It can be challenging when your skin condition fluctuates due to hormonal changes that can profoundly affect it at any time in your life. The majority of cases of acne are hormonal acne.
It is still not clear how estrogens contribute to acne. (1) Researchers and specialists agree that females with higher estradiol (estrogen) levels are less likely to develop acne during puberty. (2)
According to a meta-analysis of over a thousand studies, serum estrogen levels were lower in patients with acne vulgaris. This data point to a potential role for estrogen in the pathogenesis of acne, albeit at a more subclinical level. (3)
Read on to know about how high estrogen levels influence acne formation.
What Is the Role of Estrogen?
Both sexes use estrogen during the reproductive process. (4) Estrogens are a class of steroid hormones that include estradiol, estrone, and estriol. (5)
Estrogen, a steroid hormone found in females, is instrumental in the maturation of female sexual characteristics. Hormone replacement therapy (HRT) with estrogen or estradiol is the most common hormone treatment used for menopause symptoms. (6)
Does Elevated Estrogen Cause Acne?
Researchers have hypothesized that estrogen plays a protective role in acne vulgaris. (7) Elevated levels of estrogen do not trigger acne.
Sebaceous gland (sebum) suppression and decreased endogenous androgen (hormone) secretion are thought to be the mechanisms by which elevated estrogen protects against acne. Increased estrogens are required to reduce sebum production. (8)(9)
In many cases, females with acne have low estrogen levels, according to a 2011 review article on the role of hormones in acne published in the journal Clinical Biochemistry. (10)
During puberty, acne is common when women’s menstrual cycles are still developing and estrogen levels are low. When estrogen levels in women drop, often just before their periods start, acne may flare up. There is a correlation between acne and low estrogen levels in women.
When administered in high enough doses, estrogen reduces sebum production. In terms of reducing sebum production, some women will respond to lower doses of estrogen, whereas others will need higher doses.
High estrogen states, such as pregnancy, can exacerbate acne for some women, yet estrogen receptors’ expression in the sebaceous gland is poorly understood. (1)
The gonadal axis is negatively affected by high doses of estrogen. Sebaceous gland size and sebum production both decrease as a result. (11) Therefore, experts and researchers conclude that high estrogen levels reduce sebum and protect against acne but that increased estrogen levels themselves can cause acne, but only very rarely.
Relationship Between Estrogen and Androgen Levels and Acne
Acne severity correlates independently with the androgen-to-estrogen ratio, suggesting an elevated androgen ratio is associated with more severe acne. According to researchers, an imbalance in the transition of androgens to estrogens has been suggested as a critical process in the emergence of acne (8)
Acne severity increased with an increase in the androgen-to-estrogen ratio, which was found to be an independent risk factor for acne. As a result, the androgen-to-estrogen balance may serve as a valuable indicator of acne severity. (8)
Postmenopausal hyperandrogenism is characterized by increased androgen levels and decreased estrogen levels. This hormonal imbalance can trigger an acne outbreak. (12)
Estrogen suppresses sebum production when given in sufficient amounts. (8)(13)
According to a scientific theory, the mechanism relating to high levels of estrogen during acne is, when there is mild and moderate acne, there are increased estrogen levels to balance out the effect of high androgen levels by negative feedback mechanism and to decrease the excess sebum production.
However, when estrogen that isn’t correctly metabolized because your liver is overworked processing other toxins is recirculated back into your system, an imbalance in the androgen and estrogen ratio occurs. This imbalance between the androgen and estrogen ratio causes inflammation and acne in the skin, not elevated estrogen levels. (8)(13)
Symptoms of High Estrogen Levels
Some of the signs of excessive estrogen are heavy menstruation, irritability, mood swings, headaches, insomnia, breast cysts, endometriosis, fibroids, gallstones, and thyroid disorders. (6)
Tips for Acne Caused by Hormones
Always keep your face clean. Two daily washes with a mild cleanser will keep your pores clear of oil and dead skin.
Moisturize your skin. Moisturizers are an essential part of any skin care routine. Flare-ups and irritation are possible with dry skin. In addition, using a moisturizer is necessary if you are employing acne treatments that can dry out your skin.
Use products that won’t clog your pores. Fluctuations in hormone levels can cause acne, and using products that clog pores won’t help. Acne can be prevented using noncomedogenic cosmetics, skin care products, and hair care products.
Incorporate organic foods into a healthy diet plan. The hormone-balancing effects of a diet high in phytoestrogens have been hypothesized.
Lessen your toxic burden and try detox aids. Ensure adequate physical activity. Regular exercise is a great way to control your weight and stress levels.
