Seemingly random outbreaks and the clear physical effect of acne makes it a frustrating and oftentimes inopportune condition. In response to acne flare ups, most immediately turn to topical treatments such as creams and lotions to alleviate the undesired blemishes.
Even though the most notable effects of acne affect external appearance, the cause is frequently internal. Hormone imbalance is perhaps the greatest contributor of acne. The thyroid is an integral component of hormone production, regulation, and function meaning that it plays an important role in the occurrence of acne and many other conditions. Having a greater understanding of thyroid function and how it relates to skin conditions such as acne may help alleviate this noticeable and frustrating condition.
The Impressive Effect of the Thyroid
Many assume that acne breakouts are caused only by imbalances of estrogen, progesterone, or testosterone. This is not surprising as fluctuations of these hormones is the predominant cause of acne during puberty. However, in adults, the cause of acne more than likely involves thyroid dysfunction or deficiency.
The thyroid is an essential component of health and exerts its influence through the production of hormones. Thyroid hormones influence numerous functions including metabolism, conversion of food into energy, cellular and tissue regeneration, sleep, and more. Thyroid dysfunction can result in a wide array of symptoms (full list of thyroid dysfunction symptoms here), specifically regarding hormone balance. Therefore, it should not come as a surprise that inhibited thyroid function can result in skin conditions such as acne.
Taking a Look at Thyroid Dysfunction
Hypothyroidism is the most common form of thyroid disease. The condition causes a slowing of thyroid activity resulting in various forms of dysfunction including insomnia, sensitivity to cold, digestive issues, cognitive dysfunction, difficulty losing weight, and skin conditions. It is estimated that approximately 12% of the American population will develop a thyroid condition. Depending on the study, Hypothyroidism impacts between 5 and 10% of the population. Women are more likely to develop thyroid disease than men.
One leading cause of hypothyroidism is an autoimmune thyroid condition called Hashimoto’s thyroiditis. Hashimoto’s causes an increase of Thyroid Peroxidase Antibodies (also known as TPOAb or TPO or anti TPO) and Thyroglobulin Antibodies (or TGAb and anti-TG). An excess of either substance can indicate that the immune system has turned against the thyroid and is actively attacking it. If the condition is left untreated, irreparable damage can be done to the thyroid resulting in lifelong hypothyroidism.
How Thyroid Dysfunction Can Cause in Breakouts
Because the thyroid influences many different areas of the body, it can contribute to acne breakouts and the development of skin conditions in a variety of ways.
One of the first studies to investigate the connection between thyroid disease and acne was conducted in 2009. The study investigated the occurrence of skin-related symptoms such as acne among thyroid patients. Of the 220 participants, nearly 57% experienced skin issues including acne, dermatosis, hives (chronic urticaria), and severe itchiness (pruritus).
Further studies have shown that greater prevalence of thyroid antibodies, typically seen in those with Hashimoto’s, increases the risk of skin conditions. A 2012 study titled Association of Thyroid Autoimmunity with Acne in Adult Women published in the Journal of the European Academy of Dermatology and Venereology, found that women with acne are statistically far more likely to have increased levels of Thyroglobulin Antibodies (anti-TG) than those without acne. This connection is present regardless of age and suggests that there is a link between autoimmune thyroid disorders and acne.
Keeping skin healthy is an important part of treating and preventing acne. Those with hypothyroidism have greater difficulty maintaining healthy skin than those without a thyroid disorder. Poor thyroid function can slow cellular activity and inhibit the transport of oxygen. Less blood and oxygen being delivered to skin cells means that the skin is not able to regenerate as well as it should. Furthermore, dead and dying skin cells that are not removed through healthy skin generation can increase the risk of breakouts by blocking pores and promoting inflammation.
Progesterone helps maintain appropriate levels of estrogen and too much estrogen in the system frequently results in breakouts. The thyroid regulates the production of hormones that are involved in the conversion process of cholesterol into progesterone. If the thyroid is underactive, the body may suffer from a progesterone deficiency and subsequent estrogen dominance which promotes breakouts and oily skin.
Testing and Treating Thyroid Disease
Sadly, many patients suffer from acne and other skin conditions without knowing the reason why. Part of the problem may be that they are not receiving proper testing for thyroid dysfunction. Most doctors rely solely on TSH (Thyroid Stimulating Hormone) tests to assess thyroid function. However, this metric completely overlooks autoimmune thyroid disorders such as Hashimoto’s and is not enough to accurately gauge thyroid function on its own.
An accurate measure of thyroid health should include the following tests:
- Free T3
- Free T4
- Reverse T3
- SHBG (Sex Hormone Binding Globulin)
- Thyroid antibodies (TPO and TGAb)
These tests provide a more accurate look at individual thyroid function and allows for better treatment. Effectively diagnosing and treating the thyroid may resolve acne and other areas of dysfunction.
Synthroid or Levothyroxine are the most common forms of thyroid medication, but many patients do not experience an improvement of their symptoms with this approach – find out why T4-only medications don’t work for many patients. More effective treatment involves bioidentical thyroid hormones or Natural Desiccated Thyroid Drugs (NDTs). Some natural thyroid medications to consider are Naturethroid and Armour Thyroid. Unfortunately, many doctors are hesitant to prescribe these treatments because they are not the established standard for treating thyroid disease.
Stopping Acne at the Source
Acne is a frustrating condition and without properly diagnosing the cause there is little hope of resolving it. Sadly, many are unaware that thyroid dysfunction can be a primary contributor to skin conditions and acne. If a thyroid condition is the cause of your acne, accurate testing and individualized treatment is the only way to effectively resolve it.
If you are suffering from acne, ask your doctor about getting your thyroid tested and treated.
1. Acne. Melasma. Could it be your thyroid? Hypothyroid Mom. https://hypothyroidmom.com/acne-melasma-could-it-be-your-thyroid/
2. Hypothyroidism and Acne + 6 Steps to Clear up your Skin. Restart MD. https://www.restartmed.com/hypothyroidism-acne/
3. Hypothyroidism and Acne Relationship. Thyroid Central. https://www.thyroidcentral.com/hypothyroidism-acne-relationship/