Maybe you’re like me and you’ve had acne as long as you can remember. I was the first girl in my class (5th grade!) to go through puberty. This also meant I was the first to get acne. I experienced crazy, face-covering, deep and painful cystic acne from that time through most of my young adult life. I saw some reprieve after 2 courses of Accutane, but the acne kept coming back.
Years later when I was diagnosed with PCOS after discontinuing the birth control pill, my acne flared up again and put me right back to those days. The embarrassment, the judgment, the insecurity. All while I was back in school for holistic nutrition. I tried covering it with my makeup and hair and scarves, but I knew it was on display and people were looking. I didn’t feel sexy in front of my partner and wanted to shy away instead.
Once I was on track to reversing many of my PCOS symptoms, my acne began to disappear. Now I almost never get cystic or deep acne, and if I do breakout, it’s on the surface and goes away very quickly. I’m no longer afraid to look at my skin in the mirror, and feel comfortable going out in public without makeup.
I want this for you too, so I’m outlining 5 natural ways to get rid of hormonal acne breakouts below (and what might be causing them!).
What’s Causing My Hormonal Acne Breakouts?
Truthfully, there are many causes, but as a woman with PCOS, I’m going to stick with the one most relevant to this condition: androgen excess.
Androgens are a class of hormones. To break it down even more, hormones are simply substances that are created in specific glands (like your ovaries) which have very specific functions in the body, including regulating many processes.
Androgens are a class of hormones often thought of as “male hormones” because men experience higher levels of these hormones as a regular function. Androgens are necessary in us women too, and I’ll explain why in a minute.
They are produced in the ovaries, adrenal glands and fat cells for the most part, but may also be created right at the active tissue site (hair follicles, for example). In women, androgens, like testosterone will:
- Be converted into other hormones like estrogen
- Prevent bone loss
- Increase libido and sexual satisfaction
- Regulate other functions including menstrual cycles/reproduction, liver, kidney and muscle health
- Help create lean muscle mass
How Do Androgens Contribute To Acne?
First, one of testosterone’s jobs is to increase sebum (oil) production on the skin. If your androgens are going crazy, chances are you’re super oily, regardless of how many times you wash your face, and you’re breaking out.
Second, testosterone has some really awesome benefits, as you can see from the list above, but it can go rogue. Specifically at the tissue site (IE your skin or even hair follicles in the case of hair loss/facial hair), testosterone and other androgens can be converted into a “bad” form of testosterone know as DHT or dihydrotestosterone. This DHT is much of what’s responsible for hormonal acne breakouts.
The enzyme responsible for the conversion of testosterone to DHT is known as 5-alpha reductase, and some androgen-blocking medications aim to reduce levels of this enzyme. When you have chronically high levels of androgens like testosterone, they float around in your blood. Couple this with high levels of the pituitary hormone Luteinizing Hormone (LH), and testosterone production is put into overdrive. A woman’s body doesn’t need so much testosterone like men do, so when there’s excess floating in the blood stream, it will end up binding to androgen-receptors in the skin cells so that your body can get rid of it- through acne lesions on the skin.
If you are a woman with diagnosed or suspected PCOS, this is especially true for you. Women with PCOS often have chronically high levels of LH, which will increase production of testosterone, increasing the likelihood of the extra androgens binding to receptors in the skin cells and creating more acne.
Lastly, insulin plays a role here as well. If your levels of the blood sugar-balancing hormone insulin are too high (from poor diet, stress, etc), this will stimulate your ovaries (and potentially your adrenals) to produce even more testosterone, promoting this vicious cycle. Balancing insulin and reducing stress are key to reducing androgens in women.
Beyond hormonal acne breakouts, there are numerous symptoms of high androgens, so check out my Hormone Imbalance Quiz to see if this is possibly an issue for you.
5 Natural Ways to Get Rid of Hormonal Acne Breakouts
Seeing as we’re talking about androgens as a leading cause for acne breakouts in adult women, it makes sense to talk about how to reduce them to possibly reduce your acne. There is a lot involved in reducing androgens, and luckily there are some simple steps you can take to do this yourself- no crazy meds required!
The first step to reducing androgens in women is to balance your blood sugar. If you’re not sure what this is or what it means, check out this post.
The main components of a blood sugar-balancing diet (and should be included with all meals and snacks) are:
- Protein: 20-30g per meal and 5-10g per snack
- Fat: 1-3 tbsp added fat per meal and 1 tbsp per snack
- Fibre: 35-45g daily total, going for the lower end of the spectrum if you are trying to get pregnant or don’t ovulate regularly.
