Downside to Progesterone Cream: Acne

On September 11, 2009 I wrote the post Can Progesterone Be The Solution? and then on February 16, 2010 I wrote Verdict On Progesterone Cream: Yay! In both posts I raved about how progesterone has been my cure for severe menstrual cramps, migraines, and feeling moody before that time of the month. But, as with everything, I have discovered after more than a year on it that there is a downside to progesterone for many women: acne.

I began using progesterone cream on August 29, 2009. In mid-October 2009 I decided to stop using Clearasil acne spot treatment which I'd been using since I was sixteen because I felt it was damaging my skin -- staining it an orange color and making the texture rubbery. At almost thirty years old, I wanted to start taking better care of my skin to avoid lines and wrinkles.

I bought some organic non-pore-clogging make up at Sephora and used that with my Clearasil cleanser instead of spot treatment. My face broke out but I assumed it was because of the elimination of my spot treatment and that once my face got used to the change it would clear up. I had my first (and only so far) facial in November 2009 hoping that would help, and I was also given samples of the organic and popular Bare Essentials spot treatment, etc.

My face got even worse -- even counting when I was in puberty. Back then, my mom had taken me to the dermatologist for the first time and I was prescribed Retin-A. It worked, but it also caused my sensitive skin to peel and turn red so I stopped using it in place of Neutrogena products which worked well for the next three years. The only reason why I switched to Clearasil was because I liked that it worked as a concealer since I preferred to not wear make-up due to it making my skin break out.

Anyway, in December 2009 I got the best cleanser at Sephora for my skin type but in January my face had still not cleared up so I tried Acne Free (the store's version of Pro Activ). In February my face was even worse. One day I noticed that I had acne wherever my hair touched my face and so I googled whether Moroccan Oil, which I'd begun using on my hair, had contributed to it. It sounded as if it had, so I stopped using it. At first I thought my face improved -- yeay, I'd found my answer!

It was short lived.

I do believe that the Moroccan Oil was "involved", because throughout the year I experimented with using it every now & then, and my face was always worse after those days, but I think my hormones were what made me prone. For example, one day I wore my sunglasses and ended up with pimples right where my glasses had been. It's just like with virus' -- they're always around us, but if our immune systems are weak then we are more prone to catching them. Just as, there are a ton of things in the environment that can cause pimples, but we won't always get them if our skin does what it's supposed to.

I hadn't realized this yet the first of April, so I began using Pro Activ. After seeing all of their commercials and even having a friend with a success story, I was sure it would work. But by July there had been NO improvement and so I canceled my membership (but it took until the end of August before I finished the bottles that I had).

I was at the end of my rope. There was clearly SOMETHING that was causing me to break out. I have always had oily skin and pimples here & there but never straight up acne for 9 entire months. I was starting to worry I was going to get scars for the first time because I hadn't had one day without any pimples (even the month that I'd had an improvement). There was nothing different about my life or me except one thing: the progesterone cream.

The reason why this didn't come up during my research before I started using the cream is that for many people progesterone actually treats acne. (In fact, there are many acne medications that have progesterone as an ingredient.) DermaDoctor says, "One woman's hormonal flare is another woman's means to a quick fix."

As with everything, we are all different. I have stated on my blog before that what is right for one person won't be for another. We are not all supposed to do the same things, have the same results, like and dislike the same things, etc. We simply do what works for us.

With that said, when I googled the actual phrase "does progesterone cause acne?" I learned that there are plenty of women who say they had been one of the lucky ones to hardly ever have a pimple in their life, even as teens, but after using the progesterone cream they struggled with acne in their thirties, forties, and even fifties.

So, I reduced my progesterone to just once a day in both July and August 2010. At first I saw a light at the end of the tunnel because my face started clearing up! But then in August I had my former off-the-charts severe cramps during my period to the point of sweating and feeling dizzy. I felt my mood take a nosedive. I began having migraines again. When my face began breaking out anyway I decided that it wasn't worth all of those other things to reduce the progesterone cream and so therefore I went back up to two times a day in September. Plus, with trying to get pregnant, I didn't want to reduce my progesterone levels since you need that to be high to get pregnant and stay pregnant.

However, even though my migraines and cramps went away and my mood improved once I returned to twice a day, my skin got the worst yet in September 2010 -- thus causing an infection in my chin which I blogged about in Autumn Update. I went to the dermatologist for the second time in my life and started an antibiotic and topical cream. (After I stopped Pro Activ I had used Melaleuca's acne systerm and from now on am usuing their Sci Bella facial products.) Since acne is a bacteria infection, the plan was that the antibiotics would fight away the pimples that were on my face and prevent new ones from forming.

