Acne Is Likely Caused By Estrogen, NOT Androgens

[haidut]

Ray wrote several times that acne and its occurrence in "syndromes" like PCOS is an estrogen-driven phenomenon. However, the medical profession is firmly holding onto its dear idea that it is androgens like DHT, DHEA, T, and androsterone that are causing the acne and the insulin resistance in PCOS.
This study found no link between any androgen and acne. It concludes that previous studies linking acne and androgens suffer from methodological flaws - i.e. the population as a whole has very high (50%+) prevalence of acne and other studies have not really been able to isolate a true control group without acne in order to properly compare links between androgens and acne. Now, given that the connection between non-bacterial acne and one or more hormones is pretty well established, what remains is mostly estrogen and progesterone. And given that progesterone is commonly reported to ease acne, estrogen remains as the lone likely culprit as the second study below shows (at least in males).

http://www.ncbi.nlm.nih.gov/pubmed/2527050
"...Our data would be consistent with a weak relationship between acne and free DHT. However, it is important that this correlation should not be regarded as implying causation. Male DHT levels are much higher than female levels. Even the males with the lowest acne grades had mean DHT levels of at least three times that of the females with severe acne. Clearly, circulating DHT is not causing acne. However, DHT arises partly by peripheral conversion from testosterone and the results are consistent with greater rates of conversion in skin containing active sebaceous glands."

"...To conclude, there is little evidence that high levels of androgens are responsible for some young people having particularly severe acne. Circulating androgens play, at the most, a permissive role in acne. Much of the published clinical evidence is based upon an unsound experimental approach that fails to recognize the consequences ofthe high prevalence of acne."

Serum hormone levels in men with severe acne. - PubMed - NCBI
"...In order to evaluate the hormonal milieu in young men with severe acne, we measured serum estradiol (E2), total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) levels in sixteen male patients aged 20-30 years with severe acne, including twelve cases of nodular-cystic acne, and in seventeen age-matched normal controls. There were no significant differences in the serum levels of T, FT, DHT, DHEA-S, or SHBG between the patients and the controls, but serum E2 was significantly higher in the patient population. Thus, the hemodynamics of serum androgens in male patients with acne do not seem to differ significantly from that of normal controls. Elevated E2 levels might affect the inflammatory response of acne vulgaris through the release of thymic hormones, as reported in the literature."

 

[TheHound]

is there a correlation between acne and thinning hair?

 

[haidut]

is there a correlation between acne and thinning hair?

Some studies did find that, so possibly yes.

 

[TheHound]

Some studies did find that, so possibly yes.

also eating peat style has pretty much reduced my facial acne by about 95%, however back acne remains and some chest as well. these may have gotten a little worse eating this way actually. any reason for this?

 

[haidut]

also eating peat style has pretty much reduced my facial acne by about 95%, however back acne remains and some chest as well. these may have gotten a little worse eating this way actually. any reason for this?

See second study above - i.e. estrogen is likely cause. So, lowering it in any way should benefit you.

 

[dfspcc20]

Devil's Advocate question: wouldn't acne get worse as people age then, with menopausal women being the hardest hit? In my very limited experience and observations, acne seems to peak during puberty and young adulthood.

 

[Tenacity]

Devil's Advocate question: wouldn't acne get worse as people age then, with menopausal women being the hardest hit? In my very limited experience and observations, acne seems to peak during puberty and young adulthood.

That's a great question. I'd be very interested in the answer too.

I think I read that structural deformities like pectus excavatum and varicose veins are also caused by high estrogen. Can anyone confirm this? If this is true it kills four of my health issues (acne, thinning hair, pectus excavatum and vein issues) with one stone.

 

[lindsay]

Devil's Advocate question: wouldn't acne get worse as people age then, with menopausal women being the hardest hit? In my very limited experience and observations, acne seems to peak during puberty and young adulthood.

Well, for females it makes a lot of sense (not sure for males), due to the beginning of menstruation.

I don't understand why some people get acne and others don't, however. I never had acne (a zit would cause me to freak out) and I would always put myself into the more estrogen dominant (or rather lacking progesterone) category. However, I did suffer from eczema and always tend towards dry skin. So why some people get the one and others get the other, is beyond me.

 

[InChristAlone]

Yeah some of the only times my acne almost completely cleared were during pregnancy. I also get clearing middle of my menstrual cycle. Also getting enough sunlight can increase progesterone and therefore clear up acne.

