It always puzzles me how doctors (GPs, dermatologists and gynecologists) give young women hormonal acne treatments without ever testing to see what their hormone levels are. So today I’m going to go through with you why it’s so important to get your hormones tested if you want to eliminate your hormonal acne for good.
It seems pretty straightforward to me that if something is being driven by hormones, like hormonal acne, you need to know what the hormone levels are like before you supply or provide a treatment. Otherwise you’re just dishing out treatments willy-nilly based only on assumptions.
How can you cure hormonal acne without knowing the hormone levels?
This seems like a pretty obvious question, but as I was just saying, you might find your doctor doesn’t see it this way though.
You might have already experienced going to your doctor and asking to get your hormones tested and found they’re weren’t too keen to do it. The reason for this is because medical treatments are really strong. The birth control pill and Accutane/Roaccutane usually work regardless of what type of hormone imbalance you have, so your doctor thinks why bother testing.
They know the medications are that powerful that they will just override any hormonal imbalance.
But the problem with these treatments is that when you stop them, your hormonal imbalance returns and so does your acne. So if you want to get rid of your acne for good, then you need to balance out your hormones.
So when you want to solve your hormonal acne issues naturally, we need to know what your hormone levels are like. So testing becomes critically important. When you do the testing, you know what your hormone levels are which then allows you to be very specific around the herbs and supplements you’ll use.
Because if you don’t test, all you can do is guess at what you need, and this is where most people are at.
You might research, research, research, and see that this herb is good for hormonal acne, this vitamin’s good for hormonal acne, this mineral is good for hormonal acne but if you don’t ever do any hormone testing then all you can do is just guess at what you need and what you should take.
So what I see a lot in my clinic is patients come to see me and they’re taking a whole heap of supplements, but they’ve still got acne. And this is because they don’t really know what they should be taking and what they’re taking isn’t correcting their hormone imbalance.
So if you’re taking supplements and herbs and your acne isn’t improving, then it’s probably because you don’t know what your hormone levels are and so you’re not taking the right supplements for your hormone imbalance. And there’s a multitude of hormones you can have out of balance that affect oil production and cause acne. So let’s see what they are…
The most important hormones I’ve discovered you need to test are the male sex hormones, (testosterone, DHEA, and Androstenedione), female sex hormones (estrogen, progesterone, luteinising hormone, and follicle-stimulating hormone) and the stress hormone, cortisol. These three types of hormones all interact with each other so they all need to be tested to know what’s going on in your body.
Knowing your male sex hormones levels is super important because male sex hormones, like testosterone, increase skin pore size. And larger pores get more dirt and dead skin cells caught in them. This breeds more bacteria and the pore becomes infected.
Male sex hormones also stimulate oil production, so if your male sex hormone levels are too high you’re going to get more oil coming out of the larger pores which attracts dirt and all sorts of things. The pores then easily get clogged, inflamed and infected and so of course acne results.
Male sex hormones also stimulate hair growth in male sex hormone sensitive hair follicles. These are the follicles along the ‘beard line’, the chest, and around the nipples and navel. When male sex hormone levels are high you tend to see hormonal acne, or hair growth, in these areas. This happens because male sex hormones drive more oil production and more hair growth in these areas, and the follicles can become clogged and infected. This is why acne is so common in these areas.
Another issue to be aware of is male sex hormones can also thin the hair on your head. So if you’ve noticed that your hair’s thinning and you’ve been getting hormonal acne, then this is a classic sign that your male sex hormones are out of balance, so you should test them.
Female sex hormones (particularly estrogen and progesterone) are also critical to test because they reduce skin pore size and reduce oil production, mainly by counterbalancing male sex hormones. Female sex hormones don’t directly reduce oil production, but when they are at optimum levels they overpower and dominate male sex hormones and this stops the male sex hormones triggering extra oil production.
Good female sex hormone levels are super important because they also reduce facial and body hair, boost your energy and balance your mood.
The third type of hormone you need to get tested is the stress hormone cortisol. Stress hormones can increase oil production, like male sex hormones, but the bigger issue is too much stress hormone suppresses female hormones.
This happens because of a very primitive adaptive response in your body. Back in our ancestral past, during times of stress, like famines, it wasn’t a good time to have a baby, so to stop a woman conceiving female hormonal function was suppressed. However, these days the stress your under is not because there’s a famine, it’s because of modern life. But the part of your brain that detects stress can’t tell the difference between famine stress and modern stress and so female hormone production is still suppressed.
So then because your female hormones levels don’t get up high enough, the male sex hormones in your body start to dominate, and this increases oil production and acne flare ups.
