“Hormonal acne” isn’t a particular type of acne—it’s just plain old acne. Some refer to the skin condition as “hormonal” because it is caused by hormonal changes manifested in your skin.
Although acne often occurs during puberty, some adults experience it as well: as occasional break-outs, monthly explosions, or chronic patches. Severe acne can affect self-image and self-esteem, which have negative psychological consequences.
What Causes Acne
Acne—not an occasional pimple or bump—occurs when the level of androgens (male sex hormones) increases, causing glands in the skin to secrete extra oil (sebum) around hair follicles. This results in clogged pores. Dead skin cells that would normally rise to the surface of the skin to be washed away accumulate under the plugged pores (1).
Once the hair follicles are stopped up, bacteria can accumulate; the immune system responds to the bacteria and areas around the follicles become inflamed. Not all forms of acne cause inflammation.
There are five types of acne lesions that can form:
- Comedones – plugs that form at the base of hairs in the follicles; they can be open or closed and are non-inflammatory. Whiteheads and blackheads are comedones.
- Cysts – an infection that occurs under the surface of the skin. These contain pus and appear as bumps on the skin. Cysts don’t come to a head like pimples. They can be sore and linger for a long time.
- Nodules – similar to cysts in that they appear as sore bumps under the skin, different in that they don’t contain pus
- Papules – swollen, raised, red bumps (with no head) on the skin
- Pustules – papules filled with pus; the heads appear white or yellow
Other causes of acne include:
- Medications – corticosteroids, and drugs containing androgens, lithium, or tuberculosis drugs (2)
- Diet – dairy, wheat, and refined sugar
- Household cleaners
- Personal care products
- Internal inflammation