Looking for answers about acne? Well, this is zit! We chatted with Dr. Terry Loong (she/her), integrative skin/hormone doctor and GLITCH’s skincare expert, about blemishes, how (and which) hormones come into play, and what products and methods you need to know when it comes to taking care of your body’s outermost layer.

“I’ve always felt the skin is not just a shield to protect us from the external environment, but also a mirror to reflect our internal universe,” she says. “When there is alignment, expansion, and flow, the skin glows. When there is stagnation or suppression, we can only ignore it for so long until our body can’t take anymore and rebels. It’s the only way to get our attention to change things because what’s “working” is no longer working. Acne is not bad, and it does not make you a bad person. It’s your skin’s way to ask you to pay attention and to listen closely.”

Now let’s pop some questions (but not pimples)!

So, adult acne: Does it ever just go away?
Adult acne can be caused by a variety of reasons, with hormonal imbalance being one of them. If there is nothing else affecting the skin, acne can possibly disappear when hormones start to decline in perimenopause and menopause.

What are the different hormones that affect skin?
There are 50+ hormones in our body and I have found there to be 6 major players for skin, specifically:

1. Cortisol: The stress hormone. Also regulates immunity, inflammatory response, and blood sugar regulation.
2. Estrogen: The diva hormone. In charge of the skin’s hydration, color, and firmness.
3. Progesterone: The calming best friend. Helps to calm the skin, mind, and mood.
4. Thyroid: The builder. In charge of metabolism, weight, and energy. If it’s low, the skin can be very dry.
5. Testosterone: The bad boyfriend. You need a little to feel sexy and confident. Too much can lead to increased oil production, extra facial hair, and loss of hair on the scalp.
6. Insulin: The gatekeeper. In charge of balancing blood sugar levels, energy production, and fat storage. Too much insulin can lead to increased testosterone.

How do we know if our acne is hormonal?
Hormonal acne is usually cystic and typically in the lower half of the face. Hormonal acne can eventually become infected with bacteria when there is redness, increased pain, heat, and pus.

What products do you recommend if hormones are affecting our skin?
Hormones tend to go out of balance as a response to something else, usually due to internal or external stress. Stress can be obvious like exams or job interviews, or not so obvious things like gut dysbiosis, food intolerance, or stagnation of the lymphatic system. With skincare, less is more. Meaning, how you apply the products is equally as important as what you apply.

I would keep it simple with a gentle cleanser like this one from La Roche-Posay, a hyaluronic acid from The Ordinary, and a moisturizer with antioxidants like GLITCH’s AM and PM Hybrid Treatment serums + moisturizers.

How about treating hormonal acne if you don’t want to use too many products?
For hormonal acne, I would focus on reducing inflammation, balancing blood sugar levels, and encouraging flow (ex: lymphatic system, blood circulation, detoxification, and parasympathetic nervous system). You can do this through food, supplements, lifestyle changes, and skincare to help calm the skin and reduce breakouts.

What about vitamins? Which one(s) should we use in our regime?
Vitamin A, B, C, D, and E are great to incorporate into your skincare routine. Vitamins A and C are great for repairing skin, preventing collagen breakdown, supporting blood circulation, and giving you that glow. You can take these internally through food or via skin products. Vitamin B is important for boosting progesterone, the calming hormone which will help reduce breakouts and redness. You can get it through food such as eggs, avocado, and whole grains, and through skincare including niacinamide. Vitamin D is powerful because it fights inflammation. You can get it via sunlight and taking a supplement. Vitamin E helps to maintain the skin’s moisture and helps to balance the oil production.