Does Hormone Replacement Therapy Cause Adult Acne?

I never believed that I’d have hormonal acne breakouts once I became an adult. Well, I’m here to tell you that adult acne is real. I’ve been there. I turn 52 this month and I still get adult acne breakouts from time to time. It can be extremely frustrating, especially when you’re trying to look your best. 

Some of you may have noticed the occasional adult acne breakout after you turned 25 and that’s because some adults get acne well into their 30s, 40s, and even their 50s. Some people escape the terrible acne breakouts in their high school years just to have their first acne breakout as an adult.¹

The empowering part is that you can stop your adult acne breakouts by naturally balancing the most common reason for adult acne: your hormones. I will tell you how you can balance your hormones naturally so you can stop these annoying adult acne breakouts once and for all.  Before I do that, let’s talk more about what adult acne is and what’s causing it. 

Understanding Adult Acne

Adult acne is any skin blemish that happens after the age of 25. These blemishes can occur anywhere on your skin, however they most commonly occur on your face. Frustratingly enough, women are more likely to have adult acne than men. 

What Causes Adult Acne?

As I mentioned, hormones are the most common cause of adult acne. I’ll talk more in detail about the causes of hormonal acne later. While hormones are a common cause of adult acne, you might be surprised that some of the other causes of acne are the same as when you were a teenager. 

The causes of your adult acne can be excessively oily skin, pores becoming clogged by sticky skin cells, bacteria, or inflammation, just like when you were a teenager. Inflammation can also be a symptom of many conditions such as injury and autoimmune disease. If you are experiencing inflammation of any kind, it’s best to discuss your symptoms with your functional medicine doctor. 

Excessive Skin Oil Production

So how does your skin become excessively oily as an adult? Under each of the pores in your skin is a sebaceous gland that produces a natural oil called sebum.² This waxy-type substance coats, moisturizes, and protects your skin. It’s made up of triglycerides, fatty acids, and cholesterol.³

If your skin feels oily, it may be producing too much sebum. 

This happens for a number of reasons such as being outside in the heat and humidity, exercise, the skin care products you use, bacteria in your skin, and even genetics. However, the most common cause of adult acne is hormonal imbalances as a result of pregnancy, perimenopause or stopping the use of birth control pills. Let’s talk about how hormonal acne differs from adult acne. 

What Is Hormonal Acne And How Is it Different?

Hormonal acne is exactly what the name says: acne directly caused by a fluctuation in your hormones. Adult acne is different because it can have other causes such as stress, bacteria, your skin care products, or genetics. 

It was very common to have hormonal acne during puberty because your body produces much higher levels of androgens such as testosterone along with higher levels of estrogens. Although hormonal acne is commonly associated with puberty, it is estimated that 50% of women between the ages of 20 and 29 have hormonal acne, and 25% of women between 40 to 49 have hormonal acne. 

As an adult, your menstrual cycle, pregnancy, polycystic ovarian syndrome (PCOS), or menopause can cause an imbalance of your hormones and lead to hormonal acne. We’ll discuss more on that in just a moment.  

Physical and mental stress can also cause your hormones to get out of whack, which can also cause hormonal acne.⁴

When your body is faced with stress, it produces more androgens. These hormones stimulate the oil glands in your skin to produce sebum. 

Too much sebum can cause a sebum plug, or dead skin cells that block sebum from reaching the surface of your skin. When this happens, bacteria that normally lives harmlessly on your skin surface begins to grow in your pores and clogs them, which leads to inflammation and a breakout. You know these plugs as blackheads or whiteheads. Washing your skin with a non-toxic exfoliator can remove dead skin cells and prevent sebum plugs.⁵

Now that you understand the difference between hormonal acne and adult acne, let’s talk more about the causes of hormonal acne. 

What Causes Hormonal Acne?

There are three main causes of hormonal acne: menstruation, PCOS, and menopause. Here’s how each causes hormonal acne. 

Menstruation Cycles

There are two primary hormones in play during a woman’s menstrual cycle: estrogen and progesterone. However during ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are produced to trigger the growth and development of eggs in the ovaries. 

Levels of progesterone and estrogen peak at their highest levels during ovulation. When an egg is not fertilized, the uterus sheds its lining. This is what causes bleeding, or “getting your period.” 

As the bleeding ends, FSH and LH peak above their normal levels as your estrogen levels are at their lowest. This leads to a thickening of the uterine lining and maturing of the egg-containing follicles in the ovary. 

When your hormone levels fluctuate toward the end of your period, testosterone levels are high and can also trigger sebaceous gland sensitivity. The result is more sebum and clogged pores.

Your estrogen and progesterone levels drop significantly during menstruation, however your body is still producing normal levels of androgens such as testosterone. These androgens also cause an increase in the production of sebum. In fact, 63% of women that have hormonal acne, have period acne. ⁶

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women, estimated to affect more than 10% of women of reproductive age. As the name suggests, PCOS affects your ovaries, where estrogen and progesterone are produced, and ovulation occurs.

When you have PCOS the ovaries may produce many small cysts or follicles. These can be detected during a pelvic examination through an ultrasound. However, some women who suffer from PCOS do not have cysts and still experience symptoms such as infrequent or heavy periods, which is the most common sign of PCOS. You can do an at-home test for PCOS through LetsGetChecked. It’s the test I have used with my patients.

Whether there are cysts present or not, PCOS causes your hormonal balance to be disrupted. Levels of estrogen and progesterone are lowered while androgen production is higher than normal such as it is when you’re menstruating. Just like during menstruation, the increase in androgens causes an increase in sebum production that can lead to hormonal acne. ⁷

Some of the most common causes of PCOS are insulin resistance, inflammation, and genetics. 

