How to Get Rid of Hormonal Acne (Hint: It's Possible)

How to Get Rid of Hormonal Acne (Hint: It's Possible)

Hormonal acne is extremely frustrating when pimples last for weeks or months. Learn how to get rid of hormonal acne through your diet and skincare regimen.

What is Hormonal Acne?

Hormonal acne is acne caused by hormonal fluctuation. Although hormonal acne is mostly connected with hormone changes during adolescence, it can impact adults of both sexes at any age.

Our hormone system is very delicate and can easily be disrupted due to diet, lifestyle, and environmental factors. There are many health issues that can arise from hormonal imbalances, and unfortunately, hormonal acne symptoms are  is one of the issues that can manifest.

Why Is Hormonal Acne Important?

This brings us to our first point: what exactly is the big deal about hormonal acne? Well, for starters, it tends to be a more systemic issue rather than a topical one. In other words, if you try to treat it with creams or serums, it might not respond as well because the root problem isn’t having so-called “dirty” skin.

(And yes, we all know that having moderate acne doesn’t mean you’re dirty! But simply washing your face isn’t going to send hormonal acne packing. Yes, it may work on other types of breakouts, but hormonal acne tends to be a bit more stubborn than other types.)

Using a harsh acne medication out there (Accutane, we’re looking at you!) may not even cause it to budge, either. Even worse, treating it with these medicines may not even put you fully into remission, so the breakouts may still come back after you finish treatment. Our CEO Danielle did Accutane 3 separate times and hers came back each time!

Unlike other types of acne, hormonal acne can be especially brutal in its manifestation, too. It’s not uncommon to get a rash of them across your cheeks, chin, and by your mouth. They can also leave scars in their wake, a not-so-subtle reminder of your ongoing struggles with your skin. (9)

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Who Does Hormonal Acne Affect?

So, who does hormonal acne affect? In a word, everyone. In other words, well, it’s safe to say that it can affect both men and women, but hormonal acne in women does tend to occur more frequently than it does in males. (10)

This is especially true for women of reproductive age, those who are currently pregnant, and those who are going through perimenopause. If you fall into any of these checkboxes, then you’ve probably had your own fair share of hormonal breakouts in your life.

How Common is Hormonal Acne?

When it comes to skin conditions, acne is actually the most common one that can affect us. In fact, studies have shown that up to eighty percent of people will experience it in their lifetimes. Furthermore, about half of all women of reproductive age will get it, and nearly a quarter of all women in their forties will also struggle with it. (11 & 12)

Fungal Acne Vs. Hormonal Acne

While it may initially seem that hormonal acne and fungal acne are similar, there are actually a few things that set them apart. For instance, fungal acne (as the name implies) comes from yeast instead of bacteria. Hormonal acne, though, is caused by excessive sebum and bacteria.

Another difference between fungal and hormonal acne is how they show up on your skin. Hormonal acne can include pustules and nodules, as well as open and closed comedones. Fungal acne, though, looks more like pustules and can even be itchy.

What to Know About Causes & Symptoms

Are you curious to know what’s causing your hormonal acne and what some of the more common signs and symptoms of it are? Let’s go ahead and break it down together, friends.

What Causes Hormonal Acne?

So, what causes those pesky, unwanted hormonal acne breakouts crop up all over your face and body? Well, some of the more common triggers for hormonal acne include:

  • Elevated androgens. These are the male hormones that we all have. When your androgen levels rise, though, it can increase your chances of getting breakouts. (13)
  • Excessive sebum. Remember what we said about androgens? Those androgens increase sebum production, making it more likely that you’ll get hormonal acne. (13)
  • Clogged pores. Again, we’re going to implicate androgens here, but they’re the ones to blame. They can trigger something called “hyperkeratinization,” making your skin cells more clumpy and sticky. This can lead to clogged pores and, you guessed it, acne. (14)
  • Bacterial infection. Finally, to actually get acne, you need bacteria to infiltrate the affected pore. C. acnes is the one to blame, and without it, you’d just have an annoying bump on your face. (15)

Causes You Can Control

When you have hormonal acne, it’s understandable to want to get rid of it for good. Fortunately, some of the more common triggers for it are actually completely manageable. This means that with a few subtle changes, you can start to see clear skin.

