According to the Canadian Dermatology Association, women make up to 75 per cent of adult acne cases, with hormonal changes like menstruation playing a big role in those numbers.

Why do hormones have such a big impact on acne, how long will it last, and what can people do to care for their skin when they’re experiencing hormonal breakouts? Dr. Jennifer Tran, a Sunnybrook dermatologist, shares her insight.

Understanding hormonal acne

People often anticipate breakouts around the time they are menstruating. What’s less talked about is that acne can be brought on by other hormonal changes, such as starting birth control, pregnancy and menopause.

“There is evidence that hormonal fluctuations in androgens, progesterone and testosterone can worsen acne,” says Dr. Tran. Though, while these changes have been linked to acne, the connection is not so straightforward.

“The exact pathogenesis of acne in these scenarios is unclear,” she says. In fact, she adds, “Some studies have looked at measuring various hormone levels in patients with acne, and in the majority of cases, these levels are within normal range.”

How long will these breakouts last?

Similar to the uncertainty surrounding the cause of hormonal acne, the length of time that these breakouts will stick around is also unclear.

“Timing depends,” says Dr. Tran. “It can be very specific to a patient’s circumstances. For example, if someone is pregnant, it can last the duration of their pregnancy. For some, hormonal acne can last for several years.”

Treatment

To manage these hormonal breakouts, Dr. Tran encourages people to speak with their doctor to discuss options.

“Topical treatments, oral medications such as spironolactone or certain oral contraceptive pills, and even antibiotics and isotretinoin can be used for hormonal acne,” she says.

And while acne is typically harmless, in some instances, it can be indicative of a bigger issue.

“Hormonal acne is sometimes associated with polycystic ovarian syndrome,” she says. “If there are other signs or symptoms of this condition, patients should be screened.”

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Why teens get acne

Puberty causes a surge in hormones that can lead to acne in teenagers.

“Adolescents start to have increased androgen production and that stimulates sebum formation, which in turn leads to the development of acne,” says Dr. Tran, adding it is important to know that other factors do play a role in acne and its severity.

And it’s not just something high school students face: Dermatology Canada says 80 per cent of those struggling with acne are between the ages of 12 and 24, and 25 per cent of teenagers will still have acne at 25.

Treating acne

Dr. Tran says adolescents (and their families) shouldn’t feel as though acne needs to be severe before reaching out to their family doctor for a referral to a dermatologist.

“[Dermatologists] are happy to help our patients manage all types of acne, regardless of severity,” she says.

Treating acne is a personal decision, and every patient is different, says Dr. Tran. It is common and normal and doesn’t necessarily require treatment, but everyone will have a different tolerance.

“What might seem mild or inconsequential to others may in fact be having a big impact on a patient’s self-esteem,” she says. “Generally speaking, I think if your acne is bothering you, it’s worth a visit to your doctor to discuss options.”

Keep the skin care simple

For adolescents who are looking for ways to care for their skin, Dr. Tran keeps the recommendations simple.

“I usually recommend a cleanser once daily, a moisturizer and —if necessary— a prescription-grade topical treatment to start,” she says, adding there are many options for these that patients can explore with their family doctor or dermatologist.

And for those who might be concerned that their acne is caused by not washing their face enough, Dr. Tran says that’s a myth.

“Acne is not caused by poor hygiene or not washing your face enough. In fact, acne can sometimes be worsened by excessive cleansing.”

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