 

[Dante]

Ray wrote several times that acne and its occurrence in "syndromes" like PCOS is an estrogen-driven phenomenon. However, the medical profession is firmly holding onto its dear idea that it is androgens like DHT, DHEA, T, and androsterone that are causing the acne and the insulin resistance in PCOS.
This study found no link between any androgen and acne. It concludes that previous studies linking acne and androgens suffer from methodological flaws - i.e. the population as a whole has very high (50%+) prevalence of acne and other studies have not really been able to isolate a true control group without acne in order to properly compare links between androgens and acne. Now, given that the connection between non-bacterial acne and one or more hormones is pretty well established, what remains is mostly estrogen and progesterone. And given that progesterone is commonly reported to ease acne, estrogen remains as the lone likely culprit as the second study below shows (at least in males).

Acne is not associated with abnormal plasma androgens. - PubMed - NCBI
"...Our data would be consistent with a weak relationship between acne and free DHT. However, it is important that this correlation should not be regarded as implying causation. Male DHT levels are much higher than female levels. Even the males with the lowest acne grades had mean DHT levels of at least three times that of the females with severe acne. Clearly, circulating DHT is not causing acne. However, DHT arises partly by peripheral conversion from testosterone and the results are consistent with greater rates of conversion in skin containing active sebaceous glands."

"...To conclude, there is little evidence that high levels of androgens are responsible for some young people having particularly severe acne. Circulating androgens play, at the most, a permissive role in acne. Much of the published clinical evidence is based upon an unsound experimental approach that fails to recognize the consequences ofthe high prevalence of acne."

Serum hormone levels in men with severe acne. - PubMed - NCBI
"...In order to evaluate the hormonal milieu in young men with severe acne, we measured serum estradiol (E2), total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) levels in sixteen male patients aged 20-30 years with severe acne, including twelve cases of nodular-cystic acne, and in seventeen age-matched normal controls. There were no significant differences in the serum levels of T, FT, DHT, DHEA-S, or SHBG between the patients and the controls, but serum E2 was significantly higher in the patient population. Thus, the hemodynamics of serum androgens in male patients with acne do not seem to differ significantly from that of normal controls. Elevated E2 levels might affect the inflammatory response of acne vulgaris through the release of thymic hormones, as reported in the literature."

Medical science says that free hormones have the most biological effect and SHBG/protein bound hormones have the least or nil effect. Ray said that this is not true atleast in case of thyroid hormones. Personally, i find it hard to grasp that only < 2% of circulating androgens ( free hormones) have biological effects. I remember one of the posts that ideally free T should low compared to total T for most bioavailability ,right? If that's the case , wouldn't higher Free serum DHT meant less DHT being used by local tissues/cells ?
Personally, I have been having acne issues for the past 2-3 years , tried doxycycline (made the cysts worse and caused bowel problems ), no abnormalities when it comes to total T and serum E2 in my lab test. My free T was twice above the normal range though. These tests were done 2 years ago .The acne subsided on their own later.
Recently , I took sertaline/zoloft for a two months period and all of a sudden i got really big cysts and nodules ( so i think in my case high serotonin was one of the factors). My total T was still 700 (200- 827 was the normal range) during the 2 month ssri period ( i thought ssri would downregulate T but may be that happens after prolonged use of 5 months or more )

Are you aware of any studies between increased serotonin levels and acne ?

 

[mangoes]

Medical science says that free hormones have the most biological effect and SHBG/protein bound hormones have the least or nil effect. Ray said that this is not true atleast in case of thyroid hormones. Personally, i find it hard to grasp that only < 2% of circulating androgens ( free hormones) have biological effects. I remember one of the posts that ideally free T should low compared to total T for most bioavailability ,right? If that's the case , wouldn't higher Free serum DHT meant less DHT being used by local tissues/cells ?
Personally, I have been having acne issues for the past 2-3 years , tried doxycycline (made the cysts worse and caused bowel problems ), no abnormalities when it comes to total T and serum E2 in my lab test. My free T was twice above the normal range though. These tests were done 2 years ago .The acne on their own later.
Recently , I took sertaline/zoloft for a two months period and all of a sudden i got really big cysts and nodules ( so i think in my case high serotonin was one of the factors). My total T was still 700 (200- 827 was the normal range) during the 2 month ssri period ( i thought ssri would downregulate T but may be that happens after prolonged use of 5 mo

Are you aware of any studies between increased serotonin levels and acne ?

Yeah I'd be interested to hear if there's a correlation between serotonin and acne too. I have so many symptoms (like acne) that could be attributed to high estrogen but mine is out of range low. And even prolactin is nicely on the low end of the range too.

 

[keith]

Aren't birth control pills usually mostly estrogen, and doesn't that usually help with acne. I think I read that they contain progesterone too, so maybe that mitigates the effect, but I was under the impression it was mostly estrogen.

 

[XPlus]

Personally, I have been having acne issues for the past 2-3 years , tried doxycycline (made the cysts worse and caused bowel problems ), no abnormalities when it comes to total T and serum E2 in my lab test. My free T was twice above the normal range though. These tests were done 2 years ago .The acne subsided on their own later.