This is the reason why your testosterone can appear normal on a blood test yet you have hormonal acne along the jaw, cheeks, chin, neck, back etc. It’s not because your male sex hormones are actually high but because they are high compared to your low female hormones.
Now let’s go through what some of the hormone imbalances you can suffer from look like.
First we have some saliva test results from my patients. I use saliva testing a lot because it’s very easy for patients to do. You can do it at home and it’s also good because it gives us a slightly different look at the hormones compared to blood tests. This is because saliva comes out of your body, so it’s carrying the hormone levels which are very similar to what are next to your cells.
Whereas the blood, is telling you about what’s being transported out to your cells, which is slightly different.
In this example here, what we can see is the testosterone is high. It should be 100 but it’s up over 200, so that’s double the amount of testosterone. Also you can see the progesterone’s on the lower side as well. This combination of low female hormone and high male sex hormone spells trouble for your skin because it’s going to trigger excess oil production, particularly in the week before a period.
In this next chart, we’ve got high testosterone, low progesterone and high estrogen. You can see the progesterone is not out of range, but it’s sitting down the bottom end. This test was done 21 days from the start of a period and at this point of the cycle progesterone should be at the upper end, not the lower end, of the range.
The other hormones are up at the top end of the ranges. The high testosterone is particularly problematic because it’s going to increase oil production, and the high estrogen’s (Estradiol and Estrone) are an issue too because they’re contributing to the progesterone suppression.
In this next chart we actually see a low progesterone and a high normal testosterone. Again this is a bad combination. Low progetserone, high male sex hormone, that’s going to increase oil production and cause an acne flare up before a period.
This set of results is from a blood test. Here we’re looking at FHS (follicle stimulating hormone, the hormone that stimulates the growth of the ovarian follicles and egg) and LH (luteinising hormone, the hormone that triggers ovulation). This test would have been done at the beginning of the cycle on the 2nd or 3rd day of the period. At this part of the cycle the LH and FHS should be more or less equal, but here we see the LH much higher than the FHS. This can be a sign of PCOS and excess male sex hormone production because excess LH can trigger the ovaries to make extra testosterone.
Here we have blood test results again and you can see the male sex hormones are high. The total testosterone is high, the free (active) testosterone is high and the free androgen index (total active male sex hormones) is high. Then the SHBG (sex hormone binding globulin), a protein that binds up sex hormones to stop them being active, is very low. This means most of the hormones will be active and able to act on the cells. So all up these results explain why this person was experiencing a whole lot of hormonal acne.
Now we move onto the stress hormone cortisol. These are the results from a saliva test and we see the cortisol is high. It’s high in the morning, it’s high at lunch, it’s high in the afternoon, and it’s right on the border at nighttime. This shows this person’s got a whole lot of stress hormone circulating through their body and this is a problem because it’s going to be suppress their female hormones.
Next we’ve got the flip side of the previous results. In this chart we’ve got very low cortisol levels. You can see the line running along the bottom, below the green a few times. Now you might think this is good because there isn’t too much cortisol, but low cortisol isn’t good either.
When we see low cortisol it tells us there’s been long term stress and the body’s gone into shutdown mode. This is a much more advanced stage of stress issues than the case before. In the initial stress response the cortisol is high but if the stress persists then the cortisol levels eventually go low. And female hormones will definitely be suppressed.
So from these examples I’m sure you can see how crucial it is to check your hormone levels because there can be so many different kinds of hormonal imbalance. Identifying the actual imbalance is extremely important because it directs treatment. The herbs, vitamins, minerals and other supplements you need depend on the particular hormone imbalance you have because…
- There’re herbs/supplements to lower LH if it’s high
- There’re herbs/supplements to minimize testosterone production
- There’re herbs/supplements to stop regular testosterone being turned into the much stronger Dihydrotestosterone (DHT)
- There’re herbs/supplements to raise progesterone
- There’re herbs/supplements to detoxify excess estrogen
- There’re herbs/supplements to lower cortisol
- There’re herbs/supplements to raise cortisol
So if you don’t know what your hormone levels are how are you going to pick the right herbs and the right supplements to rebalance your hormones and eliminate your hormonal acne?
You won’t. You won’t know what you really need and so you won’t know what to choose.
You’ll just be guessing!
So this is why testing is very, very important. It’s one of the first things to do when you want to get rid of your hormonal acne.
If you’re not having any success getting your hormones checked with your doctor, then contact me and we’ll see about getting your hormones checked and getting your acne cleared.