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Top Treatments For Female Acne Sufferers

Acne in women and girls can be especially hard to treat. The skin of girls and women responds to constant changes in hormone levels, and the techniques that work well during one part of a hormone cycle often will not work in another. This article answers the most frequently asked questions about acne prevention and care in a woman’s life, beginning with the most important questions about acne in girls.

Hormonal acne in women
Fluctuating hormone levels is one of the main causes of acne in women.


  • Throughout the lives, girls and women need special acne care.
  • Acne in girls who have not yet had their first period is usually due to stress.
  • Premenstrual acne is caused by progesterone and relieved by estrogen.
  • Birth control pills that are relatively high in estrogen often clear up blemishes.
  • Women who have PCOS (polycystic ovarian syndrome) sometimes can clear up acne by low-calorie dieting.
  • Tretinoin treatments can relieve both blemishes and wrinkles.
  • Vitamin C is an often-overlooked treatment for acne on brown skin.
  • Certain ingredients in cosmetics can cause breakouts at any time of life.
  • Isopropyl alcohol often makes the skin oilier.
  • The easiest way to deal with acne is to use an acne treatment system, such as Exposed Skin Care.

Q. When little girls get acne, is it a sign of early puberty?
A. Although early puberty in girls can trigger early acne1, even as young as age six, more often than not girls get acne due “adrenarche,” maturation of the adrenal glands, rather than menarche, maturation of the ovaries. When the adrenal glands begin making large amounts of a substance known as DHEA, the skin can start using this substance2 to make its own stress hormones.

Acne that girls suffer before puberty is aggravated by stress hormones, rather than by sex hormones. Reducing stress in the environment and stress on the skin (ill-advised experiments with cosmetics, harsh soaps in the washroom and gym at school, and mite-filled classrooms, for instance) reduces the number of breakouts3.

Q. Why do girls get acne about the same time they get their periods?
A. Right after puberty, the ovaries produce unusually large amounts of not just estrogen but also testosterone (although girl produce much less total testosterone than boys). Testosterone stimulates the production of sebocytes4, the skin cells that make sebum. Maturing sebocytes, in turn, are especially sensitive to the skin’s stress hormones. It is a combination of sexual maturity and stress that causes acne-prone skin in both girls and boys as they mature sexually.

Q. What causes premenstrual acne?
A. In the first half of a woman’s period, her body produces more estrogen than progesterone. Estrogen tends to “calm” the skin and also to lower core body temperature. In the second half of a woman’s period, her body produces more progesterone than estrogen. Progesterone hardens the lining of the uterus so it can either receive a fertilized egg or slough off at the next menstruation. Progesterone raises core body temperature and thickens the skin around pores. Both of these effects cause breakouts5, and both of these effects are at their peak just before menstruation.

Q. Will birth control pills prevent acne?
A. Birth control pills are usually a combination of estrogen and a synthetic form of progesterone known as progestin. Estrogen is the component of the Pill that stops acne. But estrogen also stimulates growth of certain cancers6 and increases the risk of blood clots7. Too much estrogen can also cause outbreaks of acne.

Most women and their doctors can find a brand of the Pill that is safe for them and that reduces premenstrual acne outbreaks. The Pill itself, however, will not eliminate acne. Usually there is a reduction of in the number of blemishes, up to about 60%.

Q. I have PCOS. What can I do about acne other than the usual acne care?
A. About 50% of women who have acne caused by PCOS begin to see clearing in their skin when they go on reduced-calorie diets that result in weight loss. It only takes a little weight loss to see a major change in symptoms, as little as 5% of a woman’s weight, usually no more than 3 pounds/1-1/2 kilos.

The reason weight loss helps clear up acne caused by PCOS is that symptoms are caused by excessive production of testosterone8. Usually women who have PCOS also have a condition known as insulin resistance9. Many tissues in their body shut down receptors for insulin, leaving more sugar in the bloodstream.

