The Impact of Hormonal Changes on Acne, Hair Growth and Weight
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The Impact of Hormonal Changes on Acne, Hair Growth and Weight
Hormones play a very important role in promoting the health of individuals. Changes in hormones has several effects on the weight, hair growth and acne in
an individual. Improper diet, use of drugs, environmental reasons, and stressful lifestyles can result in hormonal changes (Gao et al., 2018). Weight gain can
lead to obesity, which is associated with reduced health care outcomes and decreased quality of life. Besides, it’s associated with conditions that are known
leading causes of mortality such as stroke, heart disease, diabetes and cancer. Hair growth changes and acne have a psychological effect whereby patients
suffer from low self-esteem, poor body image, and experience loneliness and constriction of activities (Khunger and Mehrotra, 2019). This literature review
was conducted in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Electronic databases and scanning
reference lists were searched to identify relevant studies. Studies that described and compared methods evaluating hormonal changes and their effect on
hair growth, weight and acne. Computerised searches of the following databases were conducted; The Cochrane Library, PubMed, CINAHL, Medline, and
Embase were the databases searched for articles published in the last five years. Search terms included ‘hormonal imbalance’ ‘the impact of hormonal
changes on weight’ ‘acne’ and ‘hair growth.’
The search strategy was based on the PICO (Patient, Intervention, Comparison, and Outcome) framework. The PICO question was; Do patients using beauty
and cosmetic products experience hormonal changes that affect acne, hair growth, and weight. The comparator was no intervention. The inclusion criteria
involved articles that had at least one outcome measure related to the impact of hormonal changes on acne, hair growth, and weight. The articles had to
incorporate certain research designs such as systematic literature reviews, randomized control trials, and cohort studies. Articles that were included had to
report prospective, randomised controlled trials (RCTs), in which the implications of hormonal changes in acne, hair growth and weight changes were
evaluated. In other studies the effects of hormonal changes were compared with standard therapy. They articles had to be published in English and
published within the last five years. Articles that were excluded included those that were not written in English and not published within the last five years.
Case reports, nonhuman studies, and non-relevant publication types such as reports from editorials and conferences were also excluded. I employed
systematic review methodology in reviewing literature by utilising a standard form for extracting information and assessing the quality of the studies. This
study did not aim for an exhaustive review since methodology is usually discussed briefly within research articles and search strategies do not always
identify all search articles because of the indexing procedures.
Data on study characteristics, hormonal changes outcomes, and patient characteristics was extracted. The outcomes had to be recognized internationally or
approved nationally. The outcome measures that were considered included changes in hair growth, weight changes, acne, activities of daily living,
psychological well-being and health related quality of life. The Jadad score was useful in assessing the quality of the studies. The Jadad scale incorporated
the following criteria: report of withdrawal and drop outs, double blinding and method of randomization in random controlled trials. However, quality scales
do not lack limitations, it was essential to evaluate the individual components of each study including systematic literature reviews, cohort studies,
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especially concerning the effects of hormonal changes on hair growth, weight changes and acne. Jadad score is a validated method that initially assess the
quality awarding 1 point in every category of randomisation, blinding and description of withdrawals and participant dropouts. The second point is awarded
for randomisation and appropriateness of the method and a point is deducted if the method was not appropriate. On the other hand a point was given for
the appropriateness of the double-blinding method. The maximum score that could be potentially given was 5 and the minimum score that could be given
was 0. With the assumption that double-blinding refers to the participant and clinician blinding as in a pharmaceutical trial, the maximum score for this
study that evaluated the impact of hormonal changes on hair growth, acne, and weight changes was around 3, since clinician blinding is near to impossible.
This review pragmatically interpreted double-blinding as either participant-evaluator or subject-clinician blinding. Checklists and guidelines that could be
utilized in appraising medical research articles were adhered to.
During study selection, I incorporated another author and we independently identified articles that were eligible. Discussion was useful in resolving
disagreements with the other author. Prospective studies, randomized controlled trials and cohort studies regarding the impact of hormonal changes on hair
growth, weight changes and acne were considered. Randomized clinical trials that incorporated patients of any age, sex, race and ethnicity with condition
that precipitated hormonal changes were considered. Trials that were eligible were included regardless of the duration or length of managing the condition.
