Why Does an Adult Female Have Acne When Hormones Are Normal?
Surging hormones cause acne, which is why teenagers suffer from it far more often than adults. In fact, according to the American Academy of Dermatology, up to 85 percent of teens will have pimples each year. But adult women also get acne frequently, even when their hormones are normal. That's because hormone levels in women normally fluctuate throughout the month.
Acne results when the skin produces too much sebum, the lubricating oil that's found on the skin's surface and also in pores below the surface, according to the Cleveland Clinic. The skin's sebaceous glands make sebum in response to signals from hormones called androgens, which are male-type hormones found in everyone, including both men and women. Women with normal hormone levels have androgens such as testosterone circulating in their bodies, and these androgens drive sebum production.
Sensitive Sebaceous Glands
Even in women who have normal levels of testosterone and other hormones, acne can form when the skin's sebaceous glands over-react to hormonal stimulation, according to the Mayo Clinic. If you have normal hormones and acne, it's likely that your sebaceous glands are simply especially sensitive to the hormonal swings that are normal through your menstrual cycle. That's why acne can flare right before your period and during pregnancy, while remaining relatively dormant through other parts of the month.
Polycystic Ovary Syndrome
Of course, some women who have bad adult acne also have another medical problem, such as polycystic ovary syndrome, or PCOS, a common disease that causes acne, male-pattern hair growth and infertility due to hormonal imbalance, according to the Mayo Clinic. Other symptoms include irregular periods and potentially a weight problem. So if you have adult acne in combination with other symptoms that might point to PCOS, you should be screened by your physician for the condition. However, PCOS affects only a minority of adult women with acne, and most women with adult acne do have normal hormone levels.
If you're an adult female with acne and your hormones test at normal levels, you still can benefit from medication to calm your acne, according to the AAD. If over-the-counter acne medications fail to clear your skin, your dermatologist likely will start with topical drugs to combat acne-causing bacteria. You might also receive a prescription for tretinoin, a form of vitamin A that's effective both in clearing pores and in helping to erase wrinkles.
Oral contraceptives also can effectively clear acne, so if you're not interested in becoming pregnant anytime soon, you might consider trying birth control pills. Three brand names hold U.S. Food and Drug Administration approval for acne, but others can be equally effective in clearing skin. Birth control pills for acne carry some disadvantages: women over 35 and those who smoke shouldn't take them, and they can cause some side effects, most notably headaches, depression and decreased sex drive. Oral contraceptives also take up to six months to clear acne in women who use them for that purpose.
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