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Chromosomes, hormones and acne – why sex matters

It’s Men’s Health Week (11-17 June) and a good time for guys to face up to some of the facts about acne. Men and women may be only an X or Y chromosome apart but it’s enough to ensure that many conditions, including acne can affect males and females differently.

Who gets what?

·         Acne is typically worse in males than in females. That’s simply because from puberty onwards, males have larger quantities of the hormones (androgens) which stimulate the oil production glands. These are the same hormones which stimulate the growth of facial hair, muscle development and other distinctly male characteristics during adolescence. Women have androgens too but much less. 

·         Men are more likely to suffer from acne scarring than women. Because they have more severe acne, males are also more likely to suffer from acne scarring in the longer term.  The best way to avoid acne scars is to seek medical advice whenever acne is not responding to over-the-counter treatments or when it gets beyond mild inflammation. Early, effective treatment will help prevent scarring.

·         Men who have acne as adults have usually been battling it since their teenage years. It’s less likely to develop for the first time in adult men. Women bear the burden of adult onset acne – a frustrating condition which is becoming more common.

What to do?

 ·         There are fewer acne treatment options for men – but only because hormonal treatments such as the oral contraceptive pill aren’t used on men. Otherwise the treatment for males and females is the same. 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 for a personal assessment which may then require prescription treatments.

·         Skin care advice for men and women is much the same. Avoid products that can clog the pores and alcohol based or highly fragranced products that can irritate the skin. For men, that might mean choosing shaving creams or gels designed for sensitive skin and avoiding aftershaves. Shaving too closely won’t help acne, so select single or double bladed razors that are sharp and only apply light pressure.

The games men play

 ·         Athletes and other physically active men can find they 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.  You can’t always avoid the irritation, but try to wear loose clothing or fabrics that wick moisture away from the skin, and be sure to cleanse the skin immediately afterwards. 

·         Body builders and others who use testosterone and anabolic steroids to increase muscle size and strength can develop severe acne as a side effect. Steroid abuse can also cause much more serious and permanent health effects including cardiovascular and liver disease.

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