Hormonal Acne in Men is Different- And Sometimes Worse

February 12, 2021
Hormonal Acne in Men is Different- And Sometimes Worse

Acne is normal for male teenagers but may persist into your 20’s and even 30’s (so sorry guys!) In this post, Dr. Zenovia explains the causes of male acne, symptoms of hormonal acne, how male acne differs from female acne, and easy to follow skin tips to help eliminate and prevent mild to moderate breakouts.

Causes of Male Acne

For men (and women), one of the main triggers of acne are fluctuations in hormone levels. Testosterone, the male-dominant androgen hormone has many receptors on the sebaceous gland. While both men and women produce androgen hormones, men secrete much more oil because they produce more testosterone. Fluctuations in testosterone levels increase sebum production and when this secretion is coupled with a clogged follicle it leads to bacterial overgrowth, causing inflammation and acne breakouts. Although men do not experience a monthly cycle of fluctuating hormones like females do, there are activities that can alter the testosterone level in the body and at the skin level leading to more acne. Stress, exercise, sexual intercourse, age, and your genetic profile all affect the level of testosterone in your body and hormone spikes in general.

Facial hair on men can also serve as a breeding ground for bacteria and trap oil. However, it is important to note that some men get facial bumps that look like acne but ingrown hairs or folliculitis in the neck area are the real culprit- mimicking traditional acne.

To avoid these problems, it is important to use a clean razor and moisturize before and after you shave. Also, if you have sensitive skin (meaning, you break out after you shave) you may want to try using an electric razor or shave in the direction of hair growth, rather than against it which can irritate the skin.

Acne also has a strong genetic component- men whose fathers or mothers had acne are more likely to get it too. Our genetic makeup largely determines the type, density, and sensitivity of our receptors on our cells to the hormones in our body. When you see a family where all the members have acne it is wrong to assume they have elevated testosterone levels. They have normal testosterone levels, but their skin has a higher density of testosterone receptors making them more sensitive to any level of testosterone. A receptor on a cell is the keyhole or specific-shaped protein that our hormones (and other signal peptides) attach to in order to signal a cellular response. Therefore, if your body produces acne, your testosterone levels may be totally normal, but your body simply is more genetically receptive to that hormone which creates more downstream effects at the skin level including more acne.

Men and women can both experience acne from puberty into adulthood. Men, however, tend to have acne for longer periods of time. Males have a longer phase of acne in their lifetime lasting from puberty to early-mid adulthood. In addition, severe forms of inflammatory acne like acne conglobate or PAPA syndrome (a combination of acne, arthritis, and pyoderma gangrenosum) mainly occur in men because high testosterone is the culprit. These are devastating forms of acne scarring and need immediate medical attention. Severe scarring often occurs and men can experience depression and mental illness from the shame of these disorders. Anabolic steroids and other drugs can also worsen acne. Any medication you believe is worsening your acne should be stopped.

Identifying Hormonal Male Acne

Hormonal acne is characterized by raised, red, and tender bumps or large red/white bumps filled with pus. Cysts are deep pimples without an opening on the surface. These pimples tend to be deeper than superficial whiteheads or blackheads. Hormonal acne often involves the lower half of the face including the cheeks, jawline, chin, and neck. Hormonal body acne is also common because men have a higher density of sebaceous glands per hair follicle on their chest, shoulders, and back.  

Related Article: How to Get Rid of Cystic Acne

Dr. Zenovia’s Tips for Male Acne Treatment

To effectively prevent and clear acne breakouts, Dr. Zenovia recommends that men wash their face every morning and night to clean the skin. Dr. Zenovia’s 10% Benzoyl Peroxide Acne Cleanser gently removes everyday impurities and excess sebum. This cleanser contains 10% Benzoyl peroxide, a powerful concentration that can also be used in the shower to clean the back, shoulders, and chest. Benzoyl peroxide mainly has antibacterial properties but also serves as a keratolytic agent, meaning it works to open congested pores.

Next, apply a spot treatment on any blemishes. Dr. Zenovia’s 5% Benzoyl Peroxide Acne Spot Treatment is clinically formulated to clear flare-ups and prevent the development of new acne blemishes and blackheads.

