Hormones+Skin

Your Skin + Your Cycle: how hormones affect your skin health

Your hormones not only help to control your menstrual cycle and reproductive function, but they also have noticeable impacts on the health of your skin. The skin is the body’s largest organ and plays many important roles like providing a physical barrier, regulating temperature and helping the body detoxify through sweat and oils. The skin is full of estrogen and testosterone receptors and to a lesser extent, progesterone receptors, and so fluctuating levels of these hormones throughout the monthly cycle have direct impacts on the skin. This is why we see changes in the skin starting at puberty. These fluctuations and imbalances in sex hormones can often lead to breakouts, inflammation, and bouts of oily or dry skin which can have a huge impact on a woman’s self-confidence.

ACNE

Acne is one of the most common skin complaints associated with the menstrual cycle. Breakouts are very common right before or during the period, but many women suffer from month-long acne.

HERE ARE THE HORMONES THAT MAY BE AT PLAY:

ANDROGENS (AKA MALE SEX HORMONES)

Androgens are the most important of all hormones that regulate sebum production. Sebum is the oil produced from the sebaceous glands that hydrates and protects the skin. Although it is necessary for skin health, excess sebum can combine with dead skin cells within a pore creating a blockage. When a pore is blocked it can trap the excess sebum creating an environment where the bacteria P. acnes can thrive. This is what leads to inflammatory, cystic type lesions. At puberty, androgens, mainly testosterone and dihydrotestosterone (DHT), stimulate sebum production and acne formation in both males and females. Women with elevated testosterone levels experience more acne month long and not necessarily right before the period, however, acne can still be exacerbated premenstrually. Acne is a hallmark of polycystic ovarian syndrome (PCOS), and this is the most common cause of elevated testosterone levels in women.

WAYS TO NATURALLY LOWER ANDROGENS:

ESTROGEN

High levels of estrogen indirectly reduce acne flare-ups. Right before the period, in the luteal phase, estrogen levels are lowest and this can explain why some women experience acne premenstrually. Estrogen is known to reduce the size of the sebaceous glands thereby reducing the amount of sebum produced. This is because estrogen competes with testosterone in the cells that produce sebum, thus reducing testosterone’s activity. Estrogen also reduces the amount of circulating free testosterone by increasing the liver’s production of sex-hormone-binding globulin, again reducing testosterone’s activity. The exact causes of premenstrual acne are still unclear; however, we may see more pronounced testosterone activity in the second half of the cycle when estrogen is lowest, without true elevations in testosterone.

Acne is a very complex concern that can affect all sexes and ages, and not all acne is related to menstrual or hormonal cycling. Genetics, diet and high levels of stress all contribute to acne as well.

OILY SKIN

Similar to acne, some women experience oily skin in the premenstrual phase. That can be explained by the same underlying factors: androgens and estrogen. Oily skin is due to increased sebum production, but in this case, it is not leading to clogged pores and breakouts. Of course, oily skin can progress to acne, however. Some women may experience oilier skin during the week preceding menstruation and also during the week of menstruation. Women typically experience the least amount of sebum production and the least oily skin during the week following the period when estrogen is highest.

SWEAT PRODUCTION

The amount of sweat production and release also changes throughout the cycle. When progesterone increases during the luteal phase of the cycle, basal body temperature rises and women produce more sweat. The increase in sweat is seen across the entire body and not only from the skin on the face. Along with the use of make-up and other beauty products on the skin of the face, the increase in sweat production during the premenstrual phase may also contribute to acne flare-ups during this time.

OTHER SKIN CONCERNS

Dry sky, psoriasis, eczema, and other skin conditions may worsen during the premenstrual phase. The reason for these skin changes is still unknown, but it may be due to low estrogen levels or normal elevation in progesterone.

OTHER EFFECTS OF ESTROGEN & PROGESTERONE

Estrogen plays an important role in skin health. It increases the production of collagen maintaining skin thickness and slowing the creation of fine lines and wrinkles. Estrogen also increases hyaluronic acid production which helps retain moisture, it improves wound healing and protects barrier function. However, high levels of estrogen contribute to period cramps, mood swings, breast tenderness and other PMS symptoms. These can interfere with sleep, cause elevations in stress, and impair digestion which can all indirectly impact skin appearance.

Progesterone’s role in the skin is not entirely clear, but it is important to note that in hormonal contraceptives. For example, the pill and the IUD, the progestins, which are a synthetic form of progesterone, can trigger acne and other skin problems in some women.

The cyclic hormonal changes that regulate the menstrual cycle are a significant biological influence on the skin and can have serious emotional ramifications. By tracking skin changes throughout the cycle you can determine patterns to identify if there is a hormonal variation or not. This helps determine what strategies may be most effective for managing your concern.

SIMPLE TIPS TO START HEALING YOUR SKIN:

  • Use limited & simple products on your skin – check out Well Daily’s skin expert for recommendations
  • Work with a professional to determine the underlying cause of your skin concern
  • Ditch the dairy and sugar, especially for treating acne
  • Incorporate stress management practices
  • Get enough good quality sleep
  • Eat foods high in skin-craving nutrients like vitamin C, zinc and omega-3 fatty acids
  • Support the gut to reduce inflammation
  • Keep your blood sugar balanced by reducing simple carbs, incorporating fat and protein with every meal and ensuring adequate fiber intake

However, if you do suspect your acne or skin concerns are hormonally driven, I encourage you to see a healthcare professional who can provide the best assessment and treatment.

To healthy skin,

Dr. Bronwyn


KEEP YOUR SKIN CLEAR NATURALLY WITH A LITTLE HELP FROM OUR FRIENDS:

Image by: @Marcymedia

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WRITTEN BY:

Dr. Bronwyn is a naturopathic doctor in Toronto, Ontario with a clinical focus in Women's Health. She works with women transitioning off the oral contraceptive pill and those with specific fertility concerns, to reach a state of hormonal balance or in preparation for a healthy pregnancy. Dr. Bronwyn is passionate about empowering women to reclaim their hormonal health, to enable a full and vibrant life.

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