Not-so-fun fact: Sebum production is controlled by hormones, specifically androgens, board-certified dermatologist and founder of NicholsMD of Greenwhich Kim Nichols, M.D., FAAD tells mbg. Androgens cause the enlargement and overstimulation of the sebaceous glands found in the hair follicles, she explains. Then, this sebum snatches up dead skin cells and clogs the pore, resulting in a breakout.
Estrogens have the opposite effect, meaning they inhibit the secretion of androgens, modulate genes involved in the growth of the sebaceous gland and inhibit their function. The activity of the sebaceous gland, therefore, depends on the estrogen and androgen ratio1—which is why many people consider birth control pills containing estrogen as a possible form of treatment.
You’ll generally find hormonal breakouts on the chin and along the jawline, often going down onto the neck as well. Back and chest acne can also be linked to hormone imbalances. Some breakouts can be pustules and papules (inflamed zits with a white head), while others can be cystic and under the skin.
“Cystic pimples are deeper, larger, and can occur when the bacteria, sebum, and dead skin cells become trapped beneath the surface of the skin and can cause a large and painful bump,” Nichols explains. And yes, you can have a combination of both.
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