In addition, it is important to use a lightweight, oil-free hydrator to moisturize the skin barrier. Many wonder if they need a moisturizer in their acne regimen- and the answer is yes! This is primarily due to the fact that products formulated for acne can dry out your skin. A lightweight moisturizer will hydrate your tissue and preserve that critical barrier necessary for healthy skin. Dr. Zenovia’s Aloe Vera Blemish Soothing Moisturizer is infused with medical-grade aloe vera to soothe sensitive acne-prone skin. This product is light enough to not make you oily and doesn’t contain fragrance. Men love the lightweight feel and neutral scent of this moisturizer!

Lastly, and equally important, is to apply a retinol 1-2 times a week. Retinol therapy is the gold standard for acne prevention and therapy! It is a powerful agent that sloughs dead skin cells, preventing clogged pores which is the hallmark of the formation of new pimples. Retinol also decreases oil secretion because it shrinks the oil glands over time. It is also a comedolytic agent, meaning it breaks down comedones and blackheads to clear your pores of debris. Dr. Zenovia’s Advanced Retinol Night Repair Treatment features our highly concentrated All-Trans-Retinol Technology that deeply penetrates the epidermis through a unique micro-polymer delivery system to support cellular turnover. With regular usage, the appearance of acne, acne scars, texture and tone is visibly improved.

Read More: How to Get Rid of Hormonal Chin Acne

An effective topical regimen is the first line for acne treatment. The critical element is to use the two actives: benzoyl peroxide and retinol.

When it comes to acne scarring, the best treatment is to prevent it in the first place! Treat pimples that flare-up and stick to an acne-fighting regimen. When it comes to shaving, try to avoid getting the blade on any blemishes as this can cause further irritation.

If you are scarring and have deep, chronic cysts Dr. Zenovia recommends seeing a board-certified dermatologist. Acne is treatable and doesn’t last forever, but scarring can last a lifetime.  

Note from Dr. Zenovia: It’s important to gradually incorporate ingredients like Benzoyl Peroxide and Retinol into your routine. If excessive dryness or irritation occurs, reduce application. Additionally, since these ingredients can increase sensitivity to the sun, be sure to follow with an SPF sunscreen during the day.

Workout-Induced Acne Breakouts

When we exercise and sweat our body heat increases, the skin increases its oil production, and our pores dilate which can leave the skin vulnerable to debris and bacteria. Making a few simple lifestyle changes can help prevent exercise-induced acne flare-ups. Dr. Zenovia recommends opting for breathable workout clothing and a thinner microfiber gym towel. Thicker and plusher towels may seem like a good option for dabbing excess sweat but can be a host for bacteria.

After a workout, it's imperative to take a shower and wipe down your face with an acne wipe or cleanser. The longer that sweat from a workout stays, the higher your chances of an acne flare-up. Dr. Zenovia’s 10% Glycolic Acne Control Peel Pads are packed with glycolic and salicylic acid to slough dead skin and clean the skin’s surface with one quick swipe. These peel pads are an excellent adjunct therapy to make your other acne topicals work better! By sloughing down the dead layer you can absorb your products deeper and they become more effective. These pads are a no-brainer for anyone who wants to clear their acne faster. They are convenient for anyone who works out and can’t get to the shower to wash their face from the sweat and debris right away. Also, don’t forget to wash your gym towel, clothes, and clean your headphones between each workout session!

How to Treat Stubborn Male Acne & Scarring

If you have tried topical treatments consistently for 2-3 months and still don’t see any improvement or if your acne is severe, consult a board-certified dermatologist to receive an evaluation for a personalized acne treatment plan. Your doctor may prescribe oral medication such as antibiotics or isotretinoin for more severe, persistent cases.

Do not let your skin scar before you seek help! Even though there are treatments for scarring, active acne must be treated completely before acne therapy can ensue.

There are a host of professional treatments for scarring including chemical peels and laser resurfacing. Again, don’t wait until you need these treatments- get help with your acne and start early.


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