Causes and Treatment of Hypothyroidism Acne

If you have hypothyroidism, acne could well be one of your symptoms.  Acne is caused by a build up of sebum in your hair follicles.  Sebum is the oily substance produced by the sebaceous gland, a tiny gland located at the top of your hair follicles, just under the epidermis.  The oil makes its way to the surface of your skin via openings in your skin called pores and is an essential moisturizer for your hair and your skin.   Your skin and hair in turn are predominantly made from a protein called keratin.  Some people though produce excess amounts of keratin, which causes a narrowing of their skin pores and traps sebum in the follicle.

Propionibacterium or Cutibacterium acnes is a bacteria that normally lives harmlessly on the surface of the skin.  It’s one of a heap of organisms that are part of the normal flora on your skin’s surface.  Generally if this bacteria invades pores it’s quickly and efficiently flushed out with the sebum.  However, if it gets trapped inside a blocked follicle it can cause a severe inflammatory reaction ie acne.

The Relationship Between Hypothyroidism And Acne

One of your skin’s best friends is vitamin A, a fat-soluble vitamin that is responsible for a number of skin maintenance activities.  It helps keratin regeneration in the skin so you’ll find it in most anti-ageing skin products.  It also helps to regulate sebum production and keeps androgen production to a minimum.

Traditionally, a major source of dietary vitamin A comes from fruit and vegetables high in carotenoids.  These are the orange-yellow pigments.  However, the body can’t actually utilize carotenoids as is.  It must convert them to retinol, the form of vitamin A it can use.   Even so, the amount of vitamin A the body can convert from carotenoids is significantly lower than the quantities of vitamin A it can receive directly from dietary sources of retinol.  In other words, it takes a lot more carotenoids to produce the same amount of vitamin A than can be obtained from retinol rich (ie animal-based) foods like liver, dairy and eggs yolks.

Further, there are only 3 types of carotenoids that can be converted to vitamin A – alpha-Carotene, beta-carotene and beta-cryptoxanthinThe conversion process also requires thyroid hormones. Therefore, someone with hypothyroidism may not be producing enough thyroid hormone to be able to effectively utilize dietary sources of carotenoids.

Vitamin A in turn is needed to convert T4 to the more metabolically active T3 so it becomes a vicious cycle.  Without enough thyroid hormones the body can’t convert carotenoids into the vitamin A it needs to produce thyroid hormones!

Interesting Questions about Thyroid:

What are the Facts for People Given Radiation (X-ray) Treatments as Children?

Between one and two million Americans received radiation treatments in childhood or adolescence between 1920 and 1960. The most common reasons for these treatments were:

  • enlarged thymus gland
  • acne
  • ringworm
  • enlarged tonsils and adenoids
  • various chest conditions

The risk factor for developing thyroid cancer if you had childhood radiation treatments is between 2% and 7% as compared to .004% in the general population.

There have been cases of side effects from radiation treatments (not radioactive iodine treatments) reported as long as 45 years after treatment.

Most physicians agree that the thyroid gland of these patients should be checked annually.

Some physicians rely solely on physical (manual) examination of patients treated as children with radiation. Others prefer to perform scans or ultrasounds for nodules too small to detect manually that might be cancerous.

A person treated as a child with radiation can request that their medical records be sent to them by writing the hospital or clinic where they had the treatments. Ask for a record of how much each dose of radiation was as well as how often and over what period of time treatments were given.

What is the Thyroid?

The thyroid is a small, butterfly-shaped gland just below the Adam’s apple. This gland plays a very important role in controlling the body’s metabolism, that is, how the body functions. It does this by producing thyroid hormones (T4 and T3), chemicals that travel through the blood to every part of the body. Thyroid hormones tell the body how fast to work and use energy.

The thyroid gland works like an air conditioner. If there are enough thyroid hormones in the blood, the gland stops making the hormones (just as an air conditioner cycles off when there is enough cool air in a house). When the body needs more thyroid hormones, the gland starts producing again.

The pituitary gland works like a thermostat, telling the thyroid when to start and stop. The pituitary sends thyroid stimulating hormone (TSH) to the thyroid to tell the gland what to do.

About 20 million Americans have some form of thyroid disease. Many are undiagnosed or misdiagnosed. No age, economic group, race, or sex is immune to thyroid disease.

The thyroid gland might produce too much hormone (hyperthyroidism), making the body use energy faster than it should, or too little hormone (hypothyroidism), making the body use energy slower than it should. The gland may also become inflamed (thyroiditis) or enlarged (goiter), or develop one or more lumps (nodules).

Fact:Two of the most common thyroid diseases, Hashimoto’s thyroiditis and Graves’ disease, are autoimmune diseases and may run in families.
Fact:Hypothyroidism is 10 times more common in women than in men.
Fact:One out of five women over the age of 75 has Hashimoto’s thyroiditis, the most common cause of hypothyroidism.
Fact:Thyroid dysfunction complicates 5%-9% of all pregnancies.
Fact:About 15,000 new cases of thyroid cancer are reported each year.
Fact:One out of every 4,000 infants is born without a working thyroid gland.

What Causes Hyperthyroidism?

There are several different causes of hyperthyroidism:

  • The entire thyroid gland may be overactive, producing too much hormone. Doctors call this problem diffuse toxic goiter, or Graves’ disease.
  • One or more lumps (also called nodules) in the gland may be overactive. One such lump is called a toxic autonomously functioning thyroid nodule, and several lumps are called a toxic multi-nodular goiter.
  • The gland may be inflamed, a condition called thyroiditis. It can release the thyroid hormone that was stored in the gland, causing hyperthyroidism that lasts for a few weeks or months.
  • Some patients may take more thyroid hormone pills than needed or prescribed.
  • Some drugs, such as Quadrinal®, amiodarone (Cordarone®), and Lugol’s solution, contain large amounts of iodine, a chemical the thyroid uses to produce its hormones, and may cause the thyroid to produce too much hormone.

® Quadrinal is a registered trademark of Knoll Pharmaceutical.
® Cordarone is a registered trademark of Wyeth Labs.


But back to hypothyroidism acne ….

We’ve mentioned vitamin A’s role in the health of our skin.  When someone doesn’t have enough vitamin A it can directly affect the health of their skin, especially if they have hypothyroidism.  Lack of vitamin A interferes with both keratin regeneration and sebum production, two of the processes that, when normal,  help prevent inflammatory conditions like acne developing.  As vitamin A is known to be deficient in many people with hypothyroidism, particularly those who rely on getting it from plant-based sources ie carotenoids, it’s easy to understand how much more prone they may be to developing conditions like hypothyroidism acne in the right circumstances.

Vitamin A deficiencies are not typically a problem for someone eating a healthy, balanced diet that incorporates animal-based sources of retinol.  Vegans on the other hand will find it very difficult to get enough vitamin A as they are restricted to obtaining it from plant-based sources ie carotenoids.

If you have acne that is failing to respond to standard treatments, perhaps it’s time to get your thyroid checked! Because you could just have hypothyroidism acne.

Donna Morgan

Donna Morgan


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