My Story Of Terrible Hormonal Acne
I used to have the WORST hormonal acne and I struggled very long to get rid of it.
It was so bad that I felt I at least deserved to be in medical posters more than the people featured in them.
I spent over a thousand dollars at dermatologists and drug stores finding the best cures to get rid of hormonal acne, such as:
- Cleansers and toners
- Moisturizers and serums
- $300 chemical peels
- $1000 lasers
I even underwent the last ditch treatment… TWICE. Two rounds of isotretinoin treatment.
But I never got down to the root cause of hormonal acne… Not until eight years later.
First, How Do You Know If You Have Hormonal Acne?
There are many types of acne but all have two things in common:
- Inflammation and infection by a bacteria called P. acnes
- High sebum (oil) production
Hormonal acne is one particular type of acne that leads to both inflammation and high sebum production.
The easiest way to tell if you have some degree of hormonal acne is if it happened during or right after puberty, and it slowly got better with age.
Another way to tell if you have male hormonal acne is by observing where your pimples tend to form.
If your pimples tend to aggregate near the chin or jawline area, there is a high chance you have hormonal acne (Elsaie, 2016).
This is because the male jaw contains a high density of androgen receptors, literally giving rise to the “male chiseled jaw”. One side effect of this, of course, is that it tends to be the cluster point of hormonal acne.
My Discoveries from Crazy Hormone Experiments
Over the last 4 years, I took my hormone optimization experiments to a crazy, crazy level.
I literally gave a whole new meaning to skin in the game.
I surged and thrashed my biological hormones, learned about their side effects and made many valuable discoveries.
- When I increased my testosterone and DHT levels, my skin became oilier
- While my estrogen was elevated, my skin became MUCH oilier and acne exploded on my face
- When I totally crushed my estrogen, I couldn’t produce any sebum and had zero acne
- When my insulin was spiking up and down, my acne came back with a vengeance
I finally made a serious realization: To get rid of hormonal acne, you need to treat your hormones.
It just doesn’t make sense to use creams and facial washes when the root cause of hormonal acne is… your hormones!
1. Reduce Estrogens, Especially Estradiol (E2)
For women, estrogen improves their acne.
For men, estrogen worsens acne (Yang et al., 1989). This fits perfectly with my observation.
If you’re a man, the amount of estrogen you have in your body depends on three things:
- Testosterone which converts into estrogen
- Aromatase which converts testosterone into estrogen
- Metabolism rate of estrogen
Obviously, you don’t want to reduce your testosterone levels because testosterone is important for energy, motivation, muscle growth and sexual performance.
Now this means you have to reduce estrogen via the other two pathways.
1A. Aromatase Reduction
Aromatase is the enzyme that converts testosterone into estrogen and particularly estradiol (E2), the most potent form of estrogen.
Therefore, you want to reduce aromatase enzymes by a little, but not too much such that E2 still within the healthy range – between 20-30 pg/ml.
The first thing is to take an E2 test at your local clinic. It costs about $30, which is much cheaper than the rip-off cleansers and creams in drugstores.
If your E2 between 20-30 pg/ml, proceed to Section 2 since your biological estrogen is in the ideal range.
If your E2 is above 30 pg/ml, read on.
To reduce E2, you can take mild aromatase inhibitors (AIs) to reduce estradiol such as:
- Button mushrooms (1-2 cups per day)
- Chrysin taken with black pepper extract
These AIs knock your E2 down by a few points to get you into the optimal E2 range. This helps you get rid of hormonal acne, or at least reduce it significantly.
Note: I do not advocate taking clinical AIs because you can crash your estrogen very easily with them.
Another important way to reduce E2 is to lose fat because it is where your aromatase enzymes are stored.
I will leave fat loss for another article but you already know the basic idea: burn more calories than you consume.
1B. Increase Metabolism of Estrogen
A second way to reduce E2 if it is over 30 pg/ml is to increase the rate at which your body metabolizes E2.
The best supplement for this is Calcium D-Glucarate. It decreases your E2 by about 5-10 points while also lowering your cholesterol levels. (Alternative Medicine Review, 2002). This will help you get rid of E2-induced hormonal acne.
Dave Asprey, the founder of the Bulletproof Blog, swears by Calcium D-Glucarate and incorporates it into his daily supplementation regime. He has written a pretty comprehensive post about it here.
2. Minimize Insulin Spikes
When I was serving in the army, I used to bring 1.5L bottles of sweetened drinks to camp EVERY week. Horrifyingly, my acne came back with a vengeance even though I had finished a round of accutane.
In retrospect, I had it coming. Those massive bottles of sugar were a recipe for pimple disaster.
It has been found that sugars and high glycemic index carbs like white rice create massive insulin spikes. In turn, insulin drastically increases sebum production (Thiboutot, 2004).
To minimize insulin spikes, avoid sugary foods and high glycemic index carbohydrates like white rice and white bread. Instead, adopt a high-protein, low-glycemic diet as it is demonstrated to decrease acne lesions (Smith et al., 2007).
Alternatively, if a high sugar, high GI diet is necessary, you can blunt the insulin spike by taking berberine.
Berberine is a powerful insulin mimetic that has been found to reduce fasting blood glucose, insulin levels, total cholesterol and LDL (Yin, Xing & Ye, 2009).
A Note on DHT Suppression
A third hormone called DHT has been implicated in acne as it activates the sebaceous glands, causing more sebum production which leads to clogged pores ripe for infection.
DHT is an important male hormone that is even more powerful than testosterone in terms of masculinizing properties. It gives men a calm sense of confidence and energy. Hence, I do not recommend reducing DHT in order to treat acne even though theoretically you could.
Action Plan For Getting Rid of Hormonal Acne
- Get a blood estradiol test. If results are over 30 pg/ml, proceed to step 2. If results are below 30 pg/ml, proceed to step 3.
- Flush out excess estradiol from your body. Use mild AIs like button mushrooms, lose fat and consider supplementing with Calcium D-Glucarate.
- Reduce insulin spikes. Eat low-sugar and low glycemic index food, adopt a high-protein diet and consider berberine supplementation.
Again, we have seen the importance of hormonal optimization. The benefits of balancing your hormones clearly branch out into many aspects of your health and well-being.
Reducing your estrogen (especially estradiol) and minimizing insulin spikes are the key to getting rid of hormonal acne.
Of course, I’m not discounting the need to cultivate proper facial hygiene and cleanliness. These are important as well, but they do not solve the root of the problem.
Hormonal acne is what it is – hormonal. As such, everyone suffering from hormonal acne should measure and manage their hormones.