When to See a Dermatologist
Acne should prompt a trip to the doctor if it is severe, persistent, painful, or itchy.
It’s also a good idea to consult a dermatologist before attempting any at-home remedies or OTC creams. Acne treatments are best determined after a thorough medical examination has been performed.
Contact your doctor immediately if you experience any adverse reactions, including a worsening of acne.
Is it possible to control my estrogen levels through diet, and if so, what foods work best?
Plant compounds called phytoestrogens play a role in maintaining a healthy estrogen level. Phytoestrogens have either estrogenic or anti-estrogenic effects, so they can help maintain a healthy estrogen balance.
Fruits (plums, pears, apples, grapes, berries), vegetables (beans, sprouts, cabbage, spinach, soybeans, (14) grains, hops, garlic, onions ), wine, tea, and a variety of botanical dietary supplements have all been found to contain phytoestrogens.
Isoflavones, primarily in soy; lignans, mostly found in grains; and stilbenes, mostly in grape skin, are all examples of these compounds. (15) Diet plays a role in maintaining a healthy estrogen balance.
Will estrogen supplements normalize my estrogen levels and reduce acne?
Estrogen (16) levels can be maintained with a daily dose of 0.5–1 g of resveratrol supplements. In addition, resveratrol, an antioxidant in grapes and red wine, could clear up nasty breakouts.
Hormones, particularly estrogen, play essential roles in the functioning of the human body for both sexes. Although estrogen is typically associated with females, men also produce a small amount of the hormone.
Estrogen suppresses the sebaceous glands that produce sebum, which contributes to acne at high levels. Thus, estrogen protects against adolescent acne.
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- Wei B, Qu L, Zhu H, et al. Higher 17α-hydroxyprogesterone levels aggravated the severity of male adolescent acne in Northeast China. Dermatology. https://www.karger.com/Article/Abstract/365656. Published November 19, 2014.
- Rao A, Douglas SC, Hall JM. Endocrine disrupting chemicals, hormone receptors, and acne vulgaris: A connecting hypothesis. MDPI. https://www.mdpi.com/2073-4409/10/6/1439. Published June 9, 2021.
- Hamilton KJ, Hewitt SC, Arao Y, Korach KS. Estrogen Hormone Biology. Current topics in developmental biology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206851/. Published 2017.
- The Embryo Project Encyclopedia. Estrogen and the Menstrual Cycle in Humans | The Embryo Project Encyclopedia. https://embryo.asu.edu/pages/estrogen-and-menstrual-cycle-humans.
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- Gayen R, Podder I, Chakraborty I, Chowdhury SN. Sex hormones, metabolic status, and obesity in female patients with acne vulgaris along with clinical correlation: An observational cross-sectional study. Indian journal of dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061487/. Published 2021.
- Zhang R, Zhou L, Lv M, et al. The relevant of sex hormone levels and acne grades in patients with acne vulgaris: A cross-sectional study in Beijing. Clinical, cosmetic and investigational dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587737/. Published October 18, 2022.
- Ianoşi S, Ianoşi G, Neagoe D, et al. Age-dependent endocrine disorders involved in the pathogenesis of refractory acne in women. Molecular Medicine Reports. https://www.spandidos-publications.com/10.3892/mmr.2016.5924. Published December 1, 2016.
- Author links open overlay panelMegha Kataria Arora, AbstractObjectiveTo elucidate the role of endogenous hormones like testosterone, Grange PA, et al. Role of hormones in acne vulgaris. Clinical Biochemistry. https://www.sciencedirect.com/science/article/abs/pii/S0009912011013932. Published July 6, 2011.
- Elsaie ML. Hormonal treatment of acne vulgaris: An update. Clinical, cosmetic and investigational dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015761/. Published September 2, 2016.
- Khunger N, Mehrotra K. Menopausal acne – challenges and solutions. International journal of women’s health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825478/. Published October 29, 2019.
- (PDF) a study of hormonal profile (luteinizing hormone … – researchgate. https://www.researchgate.net/publication/325985229/.
- Desmawati D, Sulastri D. Phytoestrogens and their health effect. Open access Macedonian journal of medical sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390141/. Published February 14, 2019.
- Bacciottini L, Falchetti A, Pampaloni B, Bartolini E, Carossino AM, Brandi ML. Phytoestrogens: Food or drug? Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781234/. Published May 2007.
- RJ; Q. The estrogenic activity of resveratrol: A comprehensive review of in vitro and in vivo evidence and the potential for endocrine disruption. Critical reviews in toxicology. https://pubmed.ncbi.nlm.nih.gov/32744480/.