How To Tell If Your Acne Is Hormonal

Adult acne affects 45% of women ages 21-30 and 26% of women ages 31-40. While there are causes beyond hormones, like inflammatory acne and topical irritants, in this article, we’re going to hone in on the hormonal type.

Although acne can occur for many reasons, here are some common signs that your acne is hormonal in nature.

  • You get pre-period acne.
  • Acne gets worse when eating more sugar, dairy products, or soy-based foods.
  • Testing confirms androgens or 5-DHT are in the upper range.
  • You have symptoms or testing of low estrogen or poor estrogen metabolism.
  • You have high blood sugar or insulin levels
  • You have PCOS (a condition often linked with high androgens).
  • Acne appears after stopping birth control.

It really comes down to the ratios of estrogen-to-testosterone and progesterone-to-testosterone.

Androgens (like testosterone) are often defined as male sex hormones, but women have them too, just in much lower quantities. With hormonal acne, DHEA, DHEAS, and androstenedione act as precursors to testosterone and DHT. 

In women, DHEA is produced from the adrenal glands (think stress). Our skin contains enzymes for converting these precursors to testosterone and DHT and these both stimulate skin cell growth and sebum production. Testosterone and DHT can cause acne because they increase the size and activity of the sebaceous glands (aka, they boost oil production in the skin).


This is an excerpt from a post written by functional medicine dietitian nutritionist, Robyn Johnson, MS, RDN, LD, CLT.

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