Hormonal Changes and Acne Breakouts

Hormonal Acne not only affects teenagers but also adults. The onset of acne lesions is triggered by the production of hormones called androgens. Androgen production stimulates sebaceous glands and cause them to enlarge. People who develop hormonal acne have over stimulated sebaceous glands. The production of androgen usually goes into full force between the ages of 11 to 14 when most young girl and boys go through puberty. Acne breakouts in young women may be influenced by hormonal changes associated with menstruation, pregnancy, stress, endocrine imbalance, and ovarian disease.

The androgen-stimulated sebaceous glands produce more sebum. Sebum is a natural oil that makes the skin soft and waterproof. The oily sebum accumulates in the follicle as it moves up the hair shaft where it mixes with dead follicular skin cells. The dead cells normally get pushed to the surface where they are expelled. The more sebum is produced the greater the chances of either lesions to the cells lining the follicles or clogged follicles that potentially result in pimples.

When hormonal changes occur, such as an increase in androgen production, the sebaceous gland and the inner lining of the skin within the hair follicle also changes. Young girls and boys going through hormonal changes during puberty shed skin more rapidly. With increase production of sebum, the dead cells stick together and clog the hair follicles.

Once follicles are clogged it becomes a breeding ground for bacteria. The bacteria (exists on everyone's skin regardless of acne) ingests sebum and produces a chemical that injures the cells in the sebum ducts and can cause your body to react with inflammation in the follicle and surrounding skin.

Anyone can develop hormonal acne, however, some people are predisposed to certain types of acne. Most hormonal changes are temporary, however, they may need medical treatment.

Females who develop acne due to the following conditions may be linked to hormonal changes:

• Appearance of pimples for the first time in adulthood or reappearance after clearing up (PMS, Peri menopause, Menopause)

• Unresponsive to treatment
• Worsening condition during pregnancy or menstruation
• Associated to masculine patterns of hair growth or hair loss, may also include darkening of the skin around the armpits or body folds, and torso obesity

The cause of adult acne associated to the above conditions and chronic emotional or physiological stress can be treated in a number of ways. Pimples or acne caused by hormonal changes may not respond to over the counter topical acne treatments that work on teenagers.

The treatment options may include oral contraceptives, oral corticoseteroids (anti-inflammatory drugs), antiandrogens (reduce androgen productions) or natural alternatives.

Oral contraceptives side effects include nausea, weight gain, menstrual spotting and breast tenderness.

The side effects associated to oral corticosteroids may cause weight gain and bone thinning. Oral corticosteroids are anti-inflammatory drugs that belong to a class of drugs produced by the adrenal glands. When adrenal glands are overactive in producing androgens, oral corticosteroids such as prednisone and dexamethasone can be prescribed to suppress androgen production. Oral corticosteroids are also prescribed to suppress inflammation in severe acne.

Antiandrogens are a class of drugs that (1) reduce androgen production in ovaries and adrenal glands, and (2) block androgen reception by cells in sebaceous follicles. Reduction of excess androgen and reduction of androgen available in the sebaceous follicle are used in the treatment of hormonal acne and include spironolactone and, less commonly, flutamide. Antiandrogens may cause irregular menstruation and breast tenderness and may be eased by taking the anti-androgen together with an oral contraceptive.