Both men and women have estrogen, but men only in tiny amounts. Women need estrogen for menstrual functioning, breast development, mood regulation, and men need estrogen for minor functions such as bone strength and again mood regulation.
Many men believe that since estrogen is a female hormone, there’s no chance that estrogen could be behind their acne, but they’re wrong. With the modern sedentary lifestyle, abundance of toxic chemicals hidden in personal care products (also a huge cause of acne), and junk food diet, men worldwide are becoming walking estrogen tanks.
In alternative health circles this has been dubbed “estrogen dominance”; where estrogen is so out of control that it crushes testosterone. Estrogen dominance is reportedly behind low fertility, mental sluggishness, fatigue, and maybe even cancer.
Could high estrogen levels be behind acne too, in both men and women? That’s what we’re going to find out.
Estrogen – not a problem for women
Every year millions of women worldwide experience acne that ebbs and flows every month with the flow of their menstrual cycle.
The cycle goes like this: a woman’s estrogen levels fall after ovulation, reach a low mid-cycle, and then rise again before the next ovulation. It’s pretty telling that women who claim of menstrual acne nearly always complain of pimples in between ovulation; when estrogen is low.
There are clear scientific mechanisms for estrogen having a protective effect. When blood estrogen is high it can bind to and activate many of the androgen receptors normally occupied by testosterone, receptors such as those in the sebaceous glands. Testosterone is prevented from stimulating your sebaceous glands to produce more oil, and hence there is less acne.
A less known protective power of estrogen is that when it is metabolised in the liver, estrogen increases sex hormone binding globulin (SHBG). SHBG has a high affinity for testosterone, binding to it and preventing it from stimulating the androgen receptors.
Furthermore, binding to SHBG prevents testosterone from converting to DHT, the most vicious androgen for acne and a particularly vicious one for women, who are ten times more sensitive to DHT than men.
The complete collection of studies on estrogen and acne
In other words, elevated estrogen levels are fairly safe for women. Estrogen is their predominant sex hormone after all, so the human body would be badly designed if a healthy hormone lead to pimples and acne.
Several studies have confirmed the safety of estrogen for women. This one gave estrogen supplements to 257 female acne patients aged 15-49, and 93.7% of the women improved by the end of the study compared to 65.4% in the placebo group. The scientists concluded that the estrogen was “safe and effective”.
Another interesting study compared 60 female acne patients with 28 controls and analysed levels of many different hormones, including testosterone, free testosterone, sex hormone binding globulin (SHBG), cortisol, estrogen, and luteinising hormone. The female acne patients had significantly lower levels of estrogen, as well as higher levels of testosterone and cortisol.
This study was similar to the first; 270 women aged between 14 and 45 were given estrogen supplements or a placebo. The estrogen supplement, in the form of an oral contraceptive, resulted in “significantly reduced acne lesion counts more effectively than placebo”.
Our biggest and best study of them all was performed in North India and it examined over 1000 acne patients. The scientists found that acne patients generally had much lower estrogen levels than average, and commented that “when a woman’s estrogen levels decline, as they do just before the beginning of a menstrual cycle, acne may worsen”.
While there are tons of women on the internet who are convinced that estrogen dominance is behind their acne, there’s plenty of evidence that estrogen deficiency is the real villain.
Don’t rush out and buy an estrogen pill though because 1) you only need your levels to be average, too much can be harmful to health, and 2) the studies on men are far murkier and if anything, show that elevated estrogen is a risk factor for acne.
In this 1992 study, scientists gathered 19 men aged between 20 and 30 and examined their levels of testosterone, DHT, SHBG and estrogen. The serum estrogen levels were dramatically higher among the acne patients. Additionally, the scientists believed estrogen might cause acne through increased inflammation: “elevated E2 levels might affect the inflammatory response of acne vulgaris through the release of thymec hormones”.
Another study gathered 45 acne patients and 38 healthy patients. Interestingly, there was no elevation in testosterone, commonly thought to be a major villain behind acne, but estrogen was 40% higher than usual. In females, testosterone was 45% higher than usual and estrogen was about the same.
Is high estrogen an acne risk for men?
