The True Cause of Hormonal Acne

What if your hormones aren’t actually the whole problem?

Hormonal acne is often (almost always!) soooo much more than just your hormones being a little out of whack.

To really heal your skin, we want to consider how your body is making, processing and eliminating your hormones but also the other whole body factors (like gut and stress) that may be impacting your skin health.

Clear skin requires a full body approach - let’s break it down!

So what actually causes hormonal acne?

Acne develops when several processes in the body overlap: increased oil production, changes to the skin cells, inflammation…

And whilst hormones can definitely influence all of these processes, it’s not necessarily about having too much of a particular hormone.

It can be abouthow sensitive your skin is to those hormones, how they are being metabolised, and what else is happening in the body at the same time.

So before jumping straight onto a random ‘hormone balancing’ supplement, here are some of the key factors to consider if you really want to heal your skin…

1. Hormonal influence - Androgens

Androgens are often associated with acne because they can increase sebum (oil) production and contribute to blocked pores. This androgen driven picture is particularly relevant when acne appears around the jaw, chin, lower face and neck.

But here’s the tricky part: you don't necessarily need to have elevated testosterone on a blood test to experience androgen-driven acne. 

In some cases, when we do a full androgen profile via a blood test, we can find markers that suggest your body is more sensitive to normal androgen levels, which can mimic ‘high androgen’ effects. This is why looking at the whole hormonal picture can be more useful than simply asking, ‘Is my testosterone high?’

Also that being said, there is a huge discrepancy between ‘fine/normal’ bloods and ‘optimal’ blood test results. Together we we will look though your bloods to make sure everything is sitting optimally for you, which will help guide targeted treatment instead of guesswork. 

2. Blood sugar and insulin

Your blood sugar regulation is another piece of the puzzle that is often overlooked.

Frequent blood sugar spikes can increase insulin and, in some people, contribute to higher androgen activity and increased sebum production.

This is one reason why acne can sometimes be worse with a diet that is high in refined carbohydrates, sugary foods or highly processed foods, particularly when meals are irregular and protein and fibre intake are low.

The goal here is to improve blood sugar stability by pairing carbohydrates with protein, fibre and healthy fats and choosing predominantly minimally processed carbohydrate sources.

3. Your gut health 

Your skin might be reflecting that something is off with your gut - this connection is called the gut-skin axis. 

Disruptions to the gut microbiome like bacterial overgrowths and/or compromised digestion, changes how your gut interacts with your immune system and influences inflammation.

Your gut is also involved in the processing and elimination of oestrogen through a collection of microbial enzymes called the estrobolome.

Also! If your gut function is impacted, so too is your nutrient absorption and we need optimal nutrient status to keep your skin looking & feeling fab.  

So gut health is one part of the wider hormonal and inflammatory picture worth considering, particularly if acne occurs alongside bloating, constipation, diarrhoea or other digestive symptoms.

4. Hormonal clearance and the liver’s role 

It’s not just about making enough or too much of certain hormones - it matters how our body clears them too.

Your liver is one of the major organs involved in hormone metabolism. After hormones have done their job, your body needs to break them down in the liver and eliminate them through the bowels.

If you're constipated, not eating enough fibre, or have an unhealthy gut microbiome, hormones may not be cleared as efficiently.

Rather than focusing only on ‘balancing hormones,’ it's equally important to support the body's natural ability to metabolise and eliminate them.

5. Stress can show up on your skin

Stress is another major piece of the puzzle.

When you're under chronic stress, your body produces more cortisol, which can:

• increase oil production

• drive inflammation

• slow skin/wound healing

• influence blood sugar regulation...

All of which can contribute to acne!

If your breakouts worsen during busy or emotionally demanding periods, your stress response may be playing a bigger role than you think.

So what can you actually do?

Rather than immediately reaching for a supplement labelled ‘hormone balancing’, start with the foundations.

• Eat regularly: Avoid consistently skipping meals and aim to include protein, fibre and healthy fats throughout the day.

• Prioritise protein: Protein provides amino acids needed for hormone metabolism, liver function, skin repair and blood sugar regulation.

• Support blood sugar: Pair carbohydrates with protein, fats and fibre rather than eating carbohydrates alone.

• Look after your gut: Aim for a diverse, fibre-rich diet and regular bowel movements. If you have ongoing digestive symptoms, this may be worth investigating further.

• Don't underestimate stress: Sleep, movement, rest and nervous system regulation are not extras when it comes to keeping everything in the body thriving 

• Look beyond the skin: If acne is persistent, painful, cystic or accompanied by irregular periods, excess facial/body hair, hair loss or other hormonal symptoms, it may be worth investigating things in more depth with an appropriately timed blood test.

Your acne is giving you information

As I always talk about with clients, symptoms are never random - they’re signs from the body that something is off. 

Acne isn’t something that you have to put up with, or hope that a new skincare routine alone will fix. Your skin is a reflection of what's happening underneath! Long term skin health comes from digging deeper. 

So if you're experiencing persistent hormonal acne and want to understand what's driving it rather than band-aiding the symptoms, this is something we can explore together.

Book in a FREE discovery call  to find out how we can get your skin feeling fab, or dive into an initial consultation.

Much love, 

Ash x