If you suffer from hormonal acne, you are not alone. Up to 23% of adult women experience acne! This number is nearly twice that of men.
Why do women suffer acne twice as much as men do?
Because of hormones.
Now there are many different factors that affect acne. Inflammation is very important. Gut health is important. Anti-oxidant status is supremely important (learn all about these factors in my program for overcoming acne Clear Skin Unlocked: The Ultimate Guide to Acne Freedom and Flawless Skin).
But hormones make all the difference for women.
Today, I provide you with the hormonal acne treatment plan that I used to personally overcome my own hormonal acne, and which I use today to cure my clients all over the globe.
Here it is:
Hormonal Acne Treatment Step 1: Is Your Acne Hormonal?
How do you know if your acne is hormonal or not? This is a very important question to ask. You don’t want to try to fix something that isn’t broken.
Here are some things to look out for to determine if your acne is hormonal:
-if your acne fluctuates with your monthly cycle
-if your acne is cystic and located around your chin, mouth, and jaw
-if your acne has also spread to your shoulders, upper back, and buttocks
-If you experience other hormonal symptoms like irregular menstrual cycles, male pattern hair growth (facial hair), balding, PMS, mood swings, hypothyroidism, or difficulty maintaining or losing weight
You can read a more in depth description of hormonal acne and things that cause it in this popular post.
Hormonal Acne Treatment Step 2: Learn about causes
This is the hardest part of hormonal acne treatment, but it is the most important, and the aspect that makes your healing the most effective in the long run.
Hormonal acne is caused by an underlying hormone imbalance. Period, that’s it, no questions about it!
The only questions remaining are: what type of imbalance is it, and what caused the imbalance?
Hormones can become imbalanced a number of different ways. The fastest way to heal is to figure out why your hormones are imbalanced, and then correct that problem.
The most likely problems affecting you are:
1) Elevated testosterone
Testosterone is one of the primary causes of female acne. Testosterone causes oil production in the pores of your skin to increase. Excess oil causes pore-clogging. This in turn creates more food for bacteria to eat, and therefore more possibilities for infection.
How does testosterone get elevated? Insulin signals to the ovaries to produce testosterone. Testosterone often becomes unhealthfully elevated as a result of insulin spikes and insulin resistance.
This means that insulin-related problems are one of the primary causes of hormonal acne for women!
As an important side note:
Usually when testosterone levels get high women develop a fertility-threaning hormone condition called Poly Cystic Ovarian Syndrome. I personally had PCOS and figured out how to overcome it (which finally made my acne go away!).
I share the secrets I learned in my journey overcoming PCOS in a manual I wrote that has now been used successfully by thousands of women all over the world. You can read about the success I and my readers have been having at this page or in this program.
2) Elevated DHEA-S
DHEA-S is another male sex hormone, so it has the same oil-enhancing effects on the skin as testosterone does.
DHEA-S is unique however because it is produced by the stress glands, instead of reproductive organs.
DHEA-S rises in response to all different kinds of stress, from the mental to the physiological. You can read about the health effects of mental stress at my blog here, or of physical stress here. You can read about the biological mechanism “pregnenolone steal” that makes DHEA-S rise here.
DHEA-S is another big problem for women with PCOS. My own DHEA-S levels were personally through the roof, due to the level of stress I was putting on my body. I talk about the intersection of stress and hormones at great length in that manual on overcoming PCOS I mentioned.
3) Reduced estrogen
Estrogen is important for clear skin because it provides a counterbalance to testosterone. It is one of the best molecules out there for creating dewy, radiant skin.
Estrogen levels can fall for any number of reasons.
Menopause is one big reason.
Low body fat percentage, extreme weight loss, excessive dieting, calorie restriction, and excessive exercise are some others. These are often related to hypothalamic amenorrhea or PCOS – and were a big factor in my own PCOS, despite the fact that most medical professionals refuse to recognize this.
Estrogen levels may also fall as a result of birth control pill usage (especially when you come off of the pill. For more on how to deal with side effects of the pill, check out my quick guide to birth control.)
4) Hypothyroidism
Hypothyroidism is not a hormone problem in the sense that sex hormones are produced by the reproductive cycle, but it is a hormone problem in the sense that thyroid function is intimately tied to reproductive function. The components of the thyroid system that are the most important for effective thyroid function are considered hormones, too.
Hypothyroidism causes cells to weaken and be susceptible to DNA damage and inflammation. It can be caused by a low carbohydrate diet, by stress, or by an autoimmune condition called Hashimoto’s Thyroiditis.
Hormonal Acne Treatment Step 3: Figure out your cause
Which of the forementioned causes of hormonal acne is yours? It could be just one of them, or it could be all four. For me, personally, it was all four.
You could simply guess which problem is your own based on the information I provided.