As one would expect given how estrogen is essential for one sex but less important in the other, the effect of estrogen on acne varies massively. Estrogen’s ability to block testosterone will help to keep oily skin and acne down in men, theoretically, but men’s skin is far less sensitive to testosterone.
In this article I discussed at length how contrary to popular belief, a healthy diet packed with antioxidants and low in insulin-spiking carbohydrates can allow you to have high androgen levels and still not get acne. Indeed, average testosterone levels have nearly halved over the last century, yet acne appears to have got worse. Higher estrogen levels will cause a slight reduction in skin oiliness for men but it’s not worth it due to the fertility issues and sluggishness.
So what about the opposite: could high estrogen levels really be causing acne? The studies above suggest it, but mechanisms are thin on the ground. The studies above suggest that estrogen causes acne via inflammation, but there’s no evidence. Excess estrogen could interfere with insulin signalling, but there’s no evidence.
One plausible theory is that estrogen itself is not directly to blame, but rather unhealthy estrogen metabolites. Different forms of estrogen may have different effects; alternative health websites theorise that 2-hydroxyestrogen protects against breast cancer, while 8-hydroxyestrogen and 16-hydroxyestrogen cause it.
As for your skin, an increasing volume of studies suggest that unhealthy estrogen metabolites increase chronic inflammation and churn out free radicals, which are big causes of acne. This study examined the relationship between estrogen metabolites and chronic disease and found that 16-hydroxy estrogen was linked to increased production of inflammatory chemicals like TNF-a.
In this study scientists concluded that patients with arthritis, at root an inflammatory disorder with root causes surprisingly similar to acne, levels of 16-hydroxyestrogen were substantially higher. This study was very interesting; whereas 2-hydroxyestrogen was benign, 4-hydroxyestrogen was found to generate large amounts of free radicals.
This large review examined the extremely complicated relationship estrogen has with inflammation, and noted that 16-hydroxyestrogen was pro-inflammatory. 2-hydroxyestrogen, on the other hand was noted to have ant-inflammatory effects. Yet another study examined patients riddled with arthritis and found that they had only 10% of the 2-hydroxyestrogen of healthy people.
While other, more negative studies mean that the theory is not yet proven, there’s a good chance that it is inflammatory estrogen metabolites which are counteracting the benefit for acne expected from estrogen’s inhibition of testosterone.
Another possibility is that because elevated estrogen is well known to supress progesterone levels, DHT could get elevated. Progesterone is needed to control 5-alpha reductase, the enzymes that facilitate the conversion of testosterone to DHT (which is how all DHT is manufactured). More estrogen could lead to an unhealthily skewed ratio towards DHT rather than testosterone, unhealthy for acne because DHT is far more powerful at stimulating the sebaceous glands to produce more oil.
What’s the conclusion then? The conclusion is that the science is completely unclear with men, but there’s a good chance that high estrogen does cause acne. Consider the unpleasant symptoms of male estrogen dominance:
- Growth of male breast tissue, known as gynecomastia also known as “bitch tits”.
- Low sex drive. Erectile dysfunction is especially common.
- A higher stroke risk. Too much estrogen is known to cause blood clots in men.
- Heart attacks. There’s evidence that estrogen dominance in older men is a risk factor for cardiovascular disease.
- Weight gain, resulting in more estrogen and further, further weight gain due to estrogen being manufactured in fat cells.
- Prostate cancer. DHT is commonly believed to cause prostate cancer but studies show that high estrogen may have a strong effect.
High estrogen levels wreaks havoc with a man’s health because unlike with women, our bodies are not designed to have them. If high estrogen can cause such vicious side effects in men but not in women, there could easily be an as yet undiscovered mechanism through which it causes acne.
The creeping menace of xenoestrogens
That raises a very important point. Even if estrogen dominance is completely unconnected to acne, no man should want elevated estrogen levels and depressed testosterone counts. However a massive proportion of us today have them thanks to xenoestrogens, a massive array of chemicals such as phthalates, BPA, and triclosan.
