Can Testosterone Trigger Acne?

Curated by Claudia Shannon / Research Scientist / ishonest

How does testosterone trigger acne?

Acne is often thought of as a problem that only affects teenagers. However, many adults deal with acne throughout their life.

Fluctuations in hormone levels, such as testosterone, can cause acne. In fact, research has found that people with acne may produce more testosterone than people without acne.

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But how exactly does testosterone trigger acne? Well, it helps to know a bit about how acne develops.

Sebaceous glands beneath your skin produce the oily substance known as sebum. Your face contains the highest concentration of these glands.

Many of your sebaceous glands are concentrated around hair follicles. Sometimes these follicles can become blocked with sebum, dead skin cells, and other particles.

When this blockage becomes inflamed, you get the elevated bumps that are commonly referred to as acne.

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Changes in your body’s secretion of sebum is thought to be one of the contributing factors that can lead to acne.

Testosterone stimulates the production of sebum. Overproduction of testosterone may lead to excessive sebum production, which, in turn, may increase the risk of inflamed sebaceous glands. This can trigger an acne outbreak.

Many people experience frequent acne breakouts during puberty when testosterone levels start to rise. However, hormonal acne can persist throughout adulthood.

Here’s a list of the different types of acne you can develop:

  • Whiteheads are closed, plugged pores. They may be whitish or skin- colored.
  • Blackheads are open, clogged pores. They’re often dark in color.
  • Pustules are tender bumps filled with pus.
  • Cysts and nodules are deep lumps under the skin that are tender to touch.
  • Papules are tender bumps that are either pink or red.
Can testosterone cause acne in women?
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Even though women don’t produce as much testosterone as men, testosterone may still play a role in acne flare-ups.

In one study, researchers looked at the hormone levels of 207 women between the ages of 18 and 45 years old with acne. They found that 72 percent of the women with acne had excess androgen hormones, including testosterone.

What can cause testosterone levels to fluctuate?

Testosterone levels naturally fluctuate throughout your life. Levels of this hormone tend to rise during puberty for both boys and girls. Your production of testosterone tends to start dropping after the age of 30.

It’s been theorized that female testosterone levels might increase during ovulation.

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However, research suggests that changes in testosterone levels during a woman’s cycle are relatively low compared to day-to-day fluctuations. Acne flare- ups during a menstrual period are more likely due to changes in estrogen and progesterone levels.

Polycystic ovary syndrome can lead to elevated testosterone levels in women.

In rare cases, testicular tumors can lead to high testosterone in men.

Taking anabolic steroids or corticosteroid medications can also lead to elevated testosterone levels.

Are there ways to help keep testosterone levels balanced?

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Adopting healthy lifestyle habits may help keep your testosterone levels balanced. Some habits that may help keep your testosterone at a healthy level include the following:

  • avoiding corticosteroids and anabolic steroids
  • getting enough sleep (at least 7 to 9 hours a night)
  • exercising regularly
  • limiting refined carbohydrates like white bread, white rice, and baked goods
  • reducing and managing stress in healthy ways

What’s the best way to treat hormonal acne?

Treatments that target your hormones are typically more effective at reducing hormonal acne.

Here are some treatment options to consider:

  • Topical treatments like retinoids, salicylic acid, or benzoyl peroxide may help improve your acne if it’s mild. They may not be effective for serious acne.
  • Oral contraceptives (for women) that contain ethinylestradiol may help minimize acne caused by hormonal fluctuations during your menstrual cycle.
  • Anti-androgen drugs like spironolactone (Aldactone) may stabilize testosterone levels and reduce sebum production.

What else can cause acne?

Testosterone fluctuations aren’t the only cause of acne. The following may also be contributing factors:

  • Genetics. If one or both of your parents had acne, you’re more likely to be prone to it, too.
  • Excess bacteria. A specific strain of bacteria that live on your skin called Propionibacterium acnes (P. acnes) play a role in causing acne.
  • Cosmetics. Some types of makeup may clog or irritate the pores on your face.
  • Medications. Some medications, like corticosteroids, iodides, bromides, and oral steroids, may cause acne.
  • A diet high in refined carbs. Eating a lot of refined and high-glycemic carbs, like white bread and sugary cereals, may contribute to acne. However, the acne-diet connection is still being researched.

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It’s difficult to treat hormonal acne without stabilizing your hormone levels. However, adopting the following healthy habits may help reduce acne caused by other factors:

  • Wash your face twice a day with a gentle, nonabrasive cleanser.
  • Use warm water. Don’t scrub your skin too hard. Be gentle!
  • When shaving your face, shave downward to avoid ingrown hairs.
  • Avoid touching your face or picking at your pimples. This exposes your pores to more bacteria that can make your acne worse.
  • If you smoke, quit. Research has shown that smoking can increase your risk for getting acne.
  • If you wear makeup, use water-based, noncomedogenic makeup products. These won’t clog your pores.
  • Completely remove any makeup or cosmetics before bed.

The bottom line

Elevated testosterone levels may contribute to acne by increasing your body’s production of a substance called sebum. When excess sebum collects around your hair follicles, you may develop acne.

If you suspect that a hormonal imbalance might be causing your acne, the best way to know for sure is to discuss the issue with your doctor. They can work with you to diagnose the cause of your acne and determine the best treatment.

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