CLR308: Assessment 1 – Critical Literature Review Proposal Appendixes
Appendix A – PICO Search Terms
Population Intervention Comparator Outcome 1 Outcome 2 Outcome 3
weightlifters Steroid medications None Hormonal changes Quality of life Weight gain
Hormonal imbalance PCOS treatment Standard care Quality of life Weight gain Hair growth
women Contraceptive treatment None Weight gain acne Quality of life
adolescents Poor diet None acne Quality of life Psychological impact
men Contraceptive pills None Hormonal changes Weight gain Quality of life
PCOS Hormonal changes None Activities of daily living Hair growth Quality of life
acne Skin care products None Psychological impact Quality of life Self-esteem
Hair growth Hair care products None Quality of life Hair loss Psychological impact
Post-menopausal women Hormonal replacement therapy None Weight gain Quality of life Hormonal changes
Weight gain Steroid medications Standard care Weight gain Quality of life Self-esteem
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Appendix B – Database Search Record
Database searched Key words used Search Results
Cochrane Library Hormonal changes 209
PubMed Hair growth 17, 434
Embase Acne 13, 443
PubMed Weight 1,700,793
CINAHL Hair growth 5,678
Medline Hormonal changes 677
Cochrane Library The impact of hormonal changes on weight 967
CINAHL Hair growth 3,455
PubMed Acne 19,929
Appendix C – Table summarizing selected studies using the following format and headings:
Authors Year
Published
Title of Study Research
Aim/Objective
Study Design Population Intervention Comparator Outcome
Measures
Results Conclusion
Muna Barakat, 2021 Knowledge and beliefs The study aimed A mixed-method 162 community They were given none Patient observed The pharmacists There is need to
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Raja’a Al-Qudah,
Amal Akour,
Mona Abu-Asal,
Samar Thiab,
Yahya H. Dallal
Bashi
about the use/abuse of
oral contraceptive pills
among males: A mixedmethod explanatory
sequential study in
community pharmacy
settings
at investigating
the patterns of
oral contraceptive
pills use and
abuse among
Jordanian males
explanatory
sequential study
through use of
questionnaires
pharmacists who
were working or
training in
community
pharmacy
questionnaires to
fill concerning
their experiences
in working with
Jordanian males
who were
abusing oral
contraceptive pills
outcomes= acne
flare-ups,
increased body
weight,
gynecomastia and
altered libido.
highlighted that
men use oral
contraceptives
mostly for body
building and they
were
recommended to
them by their
gym instructors.
Steroids resulted
in hormonal
changes and acne
flare-ups,
gynecomastia and
increased body
weight were
observed.
implement
policies that limit
oral contraceptive
pills abuse by
men because of
their adverse
effects on weight
and acne.
Michael J. Boivin,
Farnaz Fatehi,
Amy E. PhiilipsChan, Julia R.
Richardson,
Amanda N.
Summers, Steven
A. Foley
2020 Exploratory study of a
screening measure for
polycystic ovarian
syndrome, quality of life
assessment and
neuropsychological
evaluation
The study
evaluated the
symptoms of
women with
polycystic ovarian
syndrome
Exploratory study
through use of
questionnaires
120
undergraduate
psychology
women
They were given
questionnaires to
fill on a 12-item
PCOS symptoms
inventory
College women
not diagnosed
with PCOS
Patient related
outcomes=
physical
emotional, social
and spiritual wellbeing
Women
diagnosed with
PCOS scored
more poorly than
women without
PCOS on all
measures of
physical,
emotional,
spiritual, social,
and emotional
well-being.
PCOS screening is
important in
women’s care and
standard therapy
alone is not
adequate to
support
comprehensive
psychosocial and
neurocognitive
aspects to
improve their
quality of life.
I.V. Walker, C.R>
Smith, J.H>
Davies, H.M>
Inskip, J. Baird
2019 Methods for determining
pubertal status in research
studies: literature review
and opinions of experts
and adolescents
The study aimed
at identifying
emerging
methods for
pubertal
assessment and
evaluate their
appropriateness
for populationbased studies.
Literature review None none none none Hormonal
changes during
puberty
significantly
influence hair
growth, weight
gain and acne.
Although useful,
barriers still exist
that limit the
usefulness of
hormonal
changes to asses
for pubertal
changes.
Desai K., Almeida
B.