These causes that are within your scope of control include:

  • Your beauty products. If you’re using heavy lotions, creams, and other hair and skincare products, they can dribble down onto your face and back and chest. In turn, this can lead to breakouts.
  • The amount of sleep you get. Okay, maybe you’re feeling a bit pinched for sleep lately and it feels out of your control. We get it. However, regulating your sleep better, and striving for a full eight hours of shut-eye, can be transformative for your skin. (16)
  • Your overall stress levels. It can definitely sometimes feel like your stress levels are also out of your control, especially if your boss is breathing down your neck and your kids are being little hellions. But meditation can go far in managing your stress levels, allowing you to experience clearer skin. (17)
  • Your fluctuating hormones. These ebb and flow naturally around your menstrual cycle, but pregnancy and menopause can also cause changes (and, of course, breakouts). However, there is a lot you can do to naturally rebalance your hormones.

Causes You Can’t Control

On the other hand, there are a few causes for your acne breakouts that are completely out of your control. These include:

  • Your genetics. If your parents or grandparents had acne, then it’s likely that you also have it. Sure, they could’ve given you their flowing locks or dazzling eyes, but instead, they gave you acne. (Thanks, gramps.) (18)
  • Your medications. If you’re taking certain types of medications (such as steroids or thyroid treatments), this can lead to acne. Don’t stop taking any medications without first consulting your doctor, though! (19)
  • Your pre-existing medical conditions. Certain pre-existing medical conditions can cause acne breakouts, too. For instance, PCOS (polycystic ovarian syndrome) and other endocrine disorders can lead to acne. (20)

Does Pregnancy Cause Hormonal Acne?

Due to the hormonal changes that you undergo while pregnant, this can trigger acne breakouts in women. The good news is that as your pregnancy progresses, those breakouts can reduce in severity and frequency.

You’ll want to be extremely careful when trying to treat it, as some medications can harm your unborn child. For instance, certain beta-hydroxy acids (like salicylic acid) and topical retinoids can be dangerous, so be sure to talk to your OB-GYN if you’re getting hormonal breakouts while pregnant.

Is Menopause Acne a Form of Hormonal Acne?

Are those breakouts that are showing up during menopause and perimenopause a type of hormonal acne? Absolutely. Because your hormones fluctuate wildly during this time, if your male hormones (those androgens) start to outweigh your female ones (like estrogen), acne can occur.

Hormonal Acne and Birth Control Pills

Some types of oral birth control pills have been shown to exacerbate hormonal acne, too. While the “combination pill” (the type that has both synthetic estrogen and synthetic progesterone) can help manage your breakouts and reduce their severity, the “mini-pill” (which contains only progestin and zero estrogen) can actually make it worse.

Bear in mind, though, that using oral contraceptives can come with certain health risks, especially if you fall within a vulnerable demographic. It’s not our place to tell you if you are or aren’t a good candidate for it, but it’s definitely a conversation you’ll want to have with your doctor if you’re dealing with hormonal acne.

Can Working Out Cause Hormonal Acne?

While there are a vast myriad of health benefits that can come from exercising (such as improving your physical fitness and decreasing your stress levels), we do need to point out that it can increase your chances of developing hormonal acne. But don’t let that scare you off from working out! The benefits of it always outweigh the risks.

But with that said, exercise has been shown to raise your circulating androgen levels, which can make it more likely that you’ll experience a hormonal breakout. Combine that with sweaty skin and trapped dirt and sebum, it’s a double-whammy of acne-causing potential. Removing your makeup before you start, and washing your face immediately after exercising, can help you avoid some of these blemishes. (21)

What Are The Symptoms of Hormonal Acne?

Unlike other types of acne, there are a few trademark signs of hormonal acne that give it away. For instance, hormonal acne usually tends to lurk on the lower part of your face in a “beard-like” pattern, near your cheeks and your jawline. (22)

It’s not uncommon for it to show up on your T-zone, though. Finding the occasional (or even more than occasional) spot on your nose and forehead isn’t outside the realm of possibility, especially if you’re nearing your monthly cycle.

Hormonal acne also tends to come in a variety of forms, too. It’s not going to just be the pustules (the ones that are mistakenly called “whiteheads”) that show up. You may also get open and closed comedones (blackheads and whiteheads, respectively), as well as hormonal cystic acne (or “nodular” acne) on your face and body.

What Makes Hormonal Acne Worse?

Nobody likes realizing that they’ve been inadvertently shooting themselves in the foot, so to speak, when it comes to an acne breakout. However, there are a few things that can make hormonal acne worse.

