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Could Hormones Be the Trigger of Your Acne?

Acne flares up when hormone levels change. There are some hormone changes that cause acne that you can’t do anything about, but there are other interactions of acne and hormones for which smart skin care techniques make a big difference. This article about the hormones that effect acne that you control.

hormones structure
Hormone changes can cause acne and other skin problems to flare up.


  • Stress causes inflammation in the skin. Inflammation makes the skin red, itchy, and tender, and inflammation transforms blemished skin into pimples.
  • Excessive testosterone increases sebum production that can clog pores.
  • If you have an issue with excess testosterone (for example, you are a girl or woman who has PCOS, you are a teenaged or young adult male with excessive testosterone production, or you are a person of either sex who takes testosterone by injection), you can fight acne by taking special care to cleanse the skin. But don’t “get rough” with your skin. That increases its production of its own stress hormones.
  • If you have PCOS, don’t try to fight hormones with hormones. Don’t try to “neutralize” testosterone with estrogen-like herbs or supplements. Instead, lose weight to slow down your body’s excessive testosterone production.
  • Get extra sleep to keep acne in check when you have issues with either stress or testosterone levels.
  • For your body to make the melatonin that helps keep your skin clear, your bedroom must be free of blue light, or you need to wear a sleeping mask to keep your eyes from responding to blue light. Your eyes can detect blue light with your eyelids closed.
  • Managing hormones is just one part of acne care. Getting your skin clear and keeping your skin clear is easiest with a complete acne care system like Exposed Skin Care.

Acne and Stress Hormones

Everybody who has acne knows that acne can cause stress. It is also true that stress can cause acne.

Researchers at Stanford University recruited a cadre of students who had active acne, and asked them to come in for skin exams throughout the semester. As just about anyone would predict, students who had acne had more acne during final exam week, when academic stress was highest. But acne does not just respond to whole-body, general stress. It also responds to stress hormones made by the skin itself.

When the brain senses stress, it releases corticotrophin stimulating hormone to instruct the adrenal glands to make the stress hormone cortisol. When the skin senses stress, it also releases corticotrophin stimulating hormone, which instructs mast cells in the skin to release inflammatory chemicals.

What kinds of things stress out the skin? Any kind of irritation of the skin is met with inflammation of the skin. An irritant is a chemical that could potentially compromise the skin barrier protecting the rest of the body. Inflammation isolates the irritant so it cannot threaten the rest of the body.

Acne bacteria do not usually irritate the skin. In fact, one of the byproducts of their digestion of excess sebum in pores is essential fatty acids that reduce inflammation in the skin. Acne bacteria don’t want to be chased out of their home.

To protect themselves from the immune system, however, acne bacteria secrete chemicals that make surrounding skin cells more sensitive to inflammation. That way, when the skin makes stress chemicals, it is the skin itself that gets bombarded with inflammation, not bacteria. As a pimple eventually opens up, a few acne bacteria escape to go to live in a different pore.

The way to minimize stress on the skin is not to bombard it with chemicals to kill bacteria. These actually increase irritation and subsequent inflammation. The way to minimize stress on the skin is to avoid detergents, especially any kind of soap that makes big bubbles, to avoid alcohol on the skin, which dries it out, and to avoid any kind of product that makes your skin feel tingly. A tingly feeling on the skin is not a sign of healing. It’s a sign of irritation and stress that will make skin break out later.

Acne and Testosterone

Testosterone is the hormone associated with masculine characteristics. The bodies of both men and women make testosterone, men in the testes and women in the ovaries. Men’s bodies make much more testosterone than women’s. Testosterone can also be made in the skin.

Fluctuations in testosterone levels are associated with acne even in babies, especially in baby boys in their second month of life. Testosterone increases activity of the sebaceous glands that release oil onto the skin. However, the sebaceous glands themselves can make testosterone from a chemical known as dehydroepiandrosterone, or DHEA, when they are stressed. The real relationship between testosterone and acne goes something like this:

  • When the skin produces its own stress hormones, sebaceous glands are stimulated to make testosterone. This testosterone increases sebum production, which in turn clogs pores. At the same time, the skin is releasing inflammatory factors.
  • When the whole body is under stress, sebaceous glands are stimulated to make the testosterone that increases sebum production and clogs pores. The skin does not, however, add to inflammation. It’s a little easier to control acne that is triggered by “going through stress” than it is to control acne that is triggered by stressing the skin with alcohol rubs, steam treatments, harsh detergents, and strong antiseptics.
  • When children go through adrenarche, the maturation of their adrenal glands, which usually takes place 2 to 4 years before puberty, their adrenal glands start producing DHEA that the skin can convert to testosterone, when it is stressed.
  • Childhood acne is not likely to occur unless the skin is treated harshly by too much scrubbing, rubbing, and skin care products containing alcohol or menthol.

In adult men, taking testosterone injections can also trigger acne. There are women who take testosterone and who are at added risk for acne, but most women who have high testosterone levels causing them to break out in acne have a condition known as polycystic ovarian syndrome, or PCOS.

Acne, Estrogen, Testosterone, and PCOS

PCOS is a condition that is caused by overactive ovaries. The ovaries normally make large amounts of estrogen and small amounts of testosterone. In PCOS, the ovaries are overstimulated, so they make large amounts of both testosterone and estrogen.

