Everything To Know About Hormonal Cystic Acne

Of all the annoying, disheartening, infuriating PMS symptoms, acne has got to be one of the worst. At least with the rest, you can hide them in some way, right?! But acne is always there, front and centre, ready to ruin your confidence at a time when you’re already feeling pretty lousy. 

Around 50% of people with periods aged 20 to 29 suffer from acne, and it affects those younger and older, too. There are many different types of acne, but here we’re focusing on what is arguably the worst kind of all; hormonal cystic acne. 

What is hormonal cystic acne? 

Cystic acne is when a cyst builds up underneath the skin due to bacteria, oil or dry skin cells trapped inside pores. Anyone can end up with cystic acne, but the hormonal kind tends to affect those who experience oily skin due to fluctuating hormones. Mainly teenagers, people with periods, and anyone with a hormonal imbalance. 

You are most likely to develop cystic acne in your teens or early 20s, and it could affect your face, shoulders, upper arms, chest, and back. You may be more likely to suffer from it if one of your parents did, and people with periods tend to find they get cysts on the lower half of their face. Sometimes this improves with age, but it usually takes a helping hand to treat it. 

How is it different from other types of acne? 

Compared to regular acne which affects the surface of the skin, cystic acne is pretty intense as it tends to be the largest in size and begin deeper in the skin. It may look like a large white raised lump surrounded by redness, a bit like a boil. Cysts are usually tender to touch, but they’re filled with pus, so very tempting to pop! Acne cysts can also leave long-lasting deep scars that look like tiny holes, uneven skin, or wide, shallow indents. 

What causes it? 

With hormonal acne, it’s a hormone called androgen that throws everything out of whack. In teenagers, levels of androgen rise which causes clogged pores, and leads to acne. Similarly, those with fluctuating hormones could experience the same results, and some people get regular period acne. This can happen to those with PCOS (polycystic ovary syndrome), those on certain medications, or simply during PMS, when pregnant, or going through menopause. 

You may hear rumours that things like greasy foods, too much chocolate, or not washing your face often enough could be causing the problem, but this is not the case with hormonal acne. Even those with the healthiest, most strict diet and wellness routine can suffer from this if their hormones aren’t playing ball. 

What about scarring? 

Unfortunately, cystic acne is the most likely kind of acne to leave scars behind. And the best way to reduce the chance of this happening? Don’t. Touch. Cysts. We know; easier said than done. Picking and popping cysts not only increases the chance of being left with scarring, it can also spread bacteria around the face, leading to even more acne. Try your best to leave all cysts alone no matter how much you want to keep popping! 

If you have scars from past acne, there are skin treatments that may reduce their appearance such as chemical peels, dermabrasion and laser resurfacing from a dermatologist, but you should only go through with treatments like this if your acne has properly healed. 

What can I do about my cystic acne?

While medications that treat regular acne aren’t strong enough to work on cystic acne, it’s certainly not a lost cause! There are many cystic acne treatment options available, including: 

• Antibiotics that control bacteria and reduce inflammation
• Birth control to regulate your hormones
• Ointments like benzoyl peroxide to kill bacteria and calm inflammation
• Creams like retinoid (a form of vitamin A) to help unclog pores and assist antibiotics
• Medications like isotretinoin to shrink sebaceous glands and reduce oil production 
• Steroids injected into cysts by a doctor

It’s really getting me down. Is there anything else I can do?

Any kind of acne can feel demoralising and isolating, and in severe cases can make people withdraw from social events and daily activities. It can have adverse effects on your mental health, so keep in mind that if you are experiencing low mood due to issues with acne, you should discuss this with your doctor. They can try different treatments until you find something that works for you. 

Be persistent to find a solution, and in the meantime know that in most cases cystic acne resolves itself over time, so don’t be disheartened if you need to try multiple treatment options to find what works for your skin. 

Do you suffer from hormonal cystic acne? You may find others with similar issues in our Full Stop FB group. Reach out with questions there, or on Insta at @itsyoppie. Don't forget that our personalised period box can get full-cycle menstrual care from organic tampons to skin-calming charcoal sheet masks (and more) delivered easily and regularly through your letterbox so you've got one less thing to worry about during your cycle.