Acne is such a prevalent skin condition that almost all teenagers experience it. It's also fairly common to have acne beyond adolescence — around 64% of people in their 20s and 43% of those in their 30s get acne .
But even though acne is quite a normal skin condition, it's still important to treat it in order to prevent it from getting worse and to minimise the risk of scarring. Plus, there's no doubt that breakouts can have an impact on your self confidence.
What is hormonal acne?
Hormones actually play a role in all types of acne. Increased levels of male hormones, also known as androgens, cause excess sebum production. Sebum is the natural oil on your skin's surface that helps keep it protected and moisturised.
However, having too much sebum that isn't efficiently cleared away from the skin can end up clumping together with dead skin cells and clogging your pores. This is what forms the tender bumps we normally associate with acne breakouts .
Puberty is usually the trigger for acne because it is a time when your hormone levels change.
Can males get hormonal acne?
Even though an overproduction of sebum is caused by male hormones, both men and women get hormonal acne as these hormones are present in all genders. In fact, almost 85% of males and females develop acne between the ages of 12-25 .
However, hormonal acne seems to be more common and more severe in males in adolescence and early adulthood. This is because they have a higher level of male hormones such as testosterone .
Transgender individuals who receive masculinising hormone therapy tend to experience hormonal acne because of increasing testosterone levels. This usually occurs within 2 years of starting testosterone treatments .
What does hormonal acne look like?
Acne breakouts can come in a few different forms. When you have clogged pores, these can become blackheads or whiteheads, which are black or skin-coloured bumps.
Blackheads and whiteheads can become infected by the bacteria that normally lives on your skin and turn into red, swollen pimples . Severe cases of acne may have larger red bumps greater than 1cm in diameter, called nodules .
Based on the appearance of your breakouts alone, it may not be possible to distinguish between acne breakouts purely caused by hormones and those exacerbated by other causes such as sweat and skincare products. But, the location of your acne breakouts can be an indicator of the cause.
Hormonal acne tends to occur on the lower third of your face — like your jawline and chin — as well as your chest, back and upper arms . Acne breakouts isolated to other parts of your body may be flaring up because of sweat or constant rubbing.
For example, pimples on your legs may be caused by wearing tight shorts while playing sport and forehead breakouts could be a result of constantly wearing a bike helmet.
How does it differ from hormonal acne in women?
When it comes to adult acne, women tend to be more affected than men. Adult acne is defined as acne that is experienced for the first time after the age of 25, or acne that started during puberty and has persisted into your late 20s.
Women seem to be more affected by adult acne, partly because of the hormonal fluctuations of their menstrual cycle, but also because of other medical conditions that affect their ovaries and hormones, such as polycystic ovary syndrome .
The term 'hormonal acne' is sometimes used as a label for this type of acne in women, even though men experience acne caused by hormones too.
It's also a label commonly used when specifically talking about female acne because women have the option to treat their acne using hormonal therapy, such as oral contraceptives .
What causes hormonal acne in men?
Aside from puberty, when teenage boys experience elevated testosterone levels, there are some other lifestyle factors that contribute to male hormonal acne.
There is some research data that suggests that stress can worsen acne. A small study that tracked the acne severity and stress levels of university students found that higher stress levels during exams correlated with more severe acne. This is because stress can lead to hormonal fluctuations and increased oil production from the sebaceous glands .
Nutrition can also play a role in acne. High glycaemic index foods, meaning foods that can rapidly increase your blood sugar levels, have been found to increase acne. Foods that are high on the glycaemic index are refined carbohydrates, such as white bread, and sugary foods such as soft drinks.
One study compared 2 groups of young men with mild to moderate acne after 12 weeks of following different diets. The group that ate a low glycaemic diet had significantly less acne at the end of the study, compared to the group that stuck to a high glycaemic diet .
Whey protein supplements, which are a byproduct of dairy, and overall high consumption of dairy foods are also known for worsening acne .
Another factor that can lead to male hormonal acne is the use of steroids. These might be steroid medications used to treat medical conditions as well as anabolic steroids, which are performance-enhancing drugs used by athletes and bodybuilders and are chemically similar to testosterone .
Anabolic steroids tend to cause severe acne nodules that are more likely to leave acne scars .
How to balance male hormones for acne
In order to keep your hormones balanced and reduce the severity or likelihood of acne, it's important to try your best to reduce the risk factors mentioned previously.
Anything you can do to reduce your stress levels will benefit your skin, since stress can trigger acne or make existing acne worse. This might include setting better boundaries, asking for support from loved ones or a professional, practising mindfulness and taking time for self-care .
Changing the foods you regularly eat is another way of balancing hormones and minimising inflammatory acne. Try cutting back on dairy and eating more low glycaemic index foods such as fruit, vegetables, beans, lentils and whole grains like oats, brown rice and quinoa.
Eating in this way can reduce inflammation and your skin's oil production. A dietitian can provide professional advice on changing your diet.
Stopping the use of anabolic steroids will also help with reducing testosterone levels, however, it is important to consult a doctor before doing this as suddenly stopping can lead to steroid withdrawal symptoms .
How can men treat hormonal acne?
As well as making lifestyle changes to balance your hormones, topical treatments can be effective at soothing the appearance of acne and reducing frequent acne breakouts — simple but effective skincare.
Pilot's prescription acne treatment is custom formulated to address your individual acne. To work out the specific needs of your skin type, simply complete an online consultation with an Aussie practitioner who will create your personalised medical-grade treatment.
Our acne treatment features a bunch of ingredients that work together to improve inflammatory acne. Azelaic acid brings down the swelling and redness of irritated skin, while niacinamide can help to clear away oil and reduce clogged pores.
Prescription retinoids are also great for reducing the production of sebum while also helping to fade scars that might be left behind in severe cases, such as steroid-induced acne.
Antibiotics are also an option for bringing down the inflammation of really painful breakouts and can be prescribed by your Pilot practitioner if needed.
It typically takes around 8-12 weeks of using your custom Pilot formula before you see improvements to long-term acne, although some people see results earlier.
You might also want to consider trying an over-the-counter acne treatment that contains salicylic acid. Software's Salicylic Acid Foaming Wash helps unclog pores and ingrown hair follicles, while also clearing away acne-causing bacteria. And, you can use it on your face and across your body — yep, even on that pesky back acne — 1-2 times a week.
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