Androgens (Male Hormones) and Female Acne

What an unpleasant surprise! You're an adult woman in your 20s or 30s, who has never suffered through an acne breakout and suddenly, out of the blue, you begin to see pimples. Or, you've finally been able to clear up your skin, and, as an adult, you're developing blemishes that seem to pop up overnight.

The acne usually is not severe but all those treatments you relied on as a teenager no longer seem to work. Some sort of hormonal change is probably responsible. The required treatment isn't the sort of thing you can just pick up at your local drugstore. Medical treatment by a dermatologist, after an appropriate examination, is needed to determine any hormonal causes of acne.

If you're an adult female, and one or all of these are true, raise your hand:

you've never had serious acne pimples until after you became an adult, or your adolescent acne had cleared up and now has reappeared in adulthood,

traditional acne treatments don't help clear your breakouts,

during pregnancy or your period, your acne gets worse, or

you're experiencing acne breakouts along with what feels like "masculine" hair growth or hair loss the skin in your armpits or body folds has darkened, or your mid-section has thickened.

Male hormones, called androgens, exert the strongest influence on acne. What you should know is that both males and females produce these hormones, although the quantity is much higher in males. How do androgens cause acne? They stimulate sebaceous follicles, the openings in the skin where hair grows. Blackheads, whiteheads and other breakouts begin in these follicles. Healthy adult women experience several types of hormonal acne:

The menstrual cycle causes acne to come and go, along with the hormonal changes associated with the monthly cycle.

Pregnancy brings about acne "flares" as the hormonal balances of the body shift according to the woman's changing physiology.

Chronic stresses on the emotions and/or the body can cause breakouts. Stress can produce body changes that create hormonal imbalances.

Underlying abnormalities caused by other medical conditions can influence androgen levels, and create acne in adult women. These conditions may include:

Irregular or skipped periods,

Male pattern facial hair

Female pattern baldness

Noticeable deepening of the voice, or darkening skin in the armpits or body folds.

Hyperandrogenism (excessive production of androgens) can be a contributing factor to the development of acne in any woman. If female adult acne is severe, sudden in onset, or accompanied by atypical hair growth/loss or irregular menstrual periods—excessive androgen production is usually responsible. A medical exam should determine whether a female with acne also suffers from diseases of the adrenal glands, abnormalities of the ovaries or pituitary gland, or diabetes. Treatment options include oral contraceptives, anti-inflammatory drugs and/or antiandrogens.

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