• Dr. Sarah Dimunno, ND

The Scoop on Skin and Sex Hormones

Picturing puberty can bring back memories of changing voices, hair in new places, mood swings and pimples. Most understand puberty as physical changes initiated by hormonal fluctuations in estrogen and testosterone as a youth (beginning between 10-12 years old). Sex hormones cause changes even outside of the reproductive system including the brain, bones, muscles, blood, skin, and hair. Puberty can be a teenager’s worst nightmare but for some, this terrible set of symptoms doesn’t end. Today’s article is going to focus on hormonal acne.

Hormonal Acne

Do I have hormonal acne? In females, hormonal acne can appear or worsen in a cyclical fashion which occurs before or after your menstrual period every month. If your acne is predominantly on the chin, this can also be a clue that your acne is hormonal in nature. Finally, If you’ve received benefit from taking oral contraceptive, your acne is likely due to hormonal imbalances.

Why? Testosterone, although thought to be solely male related, is actually produced in small amounts by the ovaries. Androgens (male sex hormones) stimulate sebum production creating an enticing environment for bacteria to live and voilà – a pimple has formed! Many females get an aggravation of acne before their menstrual cycle because this is when estrogen levels naturally decline. Estrogen and testosterone compete to stimulate the sebaceous glands in the skin. Normally estrogen wins this battle causing the sebum to liquefy. However, when estrogen levels decline, they are no longer able to inhibit the binding of testosterone to the sebaceous glands. As a result, androgens bind and activate them leading to an increase in oil production and bacteria inhabitation aka more pimples. A few days after menstruation the estrogen levels rise allowing symptom relief.

How can I solve this? Treatment for hormonal acne would typically include focusing internally and correcting hormonal imbalances. The problem might involve having too many androgens as in conditions like PCOS (Polycystic Ovarian Syndrome), too little estrogen, or even high estrogen making the drop of hormones before menses relatively really low. Bottom line it's complicated. As mentioned above, conventional medicine commonly suggests the oral contraceptive pill as a solution which is effective but isn’t always well tolerated due to side effects. However, the contraceptive pill doesn't treat the root cause and for that reason your acne is likely to return after stopping the pill. Alternatively, botanicals such as Black Cohosh and Chasteberry have shown to be useful in modulating hormonal effects. Including anti-androgenic foods into your diet like pumpkin seeds can help decrease testosterone levels. It should be highlighted that hormone balancing is a tricky process due to feedback systems compensating for changing hormonal levels. This is why a unique treatment plan should be created for just YOU and your hormones!

Bonus Skin Care tips! When considering hormonal related acne, you want to encourage your body to limit the build up of excess hormones. This can be done by supporting your natural detox pathways and avoiding hormonal exposure. Most people think about the liver when I say the word detox, which is true, but detoxing through sweating and having regular bowel movements is important too. When you don’t have a regular BM, your body reabsorbs the hormones and toxins it tried to get rid of, adding to a hormonal imbalance. Switching from plastic to glass is not only great for the environment but also for limiting your exposure to endocrine disrupting chemicals that mimic naturally occurring sex hormones. Switching to sources of clean meat will also aid in decreasing your consumption of exogenous hormones. Focusing on these internal root causes will help clear your skin externally. Treatment works best when you have an individualized plan that considers all aspects of you and your health history. If you are interested in investigating your hormonal acne further, please don’t hesitate to contact me at


  1. Black Cohosh. Natural Standard Database Web site. Accessed at on July 4, 2016.

  2. Chasteberry (Vitex agnus-castus). Natural Standard Database Web site. Accessed at on July 4, 2016.

  3. Heldring, N., Pike, A., Andersson, S., Matthews, J., Cheng, G., & Hartman, J. et al. (2007). Estrogen Receptors: How Do They Signal and What Are Their Targets. Physiological Reviews, 87(3), 905-931.

  4. Hong, H., Kim, C., & Maeng, S. (2009). Effects of pumpkin seed oil and saw palmetto oil in Korean men with symptomatic benign prostatic hyperplasia. Nutrition Research And Practice, 3(4), 323.

  5. Hormonal Treatment of Acne in Women. (2009). The Journal Of Clinical And Aesthetic Dermatology, 2(12), 16-22.


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the  Eternal Dreamers.

Disclaimer: Any information on this website is for informational purposes only and are not intended to be used in place of professional medical advice.

Always seek the advice of a qualified health care practitioner with any questions or health concerns you may have.


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