What to do in case of hormonal acne?

Even though hormonal acne is the result of the action of male sex hormones (androgens), it more specifically refers to adult female acne. While after puberty, hormone levels stabilise in men, they still fluctuate in women. Indeed, although this skin issue affects up to 40% of adults from the age of 25, 75 to 80% of women between 25 and 40 years old are particularly prone to this type of acne.

It is characterised by the appearance of various types of spots on the face at specific times, particularly during the menstrual cycle (before or during menstruation), during pregnancy, sometimes at menopause or even during periods of stress. This term is thus less commonly used in men, as they do not undergo numerous hormonal changes throughout their lives.

How can I tell if I have hormonal acne?

You may be suffering from hormonal type acne:

• If spots are concentrated on the lower area of the face, around the jawline, chin and neck;

• If you are experiencing skin imperfections such as red spots (papules), white spots (pustules), nodules or painful micro-cysts , caused by skin inflammation.

• If outbreaks of spots occur cyclically or following a known hormonal disturbance, that is, skin eruptions trigger or intensify during the premenstrual phase and menstruation, unlike juvenile acne which disappears once puberty is over. It can also occur during specific events, such as pregnancy, menopause or when stopping contraceptive pills.

Why do I have hormonal acne?

Acne flare-ups can be linked to several factors, including hormonal fluctuations. Indeed, changes in the production of certain hormones stimulate the sebaceous glands to produce an excess amount of sebum (seborrhoea). This skin imbalance creates an ideal environment for the growth of Propionibacterium acnes, which causes inflammation of the pilosebaceous follicle and the surrounding dermis.

An excess of androgen hormones circulating in the blood, male sex hormones of which the main ones are testosterone and dihydrotestosterone (DHT), plays a significant role in the onset of hormonal acne. Indeed, these are the primary hormones that control the activity of the sebaceous glands across the entire skin surface. In women, androgens are secreted in small doses physiologically. However, in certain situations, the production of androgen is excessive:

• Stopping the contraceptive pill: Some categories of oral contraceptives are sometimes used to improve acne, as they help to reduce acne flare-ups. This includes oestrogen-progestogen (or combined pills) which block ovulation by substituting the hormones naturally produced by the body. In the absence of ovulation, the production of androgen hormones decreases, in addition to counterbalancing the acne-boosting effect of progesterone. With the cessation of the pill, the secretion of testosterone in the body resumes on a large scale, accompanied by a surge of hormonal acne a few weeks to a few months after stopping contraception.

  Note : Other progestin-type contraceptives can, on the other hand, increase testosterone levels and consequently promote acne.

• Menstrual Cycle: If there is a time when skin eruptions are particularly intense, it is just before the onset of menstruation or even during it, a time when the levels of oestrogen and progesterone are at their lowest while testosterone, although in small amounts, reaches a level higher than the feminising hormones. Indeed, oestrogen is known to prevent the production of sebum when produced in sufficient doses, by directly opposing testosterone or inhibiting its secretion. Present in small quantities, oestrogen and progesterone cannot exert their "anti-sebum" effect.

• Pregnancy: Pregnancy is another time when women experience a real hormonal upheaval. Indeed, the levels of oestrogen and progesterone increase significantly. These can lead to hyperactivity of the sebaceous glands and therefore an overproduction of sebum. It is especially during the first trimester that women are more prone to developing hormonal acne.

• Menopause: This physiological phenomenon is characterised by a significant hormonal upheaval. It occurs following a gradual and drastic decline in the synthesis of the two reproductive hormones: oestrogen and progesterone, as the ovaries cease to produce them. Conversely, during menopause, the level of testosterone tends to increase and takes precedence over the female hormones. However, this rise in male hormones is the cause of acne development in some individuals.

• Period of stress: Stress plays a fundamental role in the balance of hormones, and therefore in the amplification and frequency of acne outbreaks. Indeed, during periods of stress, cortisol is secreted in large quantities. This hormone impacts the skin by stimulating the adrenal glands, which are responsible for the production of androgen hormones. These hormones, in turn, regulate the production of sebum by the sebaceous glands.

Hormonal acne can also result from a genetic predisposition. Indeed, the number, size and activity of the sebaceous glands can be inherited. While the number of sebaceous glands remains stable throughout life, their size increases with age. A hypersensitivity of the sebaceous glands can also be a cause.

If you initially have severe acne, it is advisable to consult a dermatologist to get a professional opinion who can assist you with medications that complement cosmetics. In all cases, skin hygiene must be adapted to acne-prone skin with the use of non-comedogenic cosmetic products. Long-term care will help you minimise all the troublesome elements in hormonal acne. If you have mild acne, cosmetics will help reduce it. Therefore, incorporate care containing the following ingredients into your daily skincare routine:

• Thesalicylic acid is an organic compound from the BHA family, frequently used to limit the proliferation of bacteria on the skin's surface involved in the appearance of spots. This family of acids is also particularly recommended to decrease the cohesion between epidermal cells to promote the elimination of dead cells from the horny layer that clog the pores (exfoliating effect). Unlike AHA and PHA, BHAs are soluble in fat, which promotes their deep penetration into the pores to facilitate the evacuation of comedones and spots.

• Thegreen clay, extracted from sedimentary rocks, is rich in mineral salts and trace elements (calcium, magnesium, potassium, silica...), each of which contributes to skin health. Thanks to its "lamellar" or layered structure, it has excellent absorbent properties: it helps to regulate sebum secretion. Thus, green clay reduces imperfections by drying out spots, prevents their occurrence and mattifies the skin. Moreover, it helps to tighten the skin's pores, has a healing action to prevent marks related to acne and soothes skin inflammation.