These include not managing your stress levels, a poor diet (as both sugar and dairy can exacerbate it), and even the wrong environment (such as if you live in an area with lots of pollution or higher than usual humidity) can lead to more breakouts. On the upside, this means that if you want to know how to fix hormonal acne, taking a closer look at your diet and lifestyle can be one of the first steps in getting started on it. (23)

As tempting as it may be to want to pick at your breakouts, keep your hands off them. What happens when you don’t pop a pimple is far more convenient than popping it. If you pop it, it can push the bacteria in deeper and cause it to spread. Conversely, a good skincare routine and resisting the urge to poke or squeeze your acne can help mitigate the damage and help your skin heal.

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What Does Hormonal Acne Look Like?

Initial hormonal acne is typically located where we have the most oil glands such as the nose, forehead, and chin, specifically, during the teen years. Whereas adult hormonal acne appears on the lower half of the face such as the bottom of the cheeks and the jawline where we have the deepest hair follicles.

Hormonal acne can manifest as blackheads, whiteheads, or even cysts. Cystic acne originates deep beneath the skin and is often sensitive and even tender to the touch.

How Do I Know If My Acne is Hormonal?

Hormonal acne can be triggered by a variety of hormonal changes. Some of the most common hormonal phases that cause hormonal acne are menstruation, polycystic ovarian syndrome (PCOS), and heightened androgen levels which occur as a result of menopause.

These hormonal changes can stimulate acne problems by increasing skin inflammation as well as oil production within follicles and pores which therefore clog pores and hair follicles.

As mentioned above, hormonal breakouts often occur on the lower half of the face, especially the jawline. If you are experiencing breakouts on this area of your face, there’s a good chance you’re dealing with hormonal acne.

Various Ways People Treat Hormonal Acne?

There are a few different ways you can treat your hormonal acne. Some may be better for you than others, so it’s always a good idea to do your due diligence and research any treatment before you try it. With that in mind, if you’re wondering how to get rid of hormonal acne, here are some ways you can go about doing it.

Oral Contraceptives

Some healthcare providers may recommend oral contraception for hormonal acne treatment.  These can include a combination of ingredients, such as ethinyl estradiol and other hormones like norgestimate and drospirenone.

However, while these can help balance the hormones that are causing your acne, they also come with their own risks. For starters, they’re just a band-aid for your breakouts and don’t address the root cause of your hormonal acne.

Then secondly, not everyone’s going to be a good candidate for birth control pills (BCP). If you’re over the age of thirty-five, you have a history of high blood pressure or blood clots, you use tobacco products, or you are at a higher risk of breast cancer, then you may want to steer clear of using BCP.

Anti-Androgen Drugs

Another popular option for hormonal acne treatment  is something called anti-androgen drugs. This includes a high blood pressure medication that goes by the name of spironolactone. It’s pretty common to use it “off label” for reducing androgen levels and increasing estrogen levels, whether for acne or for other purposes. (24)

Again, though, it comes with its own risks and is also a band-aid solution. Not only can it increase your estrogen levels, which may increase your risk of developing certain types of cancer, but it’s also a powerful diuretic. Some people have also noticed that using this medication can also lead to heart arrhythmia due to electrolyte imbalance, so be sure to discuss your concerns with your GP before you start taking this medication. (25 & 26)

Alpha Hydroxy Acid

We can’t sing the praises of using alpha hydroxy acids enough. As a type of plant extract that’s usually extracted from citrus, milk, and sugarcane, you can not only unclog your pores with AHAs, but you can also treat any existing post-inflammatory hyperpigmentation (PIH) and acne scars. Just be sure to use sunblock when using them, though, as they can make your skin more sensitive to UV rays. (29)

Green Tea

Sometimes, a hot and soothing drink is exactly what you need when you’re feeling stressed to the max. That’s where green tea steps in, especially if you’ve been looking at how to treat hormonal acne naturally. Boasting anti-inflammatory benefits and delicious with a squeeze of honey, you can either sip it or – if you’re feeling feisty – make a hormonal acne mask with it. (30)

Supplements

Using a supplement for hormonal acne can also help you get relief from your breakouts and is, in our opinion, arguably the best treatment for hormonal acne. Be sure to look for a supplement that includes clinically proven ingredients, though, and no weird filler ingredients. 

