Adult acne is definitely one of the more frustrating healthcare problems we can be faced with. This is especially true because oftentimes we resort to treating the symptoms (i.e. breakouts) without looking into the true source of the problem.
Many people assume that the cause of breakouts is estrogen, progesterone, or testosterone, since the fluctuating cycles of those hormones are generally the cause of much-hated acne during puberty.
In actuality, the thyroid hormone (or rather, the lack thereof) is more commonly the cause behind acne in most adult patients.
What is Hypothyroidism?
Your thyroid gland (located in your neck) is essentially the powerhouse behind your entire endocrine system. The thyroid produces the hormones that are responsible for regulating your metabolism, converting calories into energy, and any growth/repair of your cells.
When your thyroid is not performing as well as it should, that is called hypothyroidism. Hypothyroidism can cause a number of health problems, including difficulty losing weight, insomnia, constantly feeling cold, digestive issues, cognitive dysfunction… and acne[i].
Hypothyroidism is sometimes difficult to identify because the symptoms are rather varied, and often attributed to other preexisting conditions. However, if you suspect your thyroid may be under-active, it can be diagnosed easily with a simple blood test.
Women are considered to be five to eight times more likely to suffer from thyroid disease than men. Current data suggests that up to 12% of the American population (roughly 20 million people) will develop a thyroid condition during their lifetime[ii].
How Does Hypothyroidism Cause Acne?
Your thyroid gland is responsible for creating the hormones that help the body convert cholesterol into the steroid progesterone, which is vital in preventing breakouts. So naturally, when your thyroid is under-performing, your body is receiving lower amounts of progesterone, which in turn means comparatively higher levels of estrogen and a greater chance of seeing acne.
For women, this problem is sometimes treated using birth control pills. However, this solution only treats the symptom, rather than addressing the root cause.
Progesterone also helps control the production of enzymes called 5 Alpha Reductase in males[iii]. This enzyme is produced by a form of testosterone called dihydrotestosterone (DHT). Excess of DHT in the body contributes to oily skin and clogged pores, which means more frequent breakouts.
Additionally, Hypothyroidism can contribute to poor circulation, which means that less blood (and therefore less oxygen) is making it to your skin cells. When your skin cells aren’t properly oxygenated, they regenerate less easily, and the excess of dry/dead skin cells will also be a factor in increased breakouts.
A study done in 2009[iv] measured the frequency with which patients suffering from thyroid diseases exhibited skin complaints like acne (in comparison to healthy patients as a control group). The study found that of the 220 thyroid patients examined, nearly 57% had some manner of skin complaint, ranging from acne, dermatosis, chronic urticaria (hives), and pruritus (severe itchiness). This study was the first to suggest that the thyroid could be the cause behind a wide range of skin conditions.
Treatments for Hypothyroidism
If you suspect that you may have hypothyroidism, then there are a few different solutions you can discuss with your doctor. In general, hypothyroidism is difficult to truly cure, but it easily managed with a careful regimen of thyroid replacement medication.
Synthroid (levothyroxine sodium)[v] and Cytomel (liothyronine)[vi] are two of the most commonly prescribed artificial thyroid replacement medications. There are more natural options, such as Armour Thyroid[vii]; these types of medications are called Natural Desiccated Thyroid Drugs (NDTs) and are derived from the glands of animals.
However, most doctors are reluctant to prescribe an NDT over drugs like Synthroid or Cytomel, and it is often difficult to find pharmacies who are able to fill the prescription.
Every person has different needs in relation to the thyroid, and those needs may fluctuate over time depending upon your age, overall health, and other factors. It may take a while to find a dosage that is correct for you.
Your doctor will need to monitor you for up to 8 weeks following the start of a thyroid replacement regimen in order to ensure that your body is responding appropriately to the medication, and that you are benefiting from the dosage prescribed.
If you find that you are suffering from adult acne and have had little success in controlling your breakouts with a healthy diet and basic skincare, it may be time to discuss the possibility of hypothyroidism with your doctor.
As mentioned before, hypothyroidism is relatively common and is easily controlled with proper medical care, and you can be back on track to having clear skin and feeling great in no time!
[i] https://www.thyroid.org/hypothyroidism/
[ii] https://www.thyroid.org/media-main/about-hypothyroidism/
[iii] https://www.ncbi.nlm.nih.gov/pubmed/1828548
[iv] https://www.ncbi.nlm.nih.gov/pubmed/19327604
[v] https://www.synthroid.com/what-is-
[vi] https://www.rxlist.com/cytomel-drug.htm
[vii] http://www.pdr.net/drug-summary/armour-thyroid?druglabelid=2466
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