finally, it is also an interesting ingredient for acne-prone skin due to its soothing properties.

  • Plant charcoal is highly concentrated in pure carbon and has a strong absorption capacity thanks to its porous material. It traps pollutants, excess sebum, bacteria and other impurities on the skin surface responsible for shiny skin and pimples, facilitating their elimination. This thoroughly cleanses pores and combats pore clogging and bacterial growth caused by sebum production.

  • Niacinamide is a comprehensive active ingredient against impurities that acts before pimples appear, but also afterward to soften possible marks and scars. First of all, this ingredient regulates the sebum content of the skin surface, preventing the clogging of pores responsible for the development of blackheads and pimples. In addition, it has an antibacterial effect and fights microorganisms such as P. acnes, which are responsible for the inflammatory reactions in acne. Its soothing properties help reduce inflammation, thus reducing the redness associated with blemishes.

  • Retinoids include vitamin A, its metabolites and its natural and synthetic derivatives such as retinol, retinoid esters (retinyl acetate, retinyl propionate...) or retinal. Their beneficial effect on acne is attributed to their anti-dandruff action and increased cell renewal of the epidermis, preventing the formation of pimples. They promote the removal of pimples and also ensure that the activity of the sebaceous glands – rather than the production of sebum – is reduced and the size of pimples is reduced.

  • Zinc is an important ally in the fight against skin problems. This trace mineral reduces sebum secretion. When paired with PCA, it promotes the strengthening of the skin's barrier function. It also attacks microorganisms that cause pimples and inflammatory reactions. Zinc also helps clear pores of impurities and soothe irritation.

What skin care routine should you use for hormonal acne?

  1. Wash your skin morning and night with a mild cleanser suitable for blemish-prone skin to remove excess sebum, bacteria, dust, or pollutants that have accumulated during the day, while protecting the hydrolipidic film. The skin will then have better conditions to heal well.

For example, you can opt for an exfoliating cleansing gel with gluconolactone (PHA), which additionally exfoliates the epidermis to smooth skin relief and thoroughly unclog pores. The cleansing gel also contains aloe vera and inulin with moisturizing, soothing and repairing properties to calm inflamed skin and rebalance the skin's disturbed microbiota.

  1. Boost the effect of the cleansing gel and finish the cleansing routine with a toner rich in cleansing and antibacterial agents. For example, the tonic with 1% salicylic acid balances the skin and strengthens its natural defenses. This alcohol-free liquid moisturizer helps to target the outer layer of the skin, in particular by refining enlarged pores, reducing excess sebum and minimizing the growth of microorganisms. The clarifying toner is also enriched with Centifolia Rose hydrolate, which complements salicylic acid for its soothing properties. Zinc is also included in the formula.

  2. Incorporate balancing anti-blemish care into your beauty routine to protect and prevent skin from the appearance of blemishes. Our serum is concentrated with 1% Bakuchiol to help neutralize unsightly pimples and the effect of oily skin. This antibacterial and anti-inflammatory ingredient helps to permanently and deeply limit blemishes, balance sebum levels and limit the production of pro-inflammatory molecules.

Formulated without water for optimal effectiveness, this care is also composed of hazelnut oil, known to regulate sebum production and rebalance the water film thanks to its natural composition rich in vitamin E, omega-6 and oleic acid. It easily enters the skin to act on the hydrolipidic film and the epidermis, while leaving a protective film on the surface.

Note: At Typology, a range of four periodic serums was developed to meet the needs of your skin in each week of your menstrual cycle.

  1. Hydrate your skin with a purifying face cream specially formulated to meet the needs of skin with acne. The active ingredients in this non-comedogenic cream (zinc PCA, bamboo extract) hydrate the epidermis and help reduce blemishes, regulate sebum secretion, reduce skin shine by absorbing excess sebum, and soothe inflammation;

  2. Use topical care with salicylic acid in the evening to accelerate the healing of acne lesions, inhibit bacterial growth, reduce inflammation and prevent acne scars. It should be applied directly to each pimple before moisturizer ;

  3. Once a week, you should apply a purifying face mask made of cleansing green clay, mattifying pine charcoal and prickly, sebum-regulating nettle. This mask thoroughly rids the skin of impurities and leaves no trace of dehydration thanks to its creamy texture;

During the day, do not forget to apply a sunscreen to avoid the appearance of brown spots of hyperpigmentation after inflammation. Warning: some acne treatments are not well suited for sun exposure.

Sources

  • KLIGMAN A. M. & al. Rhythm of sebum excretion during the menstrual cycle. Dermatologica (1991).

  • SHAW J. C. Hormonal therapies in acne. Expert Opinion on Pharmacotherapy (2002).

  • WOLF J. & al. New insights into the management of acne: An update from the global alliance to improve outcomes in acne group. Journal of the American Academy of Dermatology (2009).

  • KIMBALL A. B. & al. A single-blinded, randomized, controlled clinical trial evaluating the effect of face washing on acne vulgaris. Pediatric Dermatology (2006).

  • THIBOUTOT D. M. & al. Pharmacologic modulation of sebaceous gland activity: Mechanisms and clinical applications. Dermatologic Clinics (2007). 

  • COLLIER C. N. & al. The prevalence of acne in adults aged 20 and over. Journal of the American Academy of Dermatology (2008).

  • DRENO B. Recent data on epidemiology of acne. Annales de Dermatologie et de Vénéréologie (2010).

  • GELLER L. & al. Perimenstrual flare of adult acne. Journal of Clinical and Aesthetic Dermatology (2014).

  • CHEN W. & al. Sex hormones and acne. Clinics in Dermatology (2017).

  • ZEICHNER J. A. & al Emerging issues in adult female acne. Journal of Clinical and Aesthetic Dermatology (2017).

  • MAWARDI P. & al. The effect of face washing frequency on acne vulgaris patients. Journal of General - Procedural Dermatology & Venereology Indonesia (2019).

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