How are acne and hormones related?

Hormonal fluctuations or the altered sensitivity of the sebaceous gland to circulating androgenic hormones (e.g. during puberty or the menstrual cycle) lead to an increase in horny cell production (hyperkeratosis) and sebum production (seborrhea). This forms the basis for the growth of bacteria, which ultimately give rise to the visible inflammations (pimples).

Hormonal differences between men and women

Despite all the differences between men and women, there are also some similarities:

During puberty, testosterone levels rise in both sexes. Testosterone is a so-called androgen, a sex hormone. In men, it is responsible for the growth of the penis and testicles, in women for muscle and bone strength. An undesirable side effect is the high probability of also developing acne during puberty. More than 70% of all adolescents have to deal with blemished, acne-prone skin during puberty.

In particular, hormonal fluctuations during puberty make teenagers susceptible to acne.

For most, acne subsides significantly after puberty. However, up to 40% of all adults (aged 25 and over) are also affected by acne, at least temporarily.1 The amazing thing is that 75-85% of them are women.2

And this is where the differences begin.

While men's hormone levels level off over the years, women's continue to fluctuate. Especially between the ages of 20 and 40, and then again during menopause, women are particularly susceptible to hormone-triggered acne. There are three factors behind this:

  • The menstrual cycle
  • Possible pregnancy(s)
  • The menopause

Acne before and during the period

According to a dermatological study, over 60% of all women affected by acne experience a regular premenstrual exacerbation of their symptoms3.

The reason for this is that the female menstrual cycle causes hormone levels to rise and fall continuously. As a result, the skin can also be affected differently in the different phases.

The menstrual cycle usually lasts 28 days. It begins with the first day of the period and ends one day before the next bleeding - and each day is hormonally different:

  • Day 1 to 14:
    FSH and LH, two hormones secreted by the pituitary gland, control ovarian function, i.e. hormone production (estrogens, progesterone) and the menstrual cycle with ovulation. Estrogen dominates over progesterone at this time.
  • Day 14 to 28:
    Estrogen levels drop again, progesterone (a corpus luteum hormone that stimulates the growth of the uterine lining and prepares it for implantation of the fertilized egg) becomes dominant - especially this increase stimulates sebum production.

Menstrual acne usually flares up seven to ten days before bleeding - so around day 18 to 21. During the period itself, the condition of the skin usually improves.

Just before bleeding begins, both estrogen and progesterone are at their lowest levels. At this time, testosterone levels (always lower in women than in men) are actually higher than female hormones, which leads to more sebum production.

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