There are also some herbs and supplements shown helpful in reducing androgens such as:
Improve Liver Function
Your liver is an important organ for hormonal health, for many reasons. One of the big reasons is that the liver metabolizes and detoxifies hormones. For example, estrogen and testosterone. If your liver isn’t functioning optimally or is sluggish, it’s more likely your blood sugar will be out of balance, your digestion will suffer and you’ll have extra hormones floating around that your body couldn’t get rid of. These extra hormones could be detrimental to health over time, and excess testosterone often ends up creating more acne as it binds to those androgen-receptors in your skin cells.
An easy way to improve your liver function beyond having a veggie-heavy, anti-inflammatory diet is to gently support detoxification with medicinal herbs. You can often find formulas specific to liver health in capsule or tincture form at the local health food store. Liver rejuvenation takes time, so it’s important to be consistent with your chosen way of gentle cleansing for 2-3 months or menstrual cycles for maximum benefit. Look out for some of these herbs when choosing a formula:
- Dandelion root
- Burdock root
- Yellow dock
- Milk thistle
Support Healthy Digestion
If your gut health sucks, so will your skin. Coming back to toxins, if a lot of toxins and inflammatory compounds are getting through your gut lining (a healthy gut doesn’t allow this to happen), your body will have extra inflammation. It will also have extra toxins that need to be dealt with. If you’re eating foods your body is especially sensitive too, the reaction is even stronger. You may not even experience gut problems like gas, bloating, constipation or indigestion if your gut needs help- so don’t discount this extremely crucial step in balancing your skin.
Low stomach acid and low levels of digestive enzymes contribute to this, and supporting your body to create optimal amounts of these is incredibly helpful for your skin.
The easiest way I know to help your digestion (besides eating a clean diet, free of food intolerances and processed junk) is to take Bitters. Digestive bitters are an herbal formula that contain herbs with bitter qualities, as the name suggests. Bitter herbs help to stimulate digestive secretions, so your body releases more stomach acid and enzymes to break down and digest your food properly. There are numerous bitters formulas out there, and they often contain liver-helpers like I’ve mentioned in the previous section.
My personal favourite bitters formula is Canadian Bitters by St. Francis Herb Farm.
When you’re stressed, most body processes get suppressed as your body is focused on saving your life! Even though your particular stress (like kids, dirty house or commute) isn’t actually life threatening, your body can’t tell the difference. When you’re in this “Fight or Flight” mode, all non essential body processes are stopped- digestion and sex hormone production (reproduction) being part of that.
So, your hormones go crazy and you don’t digest or absorb anything, and you now know that these processes are key to fighting those hormonal breakouts.
Additionally, when you’re stressed, the stress hormone cortisol tells your body to create some sugar to put in the blood for quick energy- so you can fight or flee. This adds to blood sugar and insulin imbalances that may already be present- putting weight on your belly, creating inflammation and unleveling the amount of androgens your body produces- all leading to more breakouts.
Stress management is essential, and steps must be taken every single day to manage it in a healthy way. Whether you have 5 minutes or several hours, each day must have some type of self-care.
Some of my favourite self-care activities include:
- Spending time in nature (Bonus: being in the sun gives you vitamin D, a clear skin vitamin)
- Walking or bicycling
- Infrared saunas
- Reading a fluff book
- Watching a funny TV show or movie
- Taking a hot bath
- Having a healthy treat like a few squares organic 70% dark chocolate (not the whole bar!)
- Adult colouring books
- Enjoying a cup of herbal tea
- Diffusing calming essential oils like lavender, peppermint, frankincense and cedarwood
Dysbiosis may be a new word for you, but it’s explanation is simple. Dysbiosis is simply a bacterial imbalance in the body. Our bodies have trillions of bacteria- there’s more of them then there is human cells! We need to keep these bugs happy, because they keep us happy (literally). There is a very delicate balance of these bacteria- we should have more probiotics (“good” bacteria) compared to pathogens or “bad” bacteria (like candida, parasites, etc). When these bugs are in harmony, everything is great.
When dysbiosis comes about, from poor lifestyle choices, use of medications like antibiotics, anti-depressants and the birth control pill (it’s actually an antibiotic!), acne can be an embarrassing side effect.
Like the connection between mood problems and acne I’ve mentioned in this article about probiotics and acne, people with acne are also more likely to have a variety of digestive complaints like constipation, burping, bad breath and bloating. Yuck! While this wasn’t something I ever experienced in great amounts (except maybe some bloating), I see this a lot in the women I work with.
The biggest possible reason for this is something known as Small Intestinal Bacterial Overgrowth or SIBO. What this means simply is that there’s too many ‘bad’ bacteria and other pathogens in the body than ‘good’ bacteria. While SIBO can be a severe issue, even a small amount of bacterial overgrowth like candida or even leaky gut can cause digestive and skin disturbances.
Probiotics are ‘good’ bacteria, and so help to ‘crowd out’ the bad guys with their body-loving superpowers. The means a healthy gut and healthy skin for the user!
Check out my full post on why you should be using probiotics to help your acne by clicking here.