Chromosomes, hormones and acne – why sex matters

Men and women may be only an X or Y chromosome apart but it’s enough to ensure that we aren’t built the same. So it’s not entirely surprising that acne affects males and females differently.   

From puberty onwards, males have larger quantities of the hormones (androgens) which stimulate the oil production glands. These are the same hormones that stimulate the growth of facial hair, muscle development and other distinctly male characteristics during adolescence. Women have androgens too but much less.   

So who gets what?

Men are more likely to suffer from acne scarring than women.   This is because they have more severe acne, The best way to avoid acne scars is to seek medical advice if acne is not responding to over-the-counter treatments or when it gets beyond mild inflammation. Early, effective treatment is the best way to prevent scarring. 

Men who have acne as adults have usually been battling it since their teenage years. However, adult men are less less likely to develop acne for the first time than their female counterparts. Women bear the burden of adult onset acne – a frustrating condition which is becoming more common and appears to be linked to both hormones and stress.

What to do?   

• Treatment for acne in males and females is largely the same, apart from hormonal treatments, such as the oral contraceptive pill, which helps some women. Start with gentle cleansing twice daily and for mild acne add in supermarket or pharmacy products containing benzoyl peroxide or salicylic acid. For persistent or more severe acne, visit a doctor. Prescription treatments such as antibiotics and retinoids work just as well in males and females.
• Avoid products that can clog the pores and alcohol based or highly fragranced products that can irritate the skin. For the guys, look for shaving creams or gels designed for sensitive skin, avoid aftershaves and try not to shave too closely if you have acne. 

Workout breakouts 

• Athletes and other physically active men can suffer from acne particularly on the chest, shoulders and back. This can be due to a combination of excess sweating, heat and friction from protective gear such as shoulder pads or helmet straps, tight clothing or backpacks. Acne is an inflammatory condition so anything that irritates the skin can make acne worse. If you can’t avoid the irritation, be sure to clean the skin immediately afterwards using a cleanser or wash containing salicylic acid.  
• Body builders and others who use anabolic steroids to increase muscle size and strength can develop severe acne as a side effect. Steroid use can also cause much more serious and permanent health effects including heart and liver disease, so there are plenty of reasons to steer well clear.