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Hormonal acne in men: What causes it, how to treat it and how to prevent it through lifestyle choices?

Hormonal acne in males can be a concerning illness for most men due to the cosmetic effects, inflammatory pain, and judgement from peers associated with acne. The disease is primarily triggered by fluctuations in particular androgens (testosterone, for example). These androgens tend to stimulate sebaceous glands (the oil glands on your skin), leading to increased oil/sebum production. Sebum, when in excess, combines with dead skin cells and clogs pores on the skin; This allows acne-causing bacteria to thrive, as this clogged environment is exactly what they need to reproduce and survive in. Hormonal changes during moments of stress, puberty, and even certain other medical predicaments can contribute to hormonal acne.

The primary hormones involved in hormonal acne are androgens like testosterone. High levels of DHT, also known as dihydrotestosterone, a hormone derived out of testosterone, further contributes to more sebum production and leads to severe acne development. Acne caused by hormones in males, tend to manifest as comedones (Whiteheads and Blackheads), inflammatory lesions (Papules, pustules, nodules, or cysts) and can lead to scarring if not properly treated.

Treatment for hormonal acne involves a multi-faceted approach on a case-to-case basis:

1.      Benzoyl peroxide: Typically administered as a gel for daily application on the skin, benzoyl peroxide has antimicrobial properties (which means that it kills/reduces the acne-causing bacteria on one’s skin)

2.      Retinoids: Retinoids help to unclog pores and promote cell turnover (shedding old skin cells), preventing the formation of new acne lesions and reducing pustules, papules and other types of inflammatory acne.

3.      Antibiotics: These also help to reduce inflammation, but they do this by controlling bacterial growth.

4.      Hormonal therapy: In certain severe cases, medications like anti-androgens or oral contraceptives may be advised to patients.

Lifestyle tips for those with hormonal acne:

1.      Good hygiene: Men with hormonal acne should wash their face twice a day using clean hands and a mild cleanser to remove the excess sebum, prevent bacterial growth, and prevent clogging of the facial skin with foreign pollutants.

2.      Non-comedogenic products: Those with this problem should strictly stick to non-comedogenic products for skincare and grooming to avoid clogging their skin during their daily routine.

3.      Balanced diet: Consume fruits, vegetables, and whole grains while limiting dairy and high-glycemic index foods (sugary, processed foods) in your diet.

4.      Adequate sleep: Sleeping for 8-10 hours a night can be beneficial for most teenagers (the most common age group for hormonal acne) to ensure their hormonal health is at its peak condition.

5.      Hydration: Drinking enough water with or without electrolytes (found in coconut water, rehydration salts, etc.) can promote supple skin and ensure that your skin cells are as healthy and hydrated as possible.

Hormonal acne in men, caused by fluctuations in androgens like DHT and testosterone can be appropriately managed with treatments like benzoyl peroxide, retinoids, antibiotics and hormonal therapy; or can be treated holistically through lifestyle changes like good hygiene, using non-comedogenic products, eating a balanced diet, sleeping enough, and being hydrated. Overall, even though hormonal acne is often a shame-associated illness, it can be treated and should not be stigmatized or considered as contagious.

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