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Acne and hormones: they go hand-in-hand

Hormones play a MAJOR role in acne which is why one of the most common conventional treatments for acne is the birth control pill.

Here are the major contributors to the pathogenesis of acne:1

  • Androgens (testosterone and DHEA) encourage increased production of oil (sebum) on the skin, leading to increased likelihood of clogged pores.  Puberty and premenstrual states are common times when people notice an acne flare, and are coincidently times of high androgen activity.
  • Progesterone is a funny hormone when it comes to acne.  Progesterone excess has been linked to acne as the hormone itself, like androgens, can stimulate the production of sebum.  However, healthy levels of progesterone can also stop androgen activity by blocking androgen receptors, so low levels can indirectly increase sebum production caused by androgens.
  • Estrogen plays a positive role in acne overall – it lowers androgen levels, improves skin barrier function and increases hydration to the face.  However, estrogen-excess can lead to a relative deficiency in progesterone, which is a common cause for premenstural acne.
  • Stress and stress hormones such as corticotropin-releasing hormone (CRH) and adrenaline (or epinephrine) have been well-known to be a trigger and can aggravate of acne.  Did you know that skin cells produce the same stress hormones your brain produces in response to stress?  Did you know the stress hormones can bind to cells that produce sebum (oil) in the skin and activate this production?  These stress hormones also stimulate skin cells to produce inflammatory molecules, which perpetuates the process of acne eruptions.  Not only does your skin respond directly to increased stress, but the overall effect that stress has on the body can create an environment favourable to acne flare-ups.  In response to stress, there is a decrease of blood supply to the skin, an increase in systemic inflammation, and changes in hormonal patterns such as increased androgens.  Stress is also known to alter the probiotic flora, which, as we know from before, plays an important part in the development of acne.2

As you can see, hormones are a complicated bunch but each play a prominent role in acne.  Using the birth control pill to treat acne is a temporary solution to the problem, which in many cases of acne, rebound after birth control is discontinued.  With solid work with a qualified medical professional like myself, you can regulate your hormones through natural and integrative treatments and therefore resolve hormonal acne for good.

Yours in health
Dr. Tanya Lee, N.D


  1. Arora MK, Yadav A, Saini V. Role of hormones in acne vulgaris. Clin Biochem. 2011 Sep;44(13):1035-40
  2. Alexopoulos A et. al. Stress-related skin disorders. Rev Endocr Metab Disord. 2016 Jul 2. [Epub ahead of print]

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