2021 Understanding hormonal
therapies: overview for
the dermatologist focused
on hair
The study
reviewed
literature on
particular
characteristics of
progesterone and
estrogen
containing
hormonal
treatments used
currently and
their effect for
Literature review none none none none Hormonal
replacement
therapies possess
a significant antiandrogenic effect
and have no
effect on women
who have already
lost hair.
Hormonal
therapies cause
hormonal
There’s need to
critically evaluate
various hormonal
therapies on their
impact on hair
growth or loss
before being
introduced into
clinical practice.
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patients with hair
loss.
changes, which
contribute to
acne, hirsutism
and weight gain.
Amanda L. Missel,
Laura R. Saslow
2021 Impact of an online
multicomponent very lowcarbohydrate program in
women with polycystic
ovary syndrome: A pilot
study
The study aimed
at assessing the
impact of a verylow carbohydrate
diet for 16 weeks
in obese or
overweight
women with
polycystic ovary
syndrome
Single-arm
prospective pilot
study
29 obese or
overweight
women with
PCOS
Participants were
to follow a verylow carbohydrate
diet and give
information
about a variety of
behavioral skills
such as positive
affect and
mindfulness
utilizing an
online, 16-week
intervention
none Patient related
outcome=
changes in body
weight, glycated
hemoglobin and
PCOS-related
quality of life
The findings
showed positive
outcomes
including
significant
reductions in
percent weight,
increased body
hair and PCOSrelated quality of
life.
A very low
carbohydrate diet
is effective in
promoting weight
loss and the
quality of life in
patients with
PCOS.
Anna Fuchs,
Aleksanra
Matonog, Paulina
Sieradzka, Joanna
Pilarska,
Aleksandra
Hauzer, Iwona
Czech, Agnieszka
Drosdzol-Cop
2019 Anti-androgenic therapy in
young patients and its
impact on intensity of
hirsutism, acne, menstrual
pain intensity and
sexuality –a preliminary
study
The study aimed
to investigate the
relationship
between taking
various types of
anti-androgenic
drugs and their
effect on
hirsutism,
menstrual pain
intensity, acne
and sexuality.
Prospective,
observational,
noninterventional
study
570 women in
childbearing age
that had been
using oral
contraceptives
none Women taking
oral
contraceptives
without antiandrogenic
component
Patient-related
outcomes=
quality of life,
direct causes and
effects of
treatment,
intensity of acne
and menstrual
pain before and
after
225 women
complained of
hirsutism, 192
women reported
excessive
hairiness after
treatment, and a
significant
number
complained of
increased acne
intensity
The study
identified that
anti-androgenic
drugs could
reduce pain and
acne severity, and
some like
dienogest lacked
impact on body
hairness.
Jung-Hee Kim,
Oksoo Kim, Heeja
Jung, Yanghee
Pang, Hyunju Dan
2021 Body mass index,
menstruation, acne, and
hirsutism of polycystic
ovary syndrome in
women: A cross-sectional
study
They evaluated
the relationship
between body
mass index,
menstruation,
facial acne, and
hirsutism in
women of
childbearing age
Cross-sectional
study
11,866 female
nurses aged 20-
45 years
none Women without
PCOS
Patient related
outcomes= facial
acne, hirsutism,
menstrual
distress, BMI
From the study
changes in weight
as a result of
hormonal
changes
contributes to
facial acne and
hirsutism.
It’s important for
healthcare
providers to
target weight
control to
improve facial
acne and
hirsutism among
women with
PCOS
Vidi Posdo
Simarmata, Gorga
I.V.W Udjung
2021 The relationship between
the use of Hormonal
contraceptives with
changes in the menstrual
cycle and weight gain in
acceptors in
Leuwingggung village in
2018
The study aimed
at determining
the relationship
between
hormonal
contraceptives
and hormonal
changes
Correlative study 44 respondents none none Patient related
outcomes=
weight gain and
menstrual
changes
There was a
significant
relationship
between
hormonal
contraception
and weight gain.
Hormonal
contraception
causes significant
side effects
including weight
gain and
menstrual
changes.
