The treatment of hormonal acne can be difficult and frustrating. It cannot simply be treated with topical treatments, and requires a complete approach that focuses on diet and lifestyle. Hormonal acne is a common symptom among women with Polycystic Ovarian Syndrome (PCOS). Even if you feel like you are taking every diet and lifestyle precaution, spots can still show up, especially around your jawline. This is because PCOS increases androgen levels (male hormones), which then increases sebum production.
Sebum is the oil than your skin secretes that, when in excess, can clog up pores and cause acne.
The treatment of hormonal acne can be complex, and you need to focus on a variety of factors and different hormones if you want your skin to become as clear as possible. The hormones you should mainly focus on with the treatment of hormonal acne, especially related to PCOS, are insulin, testosterone, oestrogen, and cortisol.
Here is a short outline of what you need to do to help you balance each of these hormones as part of your treatment plan:
Insulin and Hormonal Acne
High insulin levels cause a lot of PCOS symptoms, such as hormonal acne and hair loss. Some of the best things you can do to lower insulin are:
- Reducing your intake of sugar and processed foods. Perhaps even consider a low-carb diet. Carbohydrates and sugar are converted into glucose for fuel, but when glucose levels are too high, it increases inflammation and insulin. The production of testosterone is also increased in the presence of high insulin, and hormonal acne is worse. Therefore, treatment often starts by examining your intake of these foods.
- Ensure that you consume enough potassium, as low levels are linked to having higher insulin. You can find potassium in foods, such as cooked spinach, cooked broccoli, mushrooms, and avocado.
- Have things like apple cider vinegar, cinnamon, and green tea with your meals, as they help lower the glycaemic impact of the carbohydrates and balance blood sugar levels, which ultimately, improves insulin levels.
Testosterone and Hormonal Acne
There is an enzyme, called 5 alpha reductase, which converts testosterone into DHT (an even more powerful form of testosterone), which causes acne. If you have too much, you can take a 5 alpha reductase inhibitor. This can be found in cruciferous vegetables like broccoli, cabbage, cauliflower, and brussels sprouts.
You can also take a DIM supplement, which I highly recommend. It stands for 3,3′-Diindolylmethane (DIM), and it is found in cruciferous vegetables. Taking around 200mg a day is roughly equal to eating two pounds of cruciferous vegetables.
Vitamin A also inhibits the enzyme, which is why supplementing with vitamin A; eating foods that contain vitamin A like liver, cod liver oil, and egg yolks; and eating foods that are rich in the precursor to vitamin A, known as beta-carotene, such as butternut, carrots, tomatoes, apricots, etc. is a good idea.
Zinc can also lower levels of DHT, therefore, supplementing and consuming foods that are high in zinc, such as nuts, seeds, celery, asparagus, shellfish, and dark chocolate can help reduce hormonal acne and speed up skin healing as well, as it can promote faster cell turnover.
Oestrogen and Hormonal Acne
If your oestrogen levels are too high, some of it can convert to testosterone. High oestrogen is often caused by problems with the liver, such as developing a fatty liver. Support liver function and detoxification through the consumption of cruciferous vegetables and by supplementing with DIM. DIM helps your body break down oestrogen.
Exposure to environmental pollutants, chemicals in cleaning products, and plastic can also increase the amount of oestrogen in your body. Therefore, the treatment of hormonal acne can require you to reduce your exposure to them as much as possible.
Switch your cleaning products to more natural alternatives, as some of the chemicals get absorbed through your skin and can mess up your hormones and increase oestrogen. These include Phthalates, parabens, and various pesticides.
Cortisol and Hormonal Acne
A lot of women can safely say that they break out more when stressed. This is because the rise in levels of the stress hormone, cortisol, increases the production of testosterone. Feeling stressed also leads to behaviours that are triggered by stress, such as overeating, picking your skin (which spreads bacteria, and makes skin worse), and even smoking, all of which can make acne worse.
The cells that are responsible for sebum production also have receptors for stress hormones.
Caffeine can increase levels of cortisol, especially in people who already struggle with stress and anxiety. Therefore, if you have acne, anxiety, or both, and suspect that caffeine could be making your skin worse, consider cutting your caffeine intake for a while to see if it makes a difference. When I have too much caffeine, it shows on my skin.
Inflammation and Hormonal Acne
PCOS is strongly linked to having excess inflammation in your body, and acne if basically inflamed and clogged skin. The treatment of hormonal acne with PCOS requires you to follow an anti-inflammatory diet. The basics of an anti-inflammatory diet are:
- Reducing your intake of sugar.
- Eliminating processed foods from your diet.
- Not eating a lot of high-glycaemic carbohydrates, such as white bread, cake, pizza, etc.
- Cutting trans fats (hydrogenated vegetable fats) from your diet. Avoid anything deep fried and that lists hydrogenated vegetable oils or trans fats on the label.
- Getting rid of gluten in the diet. Gluten can be inflammatory for most people, and can trigger acne breakouts in some.
- Reducing dairy consumption. Dairy can cause inflammation for many, and a lot of people, who reduce their dairy intake or cut it out completely, see significant improvements in their skin.
- Adding anti-inflammatory foods, such as turmeric, fatty fish, brightly coloured vegetables, and ginger.
If you have PCOS, there is a high chance that you are also experiencing hormonal acne, but with these tips above, you can design your own perfect hormonal acne treatment plan and see an improvement in your skin over time. Be patient though, as getting clear skin takes time.