• The bakuchiol, a plant-derived chemical compound, is valued for its anti-inflammatory and antibacterial properties. Indeed, studies have shown that bakuchiol has a strong inhibitory activity against an enzyme that contributes to the formation of inflammation mediating hormones, in addition to exhibiting excellent inhibitory activity against P. acnes. This active ingredient also acts on sebum secretion by reducing the activity of an enzyme that converts testosterone into DHT. This latter binds to the androgen receptors of the sebaceous glands and causes an abnormal secretion of sebum. Finally, its soothing virtues also make it an interesting ingredient for acne-prone skin.

• The activated charcoal, highly concentrated in pure carbon, possesses a powerful absorption capacity due to its porous material that captures pollutants, excess sebum, bacteria and other impurities on the skin's surface, which are responsible for skin shine and the appearance of spots, thus facilitating their elimination. It deeply cleanses the pores, thereby combating pore blockage and the development of bacteria caused by sebum production.

• Niacinamide is a comprehensive anti-blemish active ingredient, which works both before the formation of spots, and afterwards to reduce any potential marks and scars. Upstream, this vitamin regulates the sebum level on the skin's surface, thus preventing the pore blockages that lead to the appearance of comedones and spots. Moreover, it performs an effective anti-bacterial function against the microorganisms responsible for the inflammatory reactions of acne such as P. acnes. Downstream, its soothing virtues help to decrease inflammation and thus reduce the redness associated with blemishes.

• The term 'retinoids' encompasses vitamin A, its metabolites, as well as its natural and synthetic derivatives such as retinol, retinoid esters (retinyl acetate, retinyl propionate...) or retinal. Their beneficial effect on acne is attributed to their desquamating action and the increase in cellular renewal of the epidermis, which prevents the formation of spots. They promote the elimination of spots, and also help to reduce the activity of the sebaceous glands, contrary to the production of sebum, and to reduce their size.

• The zinc is a formidable ally in combating skin problems. This trace element reduces sebum secretion. When paired with PCA, it promotes the strengthening of the skin's barrier function. It also targets the microorganisms responsible for the formation of spots and inflammatory reactions. Zinc also helps to clear the pores of impurities and soothe irritations.

What skincare routine should be adopted in the case of hormonal acne?

1. Morning and evening, cleanse your skin with a gentle cleanser suitable for blemish-prone skin to remove excess sebum, bacteria, dust or pollutants accumulated throughout the day, whilst protecting the hydrolipidic film. The skin will then be in better conditions to heal properly.

   For instance, you might choose the exfoliating cleansing gel concentrated in gluconolactone (PHA), which additionally micro-exfoliates the epidermis to smooth the skin texture and deeply unclog the pores. The cleansing gel also contains aloe vera and inulin with hydrating, soothing, and repairing properties to calm inflamed skin and rebalance the disrupted skin microbiota.

2. Boost the action of the cleansing gel and conclude your makeup removal routine with a toner rich in purifying and antibacterial active ingredients such as the 1% salicylic acid toner for a balanced skin and strengthened natural defences. This alcohol-free liquid moisturiser targets the outer layer of the skin, particularly by tightening enlarged pores, reducing excess sebum and minimising the development of microorganisms. The purifying toner is also enriched with centifolia rose hydrosol, a perfect complement to salicylic acid, due to its soothing properties. Zinc is also present in the formula.

3. Incorporate into your beauty routine a rebalancing anti-blemish treatment to prevent and protect the skin from the appearance of blemishes. Concentrated at 1% of bakuchiol, our serum helps to neutralise unsightly spots and the effect of oily skin. Antibacterial and anti-inflammatory, this active ingredient helps to limit blemishes sustainably and deeply, to rebalance sebum and to limit the production of pro-inflammatory molecules.

   This water-free formulated care for optimal effectiveness also consists ofhazelnut oil, known for regulating sebum production and rebalancing the hydrolipidic film due to its natural composition rich in vitamin E, omega-6 and oleic acid. It easily penetrates the skin to act on the hydrolipidic film and the epidermis, while leaving a protective film on the surface.

   Note : A range of 4 periodic serums has been developed at Typology to meet the needs of your skin for each week of your menstrual cycle.

4. Hydrate your skin with a purifying face cream specifically designed to meet the needs of acne-prone skin. Indeed, the active ingredients in this non-comedogenic cream (zinc PCA, bamboo extract) will moisturise the epidermis, while promoting a reduction in the number of blemishes, regulating sebum secretion, reducing skin shine by absorbing excess sebum, and alleviating inflammation;

5. In the evening, use a salicylic acid spot treatment to speed up the healing of acne lesions, halt bacterial proliferation, soothe inflammation, and prevent acne scars. It should be applied directly to each spot, before the moisturising cream;

6. Once a week, perform a purifying face mask made from purifying green clay, mattifying pine charcoal, andstinging nettle which regulates sebum. It will deeply cleanse the skin of impurities, without leaving any signs of skin dehydration thanks to its creamy texture;

7. During the day, do not forget to apply a sunscreen to prevent the appearance of post-inflammatory hyperpigmentation brown spots and moreover, contrary to popular belief, the sun promotes pimples in the long term. Additionally, some acne treatments are not compatible with sun exposure.

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