Yi Gao, Toby
Maurer, Paradi
Mirmirani
2018 Understanding and
addressing hair disorders
in transgender individuals
The study aimed
at establishing a
framework to
comprehend hair
disorders in
Literature review none none none Patient related
outcomes=
pattern hair loss,
hair growth, acne,
Within three
months of
starting
testosterone
therapy the
Exogenous
hormonal
treatment in
transgender men
leads to changes
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transgender
individuals and
effective
treatment
options.
majority of
transgender main
experience
increased acne,
facial and body
hair growth.
in hair
distribution and
pattern of
growth.
Niti Khunger, Krati
Mehrotra
2019 Menopausal acnechallenges and solutions
The study focused
on the clinical
presentation and
challenges
associated with
the treatment of
menopausal acne
Literature review none none none Patient related
outcomes: acne
During the
menopausal
period, the
majority of
women
experience
persistent or
relapsing acne.
Hormonal
changes,
especially
hyperandrogenis
m is a major
factor coupled
with cosmetics,
stress, and
lifestyle changes
in the
development of
acne.
References
Barakat, M., Al-Qudah, R. A., Akour, A., Abu-Asal, M., Thiab, S., & Dallal Bashi, Y. H. (2021). Knowledge and beliefs about the use/abuse of oral contraceptive
pills among males: A mixed-method explanatory sequential study in community pharmacy settings. Plos one, 16(5), e0251302.
https://doi.org/10.1371/journal.pone.0251302
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Boivin, M. J., Fatehi, F., Phillips-Chan, A. E., Richardson, J. R., Summers, A. N., & Foley, S. A. (2020). Exploratory study of a screening measure for polycystic
ovarian syndrome, quality of life assessment, and neuropsychological evaluation. BMC Women’s Health, 20(1), 1-12.
https://link.springer.com/article/10.1186/s12905-020-00994-8
Desai, K., Almeida, B., & Miteva, M. (2021). Understanding Hormonal Therapies: Overview for the Dermatologist Focused on Hair. Dermatology, 1-6.
https://doi.org/10.1159/000512888
Fuchs, A., Matonóg, A., Sieradzka, P., Pilarska, J., Hauzer, A., Czech, I., & Drosdzol-Cop, A. (2019). Anti-androgenic therapy in young patients and its impact
on intensity of hirsutism, acne, menstrual pain intensity and sexuality—a preliminary study. Ginekologia polska, 90(9), 520-526.
https://journals.viamedica.pl/ginekologia_polska/article/view/65707
Gao, Y., Maurer, T., & Mirmirani, P. (2018). Understanding and addressing hair disorders in transgender individuals. American journal of clinical
dermatology, 19(4), 517-527. https://link.springer.com/article/10.1007/s40257-018-0343-z
Khunger, N., & Mehrotra, K. (2019). Menopausal Acne–Challenges And Solutions. International journal of women’s health, 11, 555.
https://dx.doi.org/10.2147%2FIJWH.S174292
Kim, J. H., Kim, O., Jung, H., Pang, Y., & Dan, H. (2021). Body mass index, menstruation, acne, and hirsutism of polycystic ovary syndrome in women: A
cross-sectional study. Health Care for Women International, 1-13. https://doi.org/10.1080/07399332.2021.1939348
Missel, A. L., O’Brien, A. V., Maser, H., Kanwal, A., Bayandorian, H., Martin, S., … & Saslow, L. R. (2021). Impact of an Online Multicomponent Very LowCarbohydrate Program in Women with Polycystic Ovary Syndrome: A Pilot Study. F&S Reports. https://doi.org/10.1016/j.xfre.2021.08.008
Simarmata, V. P., & Udjung, G. I. (2021). The relationship between the Use of Hormonal Contraceptives with Changes in the Menstrual Cycle and Weight
Gain in Acceptors in Leuwingggung Village in 2018. Journal of Drug Delivery and Therapeutics, 11(4), 161-169.
https://doi.org/10.22270/jddt.v11i4.4937
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Walker, I. V., Smith, C. R., Davies, J. H., Inskip, H. M., & Baird, J. (2020). Methods for determining pubertal status in research studies: literature review and
opinions of experts and adolescents. Journal of developmental origins of health and disease, 11(2), 168-187.
https://www.cambridge.org/core/journals/journal-of-developmental-origins-of-health-and-disease/article/abs/methods-for-determining-pubertal-statusin-research-studies-literature-review-and-opinions-of-experts-and-adolescents/F8E66659419D0C62F16387713F89E842
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