Menopause

Menopause doesn’t happen overnight. The months leading up to menopause are known as perimenopause, a time when changes to your skin put their wheels in motion. I’ve been there and still notice these changes in my own skin as I approach my 52nd birthday. 

You can contribute these changes to estrogen. Estrogen is a superhero for your skin. It not only boosts collagen production, estrogen also keeps your skin hydrated by regulating water throughout your body. 

The duo of estrogen and progesterone increases hyaluronic acid production in the skin. Hyaluronic acid supports water retention and the lubrication of your tissues to give your skin a youthful appearance. 

I mentioned earlier how lower estrogen levels cause your sebaceous gland to produce more oil. At about the age of 55, when you transition from perimenopause to menopause, the ovaries make less estrogen. Just as it does in menstruation, this triggers your sebaceous gland to produce more oil in your skin, which leads to hormonal acne. ⁸

Conventional medicine is quick to prescribe birth control pills, or hormone replacement therapy, to balance hormones. Nearly 14% of the users of birth control pills take them for reasons other than birth control. Let’s talk about why you should not turn to hormone replacement therapy to balance your hormones and solve your adult acne concerns. 

The Problem with Hormone Replacement Therapy (HRT) 

Conventional medicine doctors prescribe birth control pills to help alleviate symptoms of hormone imbalance such as hormonal acne, PMS, painful periods, mood swings, and hot flashes. 

Menstruation sends your hormones on a winding rollercoaster. For many women, this process is relatively brief and painless. For others, however — especially those with autoimmune or thyroid conditions that can affect the delicate hormonal cycle — menstruation can result in painful, prolonged periods, extreme pelvic pain, acne, and mood-related symptoms of PMS and PMDD.

Taking hormone replacement therapy keeps your estrogen and progesterone levels consistently high, preventing your body from sending you on that uncomfortable rollercoaster. Regulating hormone balance can also promote regular, consistent menstrual cycle patterns, improve acne, and even protect women from ovarian and uterine cancer. However, hormone replacement therapy is not harmless. 

The main problem with birth control pills is that instead of natural estrogen, they contain synthetic estrogen, which is actually ethinyl estradiol and norethindrone. This does not provide a natural hormone balance. Instead, these synthetic hormones are not recognized or broken down by the body the same way natural estrogen is. 

Using hormone replacement therapy (HRT) can disrupt your natural hormone balance, since they keep estrogen levels artificially high, which has a ripple effect across your endocrine system. Once you stop taking them, it can cause your adult acne and other symptoms to be worse. These factors can cause a whole myriad of health issues, including an increased risk of cancer, Candida overgrowth, liver toxicity, and an increased risk of heart disease. 

I never recommend HRT or birth control pills to regulate your hormones. Instead, there are several natural ways to balance your hormones naturally.  

Natural Solutions to Hormonal and Adult Acne

Balancing your hormones naturally is a great way to stop adult acne or hormonal acne breakouts. Here are a few ways to balance your hormones naturally. 

Change Your Diet 

One of the first steps you can take to end adult acne breakouts is eating foods that balance your hormones naturally. 

Cruciferous vegetables are rich in fiber, which feeds your good gut bacteria. Research shows that friendly gut flora may play an important part in helping your body process and eliminate excess estrogen so you can avoid estrogen dominance and reduce your risk of hormone-dependent cancers such as breast, ovarian, and endometrial. 

Foods rich in vitamin C, such as cherries, strawberries, and broccoli sprouts, can help maintain a healthy hormone balance. Vitamin C is essential for creating and regulating estrogen and progesterone. 

Keep Your Skin Hydrated

One of the best things you can do to take care of your skin is to hydrate! In general, you should drink between half an ounce and an ounce of water for each pound you weigh every day. For example, if you weigh 120 pounds, you should drink between 60 ounces (7½ cups) and 120 ounces (15 cups) of filtered water each day. 

Choose Non-Toxic Body Products

Your skin is your biggest organ, and what you put on it, you absorb! Many personal care products contain parabens and phthalates, which are chemicals that mimic the activity of synthetic estrogens in your body. Once applied to the skin, they travel through your bloodstream, appearing to the body as estrogen. This incognito approach causes the body to react as if true estrogen is present in excess. 

Consider Supplements

In addition to these lifestyle changes, certain supplements can help reduce symptoms such as hormonal acne and provide some relief naturally while working to regulate hormone balance. 

One of the best ways to support a healthy balance of estrogen and achieve natural hormone balance is EstroProtect. 

EstroProtect is the most comprehensive estrogen balancing formula on the market. When I custom formulated EstroProtect, I set out to choose the most beneficial ingredients available in order to best benefit estrogen metabolism, cellular immunity, testosterone levels, inflammation, aromatase balance, and estrogen detoxification and chelation.

It features calcium-d-glucarate, which binds estrogen that would otherwise be recycled and reabsorbed by your body and flushes it out of your system. EstroProtect also includes N-Acetyl-L-Cysteine (NAC), milk thistle, and Alpha-Lipoic acid to support your liver as it works to safely detoxify and clear excess estrogen.

Hormonal acne may have been a natural part of your teenage years, however adult acne doesn’t have to be a part of your life now. Your hormones play an important role in the health of your skin. Menstruation, PCOS and menopause can cause an imbalance of your hormones. By taking these natural steps and supporting your estrogen levels, adult acne doesn’t have to affect your life.