Xenoestrogens are estrogen mimics; they are structurally similar to real estrogens and both bind to and stimulate estrogen receptors and block the activity of testosterone. Xenoestrogens can be found in personal care items, shower curtains, lunchboxes, you name it.
Wherever soft, flexible plastic lurks, so to do xenoestrogens. They are everywhere in our environment and are flooding our bodies at an alarming rate. Estrogen dominance is a big threat and leads to all the deadly symptoms outlined above. Furthermore, many of the chemicals have their own damaging effects. For example:
- BPA, found in tin cans, old drinking water pipes, and shower curtains, is known to lower children’s IQ through exposure in the womb. One study found that BPA ingested from plastic bottles or cans could raise human blood pressure within hours of ingestion. BPA is linked to structural damage to the brain, hyperactivity and aggression, altered immune functioning and the stimulation of prostate cancer cells.
- The pesticide atrazine is so estrogenic that it can turn male frogs into females, who were incapable of reproducing. The frogs that didn’t turn into female “lacked male reproductive behaviour, had reduced male features, and severely reduced sperm and low fertility”.
- Phthalates, used to give plastic strength and flexibility, are linked to birth defects, low sperm count, and delayed puberty in males. Prenatal exposure also causes lowered IQ in children and impairs a child’s future ability to concentrate, and their memory and reasoning skills.
- Literally thousands more chemicals have similar hormone altering effects.
Xenoestrogens, also known as endocrine disruptors, are one of the greatest health threats of modern times.
Even the WHO has taken notice; they reported in 2013 that endocrine disruptors could lead to “obesity, infertility or reduced fertility, learning and memory difficulties, adult-onset diabetes or cardiovascular disease, as well as a variety of other diseases.”
In men, average sperm mobility has fallen by over 25%, French sperm count fell by 33% from 1989 and 2005, and general fertility is plummeting. Various cancers are growing more and more common, especially breast cancer in women, which is known to be linked to fluctuating estrogen.
Do any of the problems above sound familiar to you? If so, xenoestrogens may be a hidden menace behind them.
As for acne, many xenoestrogens must be detoxified and this depletes levels of glutathione, the all-important antioxidant. Many of these chemicals have inflammatory properties as well. There’s no reason to be exposed to xenoestrogens so regardless of your skin, avoid them as much as you can.
In my eBook Annihilate Your Acne, there is a detailed guide on how to do so. For now xenoestrogen chemicals often lurk in shower curtains, toothpaste, mouthwash, shampoo, hand washes, shower gel, deodorant, pesticides, herbicides, plastics (the more flexible the more phthalates they contain) and tin cans.
Conclusion – what you should do
Again, you absolutely should eradicate as many xenoestrogens from your life as you can, both to avoid glutathione depletion and to stay fit.
Generally though, focussing hard on estrogen is a waste of your time and money. Unlike for the androgens DHT and testosterone, the science is clouded and unclear. It’s highly probable that elevated estrogen causes acne in men, but if you eliminate xenoestrogens you almost certainly won’t have a problem anyway.
Some other causes of high estrogen in men include obesity (estrogen is generated in fat cells), eating estrogenic foods like soy, flax, and liquorice, and eating too many grains. Unfortunately, beer is also highly estrogenic. Hops, one of the main ingredients in beer, is among the most estrogenic herbs in the world.
If you’re a woman and an abnormal menstrual cycle or fertility issues or general lethargy convinces you that estrogen is behind your acne, the best supplement to take is a DIM formula like Estroblock. DIM and indole-3-carbinol, the compound it digests from, are found in green vegetables and are behind the well-known estrogen lowering power of broccoli.
DIM has one of the best testimonial track records among hormonal women and has an anti-inflammatory bonus ability to lower NF-KappaB. If you want to try DIM, the best brand is this Estroblock Natural Anti-Estrogen Aromatase Inhibitor. Alternatively you could just eat tons of broccoli, kale and brussel sprouts, as they have vitamin C, sulforaphane and many other bonus compounds.
Promising as DIM is however, don’t blindly trust a supplement that claims to treat estrogen dominance. Remember: the most important acne hormone by a long shot is insulin! Read more about it here.
Thanks for reading!