Key Hormonal Triggers: Androgens (testosterone, DHEA) : Stimulate oil production Insulin and IGF-1 : Promote androgens and sebum Estrogen/progesterone imbalance : Influences skin inflammation Cortisol : Chronic stress promotes inflammation and sebum Clues You May Have Hormonal Acne: Flares before your period Acne on jawline, chin, neck Oily skin with irregular cycles Acne + PCOS symptoms (hair loss, facial hair, weight gain) Functional Testing: HUMAP Test (urine hormones) Serum DHEA, testosterone, fasting insulin, LH/FSH Treatment Strategies: Balance blood sugar (see insulin section) Support estrogen metabolism with: Normalize androgens : Zinc, spearmint tea, reishi mushroom For insulin resistance-related hormonal acne, retatrutide or tesamorelin may also help by restoring metabolic function
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Rotem Amirs Weight Loss and Metabolism Center
Emphasize smoking cessation Manage BP, lipids using diabetes thresholds Screen for diabetes Encourage maintenance of healthy weight Slightly higher risk of overall cancer development Emphasize need for malignancy screening, especially cervical and colorectal cancer Discuss reproductive health Assess bone health Risk of vitamin D deficiency due to sun avoidance and decreased bone density from glucocorticoid use and inflammation Assess mental health Anxiety and depression is commonly seen in patients with lupus
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