The extra testosterone circulates to the skin and stimulates sebum production. Usually this makes the skin break out in tiny, red pimples around the nose and across the forehead. The solution for this problem, however, is not to try to counteract testosterone with estrogen, since estrogen is already in excess.

The way to deal with acne caused by PCOS is to reduce the ovaries’ production of testosterone. There are hormone-based treatments, but most women have much more success with diet. If there is less sugar in the bloodstream, the ovaries are less likely to be hyperactive, and the skin may clear up on its own. It usually does not require a lot of weight loss to correct acne related to PCOS. Just 2-3% of body weight, sometimes as little as 2-3 pounds (1-1.5 kilos), is enough to clear up the skin (and also to restore normal menstrual periods and normal ovulation). Dieting to reverse PCOS symptoms, usually requires 6 to 12 months for results.

Acne and Melatonin

Melatonin is the hormone that induces sleep. Our brains make melatonin when the eyes do not detect blue light (the same wavelengths of visible light that kill acne bacteria). Even the amount of light that can be seen with the eyelids closed is enough to stop the brain’s production of this hormone that is essential for normal sleep.

But if the brain gets a chance to make melatonin in darkness during sleep, it releases less corticotrophin stimulating hormone. This is the stress hormone mentioned earlier in this article. Increased melatonin production reduces stress in the skin, and it also reduces the effects of testosterone.

This means that getting your zzz’s clears up your skin by increasing melatonin production. You can also take melatonin supplements to get better sleep, but the side effect of taking melatonin is feeling sleepy.

How to Use Your Knowledge of Acne and Hormones

You don’t have to be an endocrinologist to make use of basic knowledge of human hormones in your fight against acne, but dealing with hormones is just part of keeping skin clear. You will have more success with skin care management if you use a complete acne care system like Exposed Skin Care.

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Bobby Reply

Hey there! Question for you... Can drastic fluctuations in testosterone, cortisol levels, contribute to acne? I am 32 and graduated from US Army Ranger school at the end of last January. Ranger school is notorious for damaging the body in many strange ways. Testosterone levels drop. Cortisol levels spike. No food. No sleep. All for at least 61 days. I spent 100 days there. When I rejoined the world after graduating, I started to do the things I used to do before school. Intense athletic activity (weights, running, etc), sex, whey protein, vitamins. I began to notice arm and torso acne developing. I switched from whey to egg protein as I know that dairy products can contribute to acne. Things got a little better but never went away--and now things are worse which is why I am writing you. Can the drop and then rise in testosterone be contributing to my body acne? It is now 4 months after Ranger school. Do hormones take a long time to settle back down after an event like Ranger school happens? Flare-ups happen maybe once a month. I began exfoliating but that doesnt seem to be helping too much. What say you? Feel free to ask any questions you want. Thanks for your time, -Bobby.

June 1, 2014 at 11:12 am Reply
alicia hunt Reply

I am 70 years female who stopped taking testosterone injections and now of pimples on face. What should I do to clear up

June 19, 2014 at 10:48 pm Reply
Kelly Reply

Hi, I'm wondering if intense excessive exercise, specifically running long distances, can cause acne to flare up? I'm 31 and have been battling acne for more than half my life. It comes and goes and is sometimes moderate. When I was 26 I got pregnant with my first child and my acne seemed to clear up almost completely and has remained pretty much clear ever since. I'll get the occasional few breakouts, but nothing major. Over the past few months I've been training for my first half marathon and my face has been breaking out like crazy. Could it be because of the excessive running? My body is maybe pumping out cortisol on my long runs and causing me to break out? Thanks.

October 5, 2014 at 10:23 am Reply
Frank Reply

Please fix the 2nd sentence under topic: Acne, Estrogen, Testosterone, and PCOS . I'm pretty sure the ovaries produce large amounts of ESTROGEN and some testosterone. Otherwise, great info for my son with high testosterone who is battling acne and thinks anti-biotics are the cure-all. It's all about cortisol, gut health, and as you pointed out, not abusing the skin of all its stabilizing/homeostatic factors (such as the probiotics that normally reside on healthy skin!).

March 10, 2016 at 6:41 pm Reply
Rose Reply

They usually do,but in PCOS the testosteron and free testosteron (DHT) is higher than estrogen ....and voila you have a hormonal imbalance

August 8, 2017 at 10:00 am Reply
Rose Reply

Well this page od so wrong.... I do even feel they are promoting some Products.... Not all od the PCOS victims are over weighted. Personall, i am 168 cm and 49-50 kg.... Diet(sugat free for example) can help but there are other triggers top,for someone it is Milk qnd dairy products,for someone carbs and someone sugar.... So it Takes a lot of time to find out what May be a triggers for you.... There is NO CREAM that can help a hormonal acne !!! If the problem is inside there is no point treating it from outside. The things for skin care May only help with existing acne( help it heal faster or treating the hyperpigmentation,reduce swelling and redness) . I have tried everything except accutane. The things that worked for me the best on the long term were tinctures , BC helped at the moment and after 2 months without them the acne came im even worse stage.... Nature is should give it a try. I am switching to Ovasitol now,if someone had experience with it please prave a comment. Thank you and good luck

August 8, 2017 at 9:57 am Reply

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