Doxycycline's job is to reduce the population of existing bacteria where it reaches. Anything that happens after this depends on your lifestyle choices and the environment.
Regardless of your total and free T counts, places where blood flow is weak, light and ventilation are non-existant and temperature is low can be easily undermined by a new bacterial invation. For e.g. leaving the AC on at night while taking doxycycline, could probably leave you with a cyct on earlobe, on the short-term. Similarly, eating large amounts of starch and fibre while on doxycycline could be counterproductive if you already have slow digestion.
It is also possible that calcium may reduce the efficacy of doxycycline. So taking it at a different time than calcium-rich foods is probably a good idea.

 

[ilovethesea]

Ray has said estrogen causes oil glands to atrophy.

"Estrogen causes the oil glands to atrophy, so the skin doesn't support bacterial growth so well." - this is from the Peatarian email exchanges.

So maybe - lower levels of estrogen can give you acne, but people with extremely high estrogen (like menopausal women) don't get acne because it has impaired the oil gland function.

 

[haidut]

Ray has said estrogen causes oil glands to atrophy.

"Estrogen causes the oil glands to atrophy, so the skin doesn't support bacterial growth so well." - this is from the Peatarian email exchanges.

So maybe - lower levels of estrogen can give you acne, but people with extremely high estrogen (like menopausal women) don't get acne because it has impaired the oil gland function.

If you ask him specifically about acne, he will tell you it's estrogen and adrenal driven.

 

[Dante]

Doxycycline's job is to reduce the population of existing bacteria where it reaches. Anything that happens after this depends on your lifestyle choices and the environment.
Regardless of your total and free T counts, places where blood flow is weak, light and ventilation are non-existant and temperature is low can be easily undermined by a new bacterial invation. For e.g. leaving the AC on at night while taking doxycycline, could probably leave you with a cyct on earlobe, on the short-term. Similarly, eating large amounts of starch and fibre while on doxycycline could be counterproductive if you already have slow digestion.
It is also possible that calcium may reduce the efficacy of doxycycline. So taking it at a different time than calcium-rich foods is probably a good idea.

Intresting infos . Didn't know about this. doxy was prescribed be a derm and he didn't tell such info. As for the diarrhea and loose motions, a gastro MD said that prolonged use of doxy can kill both good and bad bacteria and can lead to gram negative overgrowth later. The bowel problems went away when i took VSL#3, a bifidobacteria & lactobacillus probiotic.

 

[ilovethesea]

If you ask him specifically about acne, he will tell you it's estrogen and adrenal driven.

Yes I know, I've exchanged emails with him on the topic . He will also tell you it's caused by low thyroid.

What I meant above was estrogen is a cause of acne but perhaps past a certain point - i.e. when estrogen gets SUPER HIGH, eg post menopause or on birth control pill - is when the atrophy happens. That's why for some people it seems to cause acne and for others it clears it.

It's very well known that oral contraceptive pill clears most women's acne.

 

[Evan]

I've been working on a book about acne, sort of in the style as how Danny Roddy writes about hair loss, where my own and Ray's research emulsify into sound logic, and this study is a big foundation in my research and theories, It's the smoking gun for sure. I definitely believe adrenal stress could have a lot to do with it also. When I was younger, anxiety and mental stress's were huge recurring states, and I believe it definitely had a big contribution to my acne for sure. Other things like diet, gut issues, chronic tobacco and marijuana use I'm sure factored into it, (more so gut issues) but poor self image, depression, and anxiety I believe were the largest factors.
Im hoping I can contribute novel ways to eradicate this condition in a sound and effective way.

 

[beachbum]

Hello all,

I just wanted to put my 2cents in. I have had acne since 20 years old and hasn't stopped until about 6 months ago. I have been in Menopause for 1 1/2 years now, but I just started using progesterone within that time frame too. they say progesterone drops more so then estrogen but come menopause estrogen drops too, but if your ratio is way off you can still be estrogen dominant. I have had awsome skin before that in high school but when I got married I went on birth control pills for only 8 months because I started breaking out and haven't stopped until recently. I had a history of hypothyroidism at that time too (goiter). I also had endometriosis. I also experienced crazy symptoms a year ago when a cyst on my ovary ruptured (only have one, the other was removed, wish I didn't do that, anyway) so now I believe I have just about no more ovary function is why I think I use alot of progesterone. so my point is I think from estrogen dominance but if adrenal excess can cause it that would be my number one cause unless it goes hand in hand with estrogen dominance. I also get chin hairs too.

Thank you

 

[johnwester130]

Devil's Advocate question: Wouldn't men turn into women as they get older, since estrogen rises ?