You can also get tests done. Here are the things you would want to test:
Free testosterone (bad for acne if elevated)
Fasting insulin (bad for acne if elevated – is a likely cause of elevated testosterone and indicates what I call type I PCOS)
Estrogen (estradiol and estrone) (bad if low)
LH (bad if improperly balanced with FSH or bad if low)
FSH (bad if improperly balanced with LH or bad if low)
DHEA-S (bad if elevated)
And for thyroid hormones test:
TPO (indicates Hashimoto’s Thyroiditis if high)
TSH (indicates Hashimoto’s Thyroiditis or other thyroid issue if high)
T4 (indicates Hashimoto’s Thyroiditis or other thyroid issue if low)
T3 (indicates hypothyroidism if low)
Your doctor or another health professional can help you go over these tests. Basically they will tell if you have elevated testosterone or low estrogen and the like. Then you can work on overcoming these issues.
Hormonal Acne Treatment Step 4: Overcome the issue
Now that you know which hormone imbalance issue you have, you can work on correcting it.
Depending on your results, you may have PCOS. This is possible if your testosterone and DHEA-S are elevated, and likely if your fasting insulin is high. If this is the case, you could honestly do no better than my innovative guide to PCOS, PCOS Unlocked.
You may have hypothalamic amenorrhea, which would be indicated by low levels of estrogen, progesterone, LH and FSH, or hypothalamic amenorrhea coupled with PCOS, which would have those problems too but also perhaps elevated DHEA-S or testosterone (generally speaking). It’s complicated. Most medical professionals don’t recognize that hypothalamic amenorrhea and PCOS can occur at the same time. I do.
You may have hypothyroidism. If you have Hashimoto’s then you will want to try healing your autoimmunity and gut with an autoimmune protocol diet like this one (it’s the best one out there). If you do not have Hashimoto’s but still suffer low thyroid levels you may want to consider reducing stress and exercise and increasing the carbohydrate content of your diet.
You may not have any of these conditions specifically. You can suffer from high testosterone but still not technically have poly cystic ovaries. In this case you would still want to address insulin resistance by eating an anti-inflammatory, lower-carbohydrate diet. (More about which here.)
Many women have a lot of success simply eliminating dairy and sugar from their diets, since these are both highly hormonal foods.
Hormonal Acne Treatment Step 5: Address other factors
Hormones are a big factor in acne, but they are not the only one. As I mentioned in the introduction to this post, inflammation is a big factor. Antioxidant status is a big factor.
In this post I talk about the effects on acne by stress, UV rays, heat, dairy, inflammatory foods, phytoestrogens, topical irritants, sleep, and low carb diets.
In this program – Clear Skin Unlocked: The Ultimate Guide to Acne Freedom and Flawless Skin – I discuss inflammation, hormones, antioxidants, irritants, UV rays, foods, various supplements, how certain renowned “health” foods are actually causing acne, and more. It’s the most in depth, comprehensive acne resource I’ve encountered to date.
Hormonal Acne Treatment Step 6: Supplement wisely
While you heal your underlying hormone imbalances, it is also important to attack acne from other angles. One is to use the best topical regimens and products possible.
For some of my favorite topical treatments for acne, check out the antioxidant cleansers, serums, and topical probiotics (my absolute fave!) I use.
Several supplements have also been shown to be very helpful with acne, sometimes reducing acne by up to 50% over the course of six weeks! Zinc, selenium, and N-acetyl cysteine have been shown to be the best antioxidants for acne.
Hormonal Acne Treatment Step 7: Experiment with patience
Overcoming acne takes time. Many different things can affect acne, so it will take you a little while to figure out which ones are the most important for you to address. Here is the trick to doing so:
Only test one thing at a time.
Hold your diet steady, and remove one food. Give it two weeks. Do you see a difference?
Or hold your diet steady, and add in 100 grams more of carbohydrate every day. Give it two weeks. Do you see a difference?
You should definitely eat as healthfully as you can in the “steady” periods. Focusing on fresh fruits and vegetables, wild-caught and grass-fed animal products, and healthy fats like olive oil and coconut oil is an excellent place to start. Organ meats are great (here’s a supplement in case you do not like to eat liver), as are eggs, fermented foods (here are my favorites) and the rockstar super-suppelment that destroys acne, fermented cod liver oil.
But too much of anything can throw an already imbalanced skin environment even further out of balance. (Did you know that the “superfood” liver, and the “superfood” goji berries can actually cause acne?) This is why I published Clear Skin Unlocked – I wanted to provide you with the most in depth information possible, so you’ll stop falling through the cracks. It’s 50% off this week, and, even better yet, fully refundable if you don’t like it for any reason.
And… that’s a wrap for my hormonal acne treatment plan! Following those steps (and doing years of research to finally figure out how to cure my PCOS) is what made my skin go from this on a good day:
To this:
On every day!
So believe me when I say that if I could do it… you can too!
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The coupon code you sent for the probiotic spray is not working…it only gave $2.00 off not 18% ???