We recommend one that uses a combination of vitamin A (a type of retinoid), glutathione (a powerful liver detoxing antioxidant), DIM (an anti-androgenic compound found in cruciferous veggies), and other skin-clearing good stuff. Combined, they can help you get those clear-skin results you crave.

When To Treat Hormonal Acne? 

There’s no time like the present when it comes to treating your hormonal breakouts. The longer you hold off on getting treatment for hormonal acne, the higher your chances of developing scarring. Plus, treating it sooner rather than later can help ward off future breakouts, too. 

How Long Can Hormonal Acne Last For?

There’s no hard and fast rule when asking how long do pimples last. As we’re all different and will react differently to the hormonal changes that trigger the breakouts. For some people, it can go away as quickly as it showed up and vanish in just a matter of weeks. For others, it can be a chronic, ongoing problem that can last for years.

How Does Hormonal Acne Affect Skin

Having hormonal acne can really take its toll on your skin. When you have a flare-up, it can cause a painful rash of breakouts across your face and body. Oftentimes, these blemishes can be quite sore, red, and angry.

Even worse, if you don’t treat them right away, they can leave scars. Because of this, it’s extremely important to take your hormonal acne seriously. While many people dismiss it as just a cosmetic issue, the truth is, it can deal serious damage to your self-esteem, too.

Does Face Wash Help With Hormonal Acne

There’s nothing more frustrating than being accused of not washing your face when you have hormonal acne breakouts. Most, if all of us, already know that washing your face can help with your acne, but it’s not going to be a cure-all and it’s not going to get rid of all of the spots on your face.

However, while some types of face wash can contain beneficial ingredients (such as tea tree oil or benzoyl peroxide), it’s not necessarily going to permanently get rid of your acne. This is because hormonal acne isn’t so much a topical issue as it’s a systemic one.

You need to balance your hormones first to get the most out of your skincare treatment. Using a face wash, though, can help remove sebum and bacteria and other dirt and grime from your day. It won’t hurt you, you may even notice benefits from using it, but it’s not the be-all and end-all of getting clear skin.

How Soon Can Hormonal Acne Go Away After Treatment?

For most people, you can hope to start to see your acne fade away after about four to six weeks. Now, everyone’s going to be different, so it may take you a bit longer to start to notice results. Even if it’s slow going and feels like it’s taking forever to work, don’t give up, as you can help prevent future breakouts while treating the existing ones.

Here's Exactly What to Do If You Struggle With Hormonal Acne:

If you are someone who deals with hormonal acne there are some simple yet effective steps you can take to control acne breakouts. 

  • Ensure that you apply a conservative amount of acne products to your skin to avoid drying out your skin and causing a backfire response of thicker oil 
  • Although it sounds obvious, it’s important to thoroughly cleanse your face morning and evening to rid your face of any makeup, oil, bacteria, or germs. 
  • Check all your current skincare and cosmetic products to ensure you are only using acne-safe products to reduce clogged pores. 
  • Wearing non-comedogenic, oil-free sunscreen is essential to keep your skin healthy. Sun exposure may dry out the skin and over time can cause the skin to generate more oil and clog pores. (1)

Look Into Potential Hormone Imbalances

There isn't one single test that doctors can use to diagnose a hormone imbalance. So it's important to make an appointment with your doctor for a physical examination to discuss your symptoms. Your doctor may recommend one or more diagnostic tests based on your symptoms. 

The most common test will test your blood as the majority of hormones are detectable through blood testing. A blood test can enable your physician to analyze your thyroid, estrogen, testosterone, and cortisol levels. If you are a female, having a pelvic exam or mammogram may also be helpful. 

There are also tests available you can do at home that can evaluate hormones such as progesterone, testosterone as well as, cortisol levels, and thyroid hormones by testing saliva or blood from your fingertip. 

LetsGetChecked offers FDA-approved at-home exams. Once you have the results back from your at-home test it’s important to discuss the results with your doctor. (2)

Pay Attention to Your Diet

Research shows that diet, specifically the Standard American Diet (SAD), is a prevalent culprit in triggering hormonal acne because of the large presence of high glycemic index (GI) foods such as fast food, cereal, and baked goods.

The glycemic index (GI) is a method of determining how foods raise blood sugar levels in the body. High GI foods are common in Standard American Diets, and they have a huge negative impact on blood sugar levels. This partially explains why acne is so common in the United States in comparison with other countries.

