Acne in Men

Are the causes of acne different in men and women? The answer is “yes” and “no”.

First, regardless of who you are, acne is the result of excess oil (sebum) production that ultimately causes a build-up of dead skin cells that block the pore of a hair follicle.  Underneath the blocked pore, bacteria grow and multiply, resulting in inflammation, swelling and infection – commonly called a pimple or zit!  See our article on Acne Vulgaris for more information on how acne is formed and the different types of acne.  What causes the excess oil, is what separates the men from the women.

Causes of Acne in Men

To begin with most acne can be traced back to fluctuations in hormone levels. For men, the primary cause of the formation of acne is a fluctuation in Androgens (male’s hormones) and in particular testosterone, DHEAS (dihyroepiandrosterone sulfate) and DHT (dehydrotestosterone).  Elevation in these hormones can lead to over secretion by the sebaceous (oil) glands and the onset of acne formation.

It is during the onset of puberty that the adrenal glands usually start to produce these hormones which explains why oily skin and acne are so prevalent among teenagers.  Naturally, since boys have more “male” hormones (androgen) than girls, teen acne tends to be more severe in males.

In adulthood, this trend seems to reverse itself and while about 17 million adults in the United States suffer from adult acne, only 25% of those are men.  Still, that’s about 4.25 million men who struggle with embarrassing, and often debilitating, acne every day.

Male hormones are responsible for the genetic differences that contribute to male acne.  These differences are:

  • Larger pores
  • More sebaceous glands (oil glands)
  • Thicker skin and body hair

As stated, all acne is the result of a blocked hair follicle (caused by excess oil), and because men have more hair, and thicker hair than women, they tend to breakout on their back, upper chest area and shoulders, especially during exercise, when intense work outs can stimulate increased production of the hormone, testosterone, which will make the skin more acne prone.

Another cause of male acne is the use of Anabolic steroids, used by athletes and bodybuilders to build muscle mass.  Studies indicate that about one-third of men who use steroids get acne, and about 50% of those, develop a severe form known as cystic acne.  Steroid-induced acne can be difficult to treat and is almost always non-responsive to treatment as long as the male continues to use anabolic steroids.

Men also can develop an acne-like disorder known as folliculitis, a condition common among Hispanics and African-Americans. This form of acne comes from the tiny nicks caused by shaving too closely – when this happens the hair curls up under the skin and causes a pocket of infection. Deep folliculitis, which affects the entire hair follicle, can cause large, painful, pus-filled bumps that may leave scars.

Simple Strategies for Men

Men tend to be less fastidious than women when it comes to skincare.  However, following a few simple rules can help minimize outbreaks and control male acne.  The key is to kill acne bacteria before pimples ever reach the surface of the skin. Here are some simple, yet effective, steps that can help prevent/control breakouts:

  • Gently wash acne-prone skin morning and night, and always after sports or exercise. It’s a simple rule, but it’s the first line of defense.
  • Don’t over-wash—cleansing more than 2-3 times a day can irritate your skin, dry it out, and increase oil production.
  • Use an electric shaver to avoid shaving too closely or nicking the skin.
  • Look for cleansers and acne products that are “non-comedogenic”—that means they won’t clog the pores.
  • Splash on a non-alcohol based toner to help further unclog pores after cleansing. Avoid alcohol-based toners, which can over-dry the skin – this can trigger the production of more oil.
  • Finish the cleansing routine with a gel or lotion formulated with benzoyl peroxide, salicylic acid or glycolic acid to unclog pores.
  • Don’t pick or pop pimples. This can lead to further infection and permanent scaring.
  • If you play a sport, line helmets and body pads with white cotton material to help absorb sweat and oil.
  • Less stressful workouts can result in less marked hormonal fluctuations which will help control breakouts.

The most important strategy is to choose an acne-fighting regimen that you can stick to. Controlling acne is an going task and calls for consistency and persistence.  Whatever strategy you chose, make sure it is designed to address prevention of acne as well as treatment of an existing condition.

If you are diligent about your acne-fighting routine and still see no improvement, it might be time to consult a dermatologist.