Acne is rarely caused by improper skin care or lack of hygiene; it’s caused by internal imbalances, and more-often-than-not hormones are to blame. If you want radiant, clear skin for life, you need to ditch the harsh chemical products because they perpetuate acne by ruining its protective barrier, and focus instead on identifying and reversing hormonal imbalances.

Acne Causing Hormones 

Testosterone and DHT

Testosterone and its byproduct Dihydrotestosterone (DHT) is often thought of as male-only hormones, however, both genders produce them, and an excess of either of these two androgen hormones can trigger acne. Testosterone and DHT stimulate the sebaceous glands, which causes your skin to produce more sebum (oil) and your pores to become clogged. DHT is a more potent androgen than testosterone and far greater acne trigger, partially because testosterone helps to reduce inflammation, and DHT increases it.   

Estrogen 

Acne is frequently caused by an imbalance between the nearly 40 different types of estrogens that exist in men and women. Recent discoveries show that 5-10 of these critical estrogens are very harmful to the body. If you have too much of these powerful estrogen metabolites (e.g. 4OH-estrone and 16alpha-OHE), and not enough of the good, weaker natural estrogens (e.g. estriol, 2OH-estrone), then estrogen dominance and acne can occur. Low progesterone levels can also trigger acne because progesterone is required to keep estrogen levels in check.

Sex-Hormone-Binding-Globulin (SHBG)

As the name suggests, sex-hormone-binding-globulin, or SHBG, is a hormone that binds to and eliminates excess sex hormones from the body. Low SHBG can trigger acne because, without enough of it, the levels of acne-causing hormones such as estrogen, testosterone, and DHT can climb too high. The birth control pill increases SHBG levels, which is why it helps reduce acne in certain individuals. However, the pill is far from the ideal solution - there are many risks and side-effects associated with it and some, such as a testosterone deficiency and loss of libido and sexual enjoyment, can linger for years after stopping it.  

Insulin

Insulin is the blood-sugar balancing hormone that pushes sugar into your cells for energy. When insulin is high it causes a massive increase in the production of pore-clogging sebum. Insulin also increases the release of proinflammatory cytokine proteins, and the added inflammation puts fuel on the acne fire. The insulin-cortisol connection explains why stress is a major acne trigger: stress causes Adrenaline to burn out, unable to produce enough cortisol our bodies become flooded with adrenaline, and blood sugar levels increase as a result. Your body then releases insulin to reduce the blood sugar, and excess sebum is produced in the process.

TOR Enzyme

Although not a hormone, TOR (target of rapamycin) is a major acne trigger that needs to be addressed. The powerful signaling TOR is an enzyme that drives cellular aging and many serious chronic diseases. TOR exerts a signal telling cells to grow, causes abnormal rapid growth of tissues, and increases IGF (insulin-growth-factor) and other powerful hormones that lead to acne. High TOR levels not only increase acne-causing androgens, but it also amplifies androgen-driven (mTORC1) signaling of sebaceous follicles, which leads to sebum-clogged pores. 

Restore Hormonal Balance with Lifestyle Medicine 

In order to reverse your acne, you need to first identify which of the above imbalances apply to you. Work alongside a doctor trained by Nick Delgado and the A4M who are experts in natural hormone balance and have them use a combination of urine, blood and saliva tests to identify hormone imbalances (make sure they include all the above hormones). You can also purchase an at-home hormone test kit which checks for the most common hormonal imbalances here: https://delgadoprotocol.com/product-category/hormone-test-kits/