According to Medical News Today research shows that in areas that consume more low GI foods, the presence of acne was found to be lower. Researchers found that acne rates spiked when participants began eating Western foods like soda, dairy, and processed foods. Other popular high GI foods are baked pastries, candy, sweet desserts, and processed carbohydrates such as sugary breakfast cereals and white bread. 

In addition to high GI foods, research shows that there could be a link between cow’s milk and acne. Some studies show that cow's milk may be an acne trigger for some people. 

Some people may benefit from modifying their diet to help heal hormonal acne. Although it’s important to always check with your doctor or a nutrition professional before making any serious dietary changes, foods that have a low GI may offer substantial positive results on your hormonal health and skin health as well.

Consuming meals with a lower GI has other positive benefits such as blood sugar control. Foods with low GI to consider are whole grains, beans, nuts, and seeds as well as non-starchy vegetables and fruits like apples, plums, and berries. 

Food rich in fiber are foods you’ll want to focus on. Many foods found within the Mediterranean diet such as olive oil, eggs, lean poultry, and fish can have a positive effect on maintaining blood sugar levels while also offering essential nutrients for optimal skin health. (3

Look into Food Sensitivities

Research shows us that acne is an inflammatory issue. Some food sensitivities can contribute to inflammation. Food sensitivities often develop when your immune system mistakenly sees a specific food as a threat and attacks it. This results in the body producing inflammatory chemicals which often trigger acne. 

If you aren’t sure of your acne triggers that occur as a result of your diet, the best way to identify them is to analyze the side effects of various foods through an elimination diet under the care of a dietitian or nutrition professional. (4

Do You Have an Excess of or Deficiency in Certain Vitamins or Minerals?

Vitamin D deficiency is linked to Hashimoto's disease, an autoimmune thyroid disorder. Although the majority of our vitamin D comes from the sun and foods such as milk, eggs, cheese, and even seafood like salmon, many people who are deficient from food and sun alone take vitamin D supplements. Vitamin D is an essential nutrient for bone-building which is vital to the thyroid because hyperthyroidism causes bone loss. 

Vitamin D deficiency is common among those with acne. Although less common, having an excess of vitamin D can trigger acne as well because excess vitamin D in the body can throw testosterone out of balance.

Research shows that around 30% of people with thyroid disorders are B12 deficient. Vitamin B12 is found in meat and dairy products as well as nutritional yeast. Deficiency in B vitamins is also common among those with acne.

Iodine is required for the production of thyroid hormones in the body and hormones regulate the body's metabolism and a variety of other functions. If you have an excess or deficiency in iodine this can negatively affect your thyroid. Iodine is used to make thyroid hormones, therefore having too much or too little can be harmful to your thyroid. (5)

Check Your Beauty Products for Hormone-Disrupting Ingredients

Endocrine-disrupting chemicals can be found in a variety of cosmetic products such as soaps, nail polish, and hairspray. Parabens are also linked to endocrine disruption and they have commonly used preservatives in cosmetics. 

Look for ingredients such as methylparaben, propylparaben, isoparaben, or butylparaben. Polycarbonate plastics and epoxy resins are ingredients to look for in cosmetic packaging. Bisphenol A or BPA is also found in the packaging of feminine hygiene products and toiletries. Research has shown BPA to interact with hormone receptors and the thyroid.

Triclosan is an antimicrobial agent used in personal care products that can be dangerous because of its absorption in the skin and its effects on reproductive issues. Benzophenone-3 is often found in sunscreen and cosmetics that contain UV protection. It can have serious negative effects on the hypothalamic-pituitary-gonadal system. 

Phthalates are another endocrine-disrupting substance often listed as a fragrance in cosmetic products such as nail polish, lotions, soaps, shampoos, perfume, and hair sprays. (6)

Your Body May Need a Functional Medicine Liver Detox

The liver is one of the most important organs within the body and it is tasked with a wide range of essential functions, including purifying toxins from the bloodstream, processing nutrients, and regulating hormone levels. Functional detoxes are a great method to keep your liver healthy.

A professionally designed detoxification plan can be a powerful way to hit the reset button for your hormones. It’s important to work with a professional when attempting to detox your liver. Some plans promote very low-calorie diets that starve the body of the nutrients needed to optimize the detoxification process. (7)

It May Be Time to Work With a Practitioner

Working with a hormonal practitioner or medical professional to get to the root cause of your specific hormonal acne is key because the root cause will be different for everyone.