But, I have heard that if you have breakouts on your chin then it is due to hormones (which are where the majority of mine have been the past year). Last month, in October, I was so embarrassed that I actually found myself avoiding others and hiding from being introduced to a couple of people by my husband! That's when I knew I had to go off the progesterone cream for good because it was interfering with my life. It has brought me to tears. Make-up does not conceal it enough (I've tried two other organic brands of make up aside from Sephora [Bare Minerals and Melaleuca's Sci Bella] but they didn't make a difference, either). Not to mention, my face often hurt. Considering I am thirty years old and spent the other twenty-nine years without this being a major issue for me, it is not something I'm just going to accept and live with. As bad as my cramps, migraines, and mood swings have been, I also can't take any more acne.

By the time I finished my prescription from the dermatologist on October 31st, the pills had definitely improved my skin and now my face is almost clear. It has been three weeks since I used the progesterone cream so I'm hoping that will prevent my face to go crazy again now that my prescription from the dermatologist has run out, and that my face will be completely clear soon.

DermaDoctor says, "Progesterone causes fluid retention and tissue swelling. We are all familiar with premenstrual "bloating". You can thank progesterone for that monthly puffiness. As the levels of progesterone rise and the skin swells, the pores are effectively compressed shut. This has 2 effects; by day 26, your pores never looked so minimized. However, this tourniquet effect causes sebum to build up beneath the skin's surface contributing to the formation of extra monthly blemishes. An interesting multicenter study showed that almost half of all women do experience a premenstrual flare of acne."

This is also why most women notice their faces breaking out during the first trimester of pregnancy -- because there is a major increase in progesterone. But in the second and third trimesters estrogen dominates which has the opposite effect. This stays in place during breastfeeding which is why I had the best skin of my life during that time. Estrogen is also the main ingredient in birth control pills, thus why that is often prescribed for acne.

The problem with estrogen is that is the hormone linked to cancer so you never want to increase estrogen, as well as it causes other side effects which I detailed in my previous posts (the pill caused me other problems).

Still, estrogen should always be higher in women than testosterone. The ovaries produce both estrogen and testosterone. In women, estrogen should be in much higher concentrations, masking the "male" effects of testosterone: acne, hair loss, and facial hair.

While I have no had facial hair (thank God), I have noticed losing more hair than normal the past few months. When I brought this up to Joe he said an emphatic "yes," as he has noticed it all over our bathroom for the first time in our seven-and-a-half years of marriage! Since progesterone often lowers estrogen, has it lowered mine too much so that my testosterone is now too high? Too much testosterone causes Polycystic Ovarian Syndrome which most often causes infertility. One of the symptoms is acne.

I finally rescheduled my appt. with a general doctor for a complete physical on November 15th (I had planned to do this twice before in the past two years for cholesterol, an EKG, and hormones but canceled). I want a complete hormonal workup done to find out where I'm at with my progesterone, estrogen, and testosterone. Obviously if these are messed up then that could be why I didn't get pregnant in September (we also sort of tried in October but didn't get pregnant last month, either).

I assume it's going to take a few months for my hormones to regulate after being off the cream, so we have decided that we will keep the plan that I wrote about in Change of Plans For Baby #2 which said that if our one try in September didn't work then we wouldn't try again until February -- and at that point we'll try until it happens. Otherwise, having a sudden drop to my progesterone could cause a miscarriage. Whenever I get pregnant, hopefully pregnancy will even out my hormones and not get messed up next time I'm done breastfeeding! (One can only hope.)

Otherwise, is there going to just be something else substituted for this (since my side effects from the pill were substituted with major cramps and then the acne was substituted for the major cramps)? Am I just going to keep trading one thing for another?

I'm disappointed that the progesterone cream didn't have a happy ending for me (especially since I was only two months into using a new tube), but at least it did cure me of cramps and migraines for one year. I still recommend it for these things, as many women don't have acne as a side effect so it's at least worth a try. But if you do break out, you'll know not to stay on it for 14 months (which is how long I did)!

UPDATE: Little did I know that I had become pregnant just 3 days prior to writing this post! (So my first month of being off the cream!) I am due to have baby #2 in July 2011! My progesterone level was perfect in the first trimester so not only did I not miscarry, but I didn't even have to use suppositories like I did with my firstborn. I also haven't had acne since going off the cream.