Never mind, Stefani, I contacted probiotic and they fixed it on their end. Thanks so much for the info and coupon!!
lol, sorry from the math I did I thought $2 was 18%.
Wonderful post! I just have one question. My estrogen levels seem to be too high, can that be causing my acne problems?
I’d guess probably no. From everything I can tell in the literature and observing people, there’s a lot of chatter about estrogen being a problem but I have yet to see results when people reduce it. I suppose it IS possible – I simply don’t know the mechanism for it. Sometimes when estrogen is high it converts to testosterone, so you could be making more testosterone than your skin can handle, maybe. High estrogen levels are also correlated with inflammation, so maybe the estrogen itself isn’t the problem but the inflammation you have riding alongside it?
Thanks. I answered my own question a short time after asking it.
I have to avoid dairy because the natural estrogen in it causes excrutiatingly painful cramping during my periods, but since I wasn’t on my cycle, I at a very small amount of chocolate and some cheese and my face broke out bad!! I was so dissapointed because my face had cleared up too! Needless to say, I am so done with dairy.
Great article! What about estrogen dominance or luteal phase defect? My hormonal acne on my chin has improved probably 90% since going Paleo. Plus cutting out dairy; taking zinc, krill oil, and other supplements, and treating my hypothyroidism. My naturopath also prescribed Thorne SAT liver support (as extra support for familial hypercholesterolemia) and that definitely made my skin improve too, but I still get a few small cysts on my chin every month and I wonder if it has to do with my recently diagnosed luteal phase defect/low progesterone? I’m going to be taking chaste tree berry to treat that as soon as I go back to see my naturopath so maybe that will help… Anyway, you didn’t mention low progesterone as a possible cause of hormonal acne so I was just wondering about that…
Do you have a recommended saliva hormone test that can be done at home?
Hi Stefani, I read all your work with interest. Although I don’t have PCOS I have much the same symptoms (acne+facial hair+can’t lose weight) stemming from low SHBG, which my doctors tell me is a problem with my liver and nothing can be done. I tried Spironolactone but all it did was obliterate my nice hourglass curves and I lost my waist – came right back when I stopped tho. These days thanks to a mostly paleo diet my acne (face/chest/back) is vastly better – but still not gone 🙁 . I eat very well and exercise some both weights and cardio. Having 2 young kids I don’t have time to overdo it, lol. I have almost no menstrual symptoms an no issues with my period at all – but any soy in my diet brings on the PMT. Any advice for me? Thanks 🙂 (PS – my skin was amazing while I was breastfeeding, but waist line very thick . . . )
Hi Stefani. I’m guess estrogen levels are likely the cause for my recurring acne problems. I had a complete hysterectomy at age 45 (everything including ovaries). I had been on a very low dose estrogen replacement therapy since then, until a new doctor decided I needed to get off it because I had a history of microcalcifications in my breast tissues (there is NO history of breast cancer in my family – anywhere – but my father passed away from leukemia 12 years ago). Even though I wanted to continue with it, she said she would note my “refusal to follow her directions” in my medical record which, if I ever did develop breast cancer, could well result in my insurance not covering any of the necessary procedures! Consequently, I gave in and have now been off any replacment therapy for the past 6 years. Not only has my skin gone “nuts,” I have also gotten to the point where I have ZERO sex drive. Thank Heaven my husband is VERY understanding, but I cannot expect him to be that way forever! I stumbled onto your site through Louise’s AncestralChef.com site and had to wonder if your information just might be the answer I have been looking for. Any thoughts for me?
YES I HAVE THOUGHTS. I am not an expert on breast cancer, so I can’t weigh in on rather that’s a risk for you. i would guess however that a very low dose wouldn’t do any damage to you beyond what a normal level of estrogen produced by your ovaries WOULD. If you want to find another doctor to proscribe you estrogen I don’t think that would be a terrible idea. Before that however you may wish to try some more natural methods of elevating your estrogen levels. phytoestrogens like legumes, soy, or flax may help you (they tend to work quite well for my own libido). you may also wish to try having one glass of wine a day? that has been shown to elevate estrogen levels, too.
FCLO is the worst thing I’ve tried for acne. Anxiety, more acne and hair loss is what I’ve experimented taking it. I do not understand why everyone in the paleo world recommends it.
Have you read about the toxicity of FCLO?? look at http://drkaayladaniel.com/
Hi Stefani, I had a question about the Green Pastures Cod Liver Oil. I am experimenting with my diet because I believe I have hormonal acne, so I am starting by eliminating dairy from my diet. I noticed that the cod liver supplement you recommended has dairy oil in it. Do you believe this will have a negative impact if I am trying to eliminate dairy from my diet? or should I look into another cod liver supplement?
Thank you!
such a good question. I do believe there is some small amount of hormones in the butter oil, but it may be small enough to be negligible. My personal solution, JUST TO BE SAFE, is to take straight up cod liver oil without the butter added. You can find that on amazon from Green pastures or from their website. 🙂