Working with a practitioner will guide you down the right path of balancing your hormones in a healthy way. Treatment for a hormonal imbalance is determined by the cause. 

There are various natural ways to balance your hormones through nutritional supplements, modifying your diet, and even yoga has shown to aid with the symptoms of hormone imbalance for some. Hormones are in charge of important essential functions. When hormones are out of balance, the effects can be life-altering and critical to address. (8

Takeaway 

Though hormonal acne is triggered by a variety of different reasons and can differ from person to person, being educated and proactive can help in taking charge of your skin health and your health in general. Hormonal acne can be triggered as a result of typical hormonal changes but it can also be an indicator of a hormonal imbalance. 

There are multiple ways to combat hormonal acne safely and naturally. From modifying your diet, reducing stress through lifestyle changes, and ensuring all cosmetic and hygiene products are safe and won’t add to clogging your pores or disrupting your endocrine system, there are many options available to empower yourself and achieve your long term health goals.

 

Sources:

Source 1: How to Prevent Acne: 14 Tips to Manage Pimples https://www.healthline.com/health/acne/how-to-prevent-pimples#10

Source 2: Everything You Should Know About Hormonal Imbalance https://www.healthline.com/health/hormonal-imbalance#diagnosis

Source 3: Can you treat acne with a hormonal acne diet? https://www.medicalnewstoday.com/articles/hormonal-acne-diet#other-options

Source 4: Top 7 Foods That Can Cause Acne https://www.healthline.com/nutrition/foods-that-cause-acne#TOC_TITLE_HDR_8

Source 5: Four nutrients to help your hormone imbalance - and two foods to avoid https://wexnermedical.osu.edu/blog/four-nutrients-to-help-your-hormone-imbalance

Source 6: The Chemicals to Avoid in Your Shampoo and Body Wash https://www.healthline.com/health-news/the-chemicals-to-avoid-in-your-shampoo-and-body-wash#What-products-should-you-choose

Source 7: 7 Ways to Improve the Health of Your Liver https://www.healthline.com/health/liver-detox-home-remedy#bottom-line

Source 8: Everything You Should Know About Hormonal Imbalance https://www.healthline.com/health/hormonal-imbalance#treatment

Source 9: Hormonal treatment of acne vulgaris: an update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015761/

Source 10: Adult Acne Versus Adolescent Acne https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788264/

Source 11: A Qualitative Investigation of the Impact of Acne on Health-Related Quality of Life (HRQL): Development of a Conceptual Model https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825329/

Source 12: Menopausal Acne – Challenges And Solutions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825478/

Source 13: Hormonal treatment of acne vulgaris: an update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015761/

Source 14: Profiling and Hormonal Therapy for Acne in Women https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969667/

Source 15: Cutibacterium acnes (formerly Proprionibacterium acnes) and Shoulder Surgery https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6874694/

Source 16: Acne Severity and Sleep Quality in Adults https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445853/

Source 17: The association between stress and acne among female medical students in Jeddah, Saudi Arabia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5722010/

Source 18: What does acne genetics teach us about disease pathogenesis? https://pubmed.ncbi.nlm.nih.gov/30854635/

Source 19: StatPearls - Acne Vulgaris https://www.ncbi.nlm.nih.gov/books/NBK459173/

Source 20: Prevalence of acne vulgaris among women with polycystic ovary syndrome: a systemic review and meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529263/

Source 21: Circulating androgens in women: exercise-induced changes https://pubmed.ncbi.nlm.nih.gov/21142281/

Source 22: Hormonal treatment of acne vulgaris: an update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015761/

Source 23: Nutrition and acne https://pubmed.ncbi.nlm.nih.gov/21034984

Source 24: Spironolactone for the treatment of acne in women, a retrospective study of 110 patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440451/

Source 25: Spironolactone use and the risk of breast and gynecologic cancers https://pubmed.ncbi.nlm.nih.gov/24189467/

Source 26: Electrolyte Abnormalities in Patients Presenting With Ventricular Arrhythmia (from the LYTE-VT Study) https://pubmed.ncbi.nlm.nih.gov/32565090/

Source 27: Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/

Source 28: Safety of skin care products during pregnancy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114665/

Source 29: Dual Effects of Alpha-Hydroxy Acids on the Skin https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6017965/

Source 30: Does supplementation with green tea extract improve acne in post-adolescent women? A randomized, double-blind, and placebo-controlled clinical trial https://pubmed.ncbi.nlm.nih.gov/27062963/