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What Is the Connection between Estrogen and Acne?

M. Walker
M. Walker

The relationship between estrogen and acne is somewhat complex because hormone fluctuations in the normal female menstrual cycle can cause acne at different times. Low levels of estrogen and proportionally higher levels of androgen hormones generally cause estrogen-related cystic acne. Hormone imbalances that decrease estrogen levels or raise androgen levels will increase the likelihood of acne formation because they increase the amount of oil produced by the sebaceous glands under the skin’s surface. Birth control pills can alleviate some severe acne, as they carefully maintain the estrogen and androgen levels in the bloodstream.

Androgens are the primary hormone-related cause of acne in many women. These hormones are what stimulate the sebaceous glands to produce an oily substance known as sebum. Too much of this substance can often become stuck in the pores, providing a breeding ground for common skin bacteria that multiply under the skin’s surface. Once the bacteria have multiplied, they can often cause inflammation, which leads to cystic acne. Estrogen is able to cancel out or mask the androgens’ effects on the body.

Lowered estrogen levels during the female's monthly cycle can cause acne.
Lowered estrogen levels during the female's monthly cycle can cause acne.

High levels of estrogen and acne occur at opposite times in a typical menstrual cycle. During the first half of the cycle, before ovulation occurs, estrogen levels gradually rise. Not only does this reduce the effects of the androgens in the body, but it also reduces the occurrence of acne. The body reaches its estrogen peak right before ovulation, after which the estrogen levels gradually taper off. Acne usually increases after ovulation in the time known as the luteal phase, and it becomes the worst just before menstruation.

Birth control pills carefully maintain estrogen and androgen levels, and may alleviate acne.
Birth control pills carefully maintain estrogen and androgen levels, and may alleviate acne.

During the luteal phase of the cycle, progesterone, a hormone that possesses both estrogen-like and androgen-like properties, gradually rises. Progesterone fluctuations can increase bloating and fluid levels, which in turn squeeze the pores on the face. This reduction in pore size often worsens the symptoms of acne because it further limits the body’s ability to clear away the excess oil.

Estrogen levels can vary greatly during the course of the typical menstrual cycle.
Estrogen levels can vary greatly during the course of the typical menstrual cycle.

Birth control pills provide carefully controlled estrogen and progesterone levels in the bloodstream. By keeping the estrogen levels consistent throughout the month, the pills are able to reduce the androgen effects during the luteal phase in addition to reducing general hormone fluctuations. This ultimately leads to a reduction in acne for many women, especially those who experienced severe hormone imbalances before beginning treatment.

Discussion Comments

StarJo

My mother experienced menopausal acne, and it shocked her. She hadn't had a pimple in years, and to suddenly see a couple pop up at that stage of life really floored her.

She knew that her estrogen levels were decreasing, and this was going to cause a lot of undesirable things to happen to her body. She went to her doctor for hormone replacement therapy.

This put a stop to the zits. It also made her skin retain its femininity, and I know that was very important to her. She always did have a horror of aging, and I knew that she would do anything to put it off as long as possible.

giddion

I didn't know that acne and hormones were connected! This makes me feel less like my breakouts are my fault.

I take good care of my skin, but the week before my period, I generally go on a greasy foods binge. I start craving pizza and chocolate, and not long afterward, I break out.

I had always assumed that my eating habits were causing my acne. Now, I can see that I probably would break out no matter what I choose to eat.

OeKc05

@JackWhack – My teenage daughter is taking the pill for her severe acne, and it is working wonders. Some parents would be hesitant to put their young daughters on the pill for this, but I don't see any problem with it.

They think that it will encourage their daughters to have sex. I think it just makes my daughter grateful to have a clear complexion. I don't believe that she is sexually active, but if she becomes active, at least she is less likely to get pregnant, so that's a bonus!

I had adult acne before I started taking the pill. I would get huge red pimples along my jawline and chin before my period would start every month. After I started the pill, this monthly acne ended, and my skin started looking so much better.

JackWhack

I started getting bad breakouts in my twenties. My friends told me that I had hormonal acne and that it would stop if I started taking a birth control pill.

I thought it strange to use the pill just for this purpose. I remember that two of my friends in high school started using the pill to help their acne clear up, and I always wondered if that really was the reason. I suppose they did have to get their parents' permission, though, so it might have been legitimate.

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    • Lowered estrogen levels during the female's monthly cycle can cause acne.
      By: Ocskay Bence
      Lowered estrogen levels during the female's monthly cycle can cause acne.
    • Birth control pills carefully maintain estrogen and androgen levels, and may alleviate acne.
      By: Jacob Kearns
      Birth control pills carefully maintain estrogen and androgen levels, and may alleviate acne.
    • Estrogen levels can vary greatly during the course of the typical menstrual cycle.
      By: designua
      Estrogen levels can vary greatly during the course of the typical menstrual cycle.
    • Correcting hormonal imbalances, paired with a regular skin care routine, may help to prevent breakouts.
      By: ipag
      Correcting hormonal imbalances, paired with a regular skin care routine, may help to prevent breakouts.
    • Some women choose to increase their estrogen levels so as to enhance their sex drive.
      By: Photographee.eu
      Some women choose to increase their estrogen levels so as to enhance their sex drive.