Cystic Acne & Thyroid Connection

Adult Cystic Acne Or Boils

The appearance of pimples, blackheads, and cystic acne is considered “normal” during the teenage years. We all suffered from those awkward moments with ugly pimples, more or less. But what if we are grown ups and inflamed pimples suddenly appear on our face, or any part of the body with hair growth?

So what exactly is cystic acne?

Cystic acne can be caused by hormonal changes with symptms of pus-filled, painful and inflamed red sacks. In a mild form the hormonal acne usually presents as bumps with whiteheads. Those are not painful.

The Cause Of Acne

  • The hair in the hair shaft is clogged up with the oily secretion called sebum. Sebum causes blockage of the pores, which also can lead to infections. The infection is nothing else but an accumulation of blood cells rushing in to fight bacteria.
  • Hormone imbalances, especially high testosterone, cause an increase in oil production in the skin.
  • PCOS (polycystic ovary syndrome) can cause acne. PCOS in an indirect cause of acne.
  • The hormone insulin, as you all know, helps to deliver blood sugar into the cells. Insulin resistance increases androgen hormone production such as DHEA and testosterone. The result is an imbalance in hormone levels which then leads to acne.

Dermatologist Treatment For Acne (And Cystic Acne)

  • Antibiotics kill bacteria and the goal is to reduce the infection in the hair shaft. But antibiotics also kill gut bacteria and actually make matters worse. Gut bacteria are important for the digestion of food we eat, vitamin production such as vitamin K, production of antioxidants. They also fight the bad guys in the gut, mouth and everywhere we have a mucous lining. The imbalance of the beneficial and harmful bacteria in the gut is called dysbiosis. Dysbiosis causes leaky gut, food sensitivities, hormone imbalance, metabolic dