Hypothyroidism is a condition where the thyroid gland produces a very low level of thyroid hormone. The thyroid hormone helps influence the growth, development, and metabolism of the body.

Deficiency in the hormone levels impacts different parts of the body adversely. This elicits various symptoms in the body, including weight gain, depression, dry or scaly skin, muscle cramps, brittle nails and hair, tiredness, and more.

Of the various changes that occur in hypothyroidism, the exacerbation of acne is a significant factor. While hypothyroidism is connected with various conditions, such as heart disease and lipid disorders; in this post, we will see about the adverse effects the condition has on the skin, particularly its role in acne formation.

Hypothyroidism Induced Skin Changes

Changes in the skin, including dryness and thickening of the skin in knees and elbow region, occur commonly. Hair loss and discoloration of soles and palms due to increased carotene accumulation are also seen in hypothyroidism.

In some cases, premenstrual acne is increased in intensity in female adults with hypothyroidism. A study published in the Journal of the European Academy of Dermatology and Venereology evaluated the relation of thyroid condition with the presence of acne in adults, especially women. The readings were compared with healthy individuals as controls.

The study result indicates that acne in adults can be related to thyroid autoimmunity and should be considered when screening the women who have post-adolescent acne.  Acne is one of the conditions that are very difficult to treat. This is due to the diverse range of causes that trigger it.

Acne and Its Treatment

Acne is often treated with over the counter medications including creams and lotions, which most often are not effective. This is especially true if the underlying cause of acne is not treated.

In fact, acne is a skin condition that is triggered by some functional disorder in the body and not due to the changes in the skin directly. Hence, the creams and lotions are not a good solution.

Hyperthyroidism and Acne

Hormonal imbalance has been cited as one of the significant causes of acne. Imbalance in androgen hormone is a common cause of acne in older women. Another less known but significant factor in acne production is the imbalance in thyroid hormone. Acne due to thyroid disturbances is more complicated to treat as the condition does not resolve easily.

To resolve an outbreak of acne, you need to first identify whether the hormonal imbalance is triggering the acne outbreak. When hormones are causing the condition you will not find relief with creams, gels, lotions, and other acne skin care brands available.

In case of imbalance in progesterone and estrogen levels, the acne breakouts occur near the hairline and jawline and the skin is very oily. Contraceptives are, thus, considered as a good treatment choice for such acne.

However, the hormonal condition may be caused by hypothyroidism. This is often overlooked leading to improper treatment of acne.  The Journal of European Medicine in a 2009 review has cited that nearly 5% of acne vulgaris and 3.6% of acne rosacea are skin findings associated with thyroid conditions.

The study reports that majority of symptoms found in thyroid conditions are related to the skin and include urticaria, alopecia, and vitiligo besides acne. Hence, treating thyroid hormone deficiency with contraceptives is not a solution to resolve acne. Moreover, hypothyroidism is related to several hormonal imbalances, which can lead to acne formation.

​Some of the causes of hypothyroidism include:

  • Low level of progesterone resulting in high estrogen dominance.
  • Affects the level of insulin, resulting in higher testosterone levels, which cause oily skin and acne.
  • Further, vitamin A formation from beta-carotenoids found in foods like pumpkins, carrots, etc. occurs due to hypothyroidism. This can result in rough and scaly skin that is prone to comedones, resulting in acne formation.

When acne is triggered by the above conditions, it can be treated properly by dealing with hypothyroidism, instead of using other treatment forms. Using thyroid hormone or improving the function of the thyroid gland naturally will help provide relief from the acne condition.

​How to Identify Thyroid Dependent Acne

Cystic acne is the typical acne form found in hypothyroidism and it shows a definite improvement in the thyroid hormone addition. Further, in general, the acne in hypothyroidism is not related to menstrual cycle. And, when it is associated with other hypothyroidism symptoms, including fatigue and brittle or dry hair and nails, it can be identified easily.

Other than directly being responsible for acne, hypothyroidism is also indirectly related to acne outbreaks. It causes disturbances in the digestive tract and hormonal levels leading to acne formation. In such cases, acne is seen all over the skin and not restricted to the face alone.

When you identify the root cause of the acne outbreak, you will be able to find a lasting solution to the terrible and frustrating acne issue. Other than wreaking havoc on your physical appearance, it can also affect you mentally. Low self-esteem and depression can occur with untreated acne. With hypothyroidism, balancing the thyroid hormone is an effective remedy for the skin lesions that accompany the condition. This includes healing the acne effectively.

Over 200 million individuals worldwide suffer from some type of thyroid condition. While thyroid conditions are treatable in a majority of cases, leaving them untreated can result in serious consequences to your health.

When you understand the disorders and treatment options, it helps you to cope better with the condition.

While there are different sets of symptoms related to hyper and hypothyroidism, all of them do not occur in a patient with the condition. Patients with thyroid conditions are frequently anxious or irritable due to the symptoms, which eventually subside with the right treatment.

Hypothyroidism is the most common condition, which is treated using different methods.

We will examine the efficacy of various thyroid treatment options in this post.

Various thyroid treatment options

The use of synthetic hormones, such as Synthroid or Levothyroxine, which have a high concentration of T4 hormone, is the staple treatment option in conventional treatment.

While the synthetic hormonal replacement helped to control the symptoms of hypothyroidism, they are often considered unnecessary in borderline thyroid conditions.

In a study published in JAMA Internal Medicine in 2014, it has been indicated that the use of synthetic hormones resulted in suppressed levels of thyrotropin resulting in greater harm than benefit to the patients. The retrospective study included data related to the level of thyrotropin for a span of 5 years from the time of initiation of levothyroxine therapy in patients with hypothyroidism.

The study results show that synthetic hormones, like Synthroid, are indicated only when the hypothyroid symptoms are clear and indicate the presence of autoantibodies, and in individuals with heart failure or cardiovascular disease (atherosclerotic) evidence.

The continual use of the synthetic hormones can cause increased osteoporosis risk and also the risk of forming atrial fibrillation.

Using Natural Thyroid Extracts

Due to the obvious side effects of synthetic hormone use, the use of natural alternative, like Armour thyroid, came into practice. Armour Thyroid, which has both T3 and T4, is considered superior to the synthetic preparations, like Synthroid, as it is not associated with the risk factors like osteoporosis.

However, it comes with the risk of thyrotoxicosis in case of improper dosage of the extract in relation to serum TSH levels.

This is of particular concern in case of thyroid cancer condition where the extract is used.

However, when compared to Synthroid medications Armour thyroid showed better patient compliance in a study published in the JCEM (The Journal of Clinical Endocrinology and Metabolism) in 2013.

This is due to two main reasons. The symptoms of the condition were relieved better and also the patients lost weight during the treatment.

Thus, about half of the patients studied (about 48.6%) indicated a preference for Armour Thyroid over Synthroid medications.

The study indicates that although improvement of the condition was the same with the two medications, the above cited reasons resulted in the desiccated or Armour thyroid therapy being a more preferred choice.

Use of synthetic L T3

L T3 is available as Cytomel in the United States. It is used for the advantage it offers in bypassing the conversion of T4-T3 stage.

The use of Cytomel is also indicated in case of patients who do not find Armour thyroid effective.

But Cytomel cannot be used on its own as pure L-T3 does not allow the production of tissue and time-specific T3. You need to use T3 in combination with T4 to get the desired effect on symptoms. Multiple dosages are also required for sustaining the T3 levels in the body as it has a shorter duration of action when compared to the L T4 medications.

Further, Cytomel is not indicated in patients with conditions, such as congestive heart failure and other cardiopulmonary diseases of acute nature. This is because the low T3 levels slow down the metabolism, which is actually beneficial. But in case of hyperthyroid conditions without accompanying cardiac conditions, this is not an issue.

Recommended therapy choice

While the alternative choices are preferred by a section of the population, a comprehensive study recommends the use of levothyroxine preparation as the ideal choice. This is because of its efficient resolution of hypothyroidism symptoms, less number of side effects, easy and inexpensive dosage, and better absorption.

The American Thyroid Association study involved asking patients on the drug treatment 24 questions on the effect, response, and efficacy of Levothyroxine. The study concluded that the synthetic form is recommended as the standard for the treatment of hypothyroidism as the product had improved health benefits in the patients studied during the clinical review.

Final thoughts

When the various pros and cons of the different forms of treatment options available are reviewed, it is clear that no single form has a superior resolving capacity than the rest. Each format has a specific drawback that makes it unsuitable for common use.

However, Levothyroxine therapy has been used for a long time as the main treatment option and has shown good results until now. Further, with the study done by American Thyroid Association supporting the use of Levothyroxine over other alternative forms, it is clear that Synthroid and other similar Levothyroxine forms offer better relief and patient response. Armour thyroid may be considered if you exhibit specific undesirable side effects on using Levothyroxine therapy.