The ovaries, however, cannot turn off insulin receptors. They are flooded with sugar that they have to “burn” to prevent free radical damage to the eggs within. The ovaries use the extra energy to make more estrogen and more testosterone, which causes mood swings, hair growth, and acne. When women diet, they remove just enough sugar from circulation to bring testosterone levels back to more nearly normal levels. The skin clears up, unwanted hair growth often stops, and fertility may also return.

Q. Why would a woman who never had acne before suddenly develop acne during menopause?
A. If the blemishes are tiny red bumps in the skin, the underlying problem is probably dryness10. Moisturizing the skin with an alcohol-free product loosens tight skin and allows pores to drain, reducing the formation of pimples.

Q. Acne and wrinkles together are just awful. What can I do about them?
A. There is a prescription-only product called Renova that stimulates skin growth to remove both fine lines and wrinkles and blemishes. It is a lotion made with the acne medication Retin-A. You can also buy non-prescription tretinoin creams (which as also Retin-A) to treat blackheads and fine lines. Be sure not to get either product in your eyes or mouth.

Q. Sometimes a new cosmetic makes me break out. Is there any way I can learn what not to buy to avoid breakouts?
A. Throughout a woman’s life, the skin repairs itself with the help of sebum. Products that irritate the skin increase the production of sebum. The most common irritating ingredient in skin care products is also one of the cheapest, isopropyl alcohol. Alcohol or anything else that leaves your skin feeling cool and tingly can also make it break out.

Often the most expensive cosmetics contain ingredients that sound natural but that irritate the skin. Some of the ingredients that are never good for your skin include cinnamon oil, isopropyl alcohol, isopropyl stearate, menthol, peppermint oil, and sodium lauryl sulfate.

Q. Are there any vitamins that are especially useful women’s skin.
A. The one vitamin that is most often overlooked in women’s acne care11 is vitamin C applied directly tot the skin, in the form of ascorbyl palmitate. This form of vitamin C is especially helpful in preventing discoloration of brown skin after it blemishes are healed, but it has to be used during the healing process, not afterward.

There literally tens of thousands of acne products. Save yourself the guesswork and use a complete acne care system such as Exposed Skin Care.


  1. Berberoğlu M. Precocious puberty and normal variant puberty: definition, etiology, diagnosis and current management. J Clin Res Pediatr Endocrinol. 2010;1(4):164–174.
  2. Zouboulis CC. The skin as an endocrine organ. Dermatoendocrinol. 2009;1(5):250–252.
  3. Maleki A, Khalid N. Exploring the relationship between stress and acne: a medical student’s perspective. Clin Cosmet Investig Dermatol. 2018;11:173–174. Published 2018 Apr 12.
  4. Makrantonaki E, Ganceviciene R, Zouboulis C. An update on the role of the sebaceous gland in the pathogenesis of acne. Dermatoendocrinol. 2011;3(1):41–49.
  5. Geller L, Rosen J, Frankel A, Goldenberg G. Perimenstrual flare of adult acne. J Clin Aesthet Dermatol. 2014;7(8):30–34.
  6. Rothenberger NJ, Somasundaram A, Stabile LP. The Role of the Estrogen Pathway in the Tumor Microenvironment. Int J Mol Sci. 2018;19(2):611. Published 2018 Feb 19.
  7. Trenor CC 3rd, Chung RJ, Michelson AD, et al. Hormonal contraception and thrombotic risk: a multidisciplinary approach. Pediatrics. 2011;127(2):347–357.
  8. Franik G, Bizoń A, Włoch S, Kowalczyk K, Biernacka-Bartnik A, Madej P. Hormonal and metabolic aspects of acne vulgaris in women with polycystic ovary syndrome. Eur Rev Med Pharmacol Sci. 2018 Jul;22(14):4411-4418.
  9. Moghetti P. Insulin Resistance and Polycystic Ovary Syndrome. Curr Pharm Des. 2016;22(36):5526-5534. Review.
  10. Herman J, Rost-Roszkowska M, Skotnicka-Graca U. Skin care during the menopause period: noninvasive procedures of beauty studies. Postepy Dermatol Alergol. 2013;30(6):388–395.
  11. Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin HealthNutrients. 2017;9(8):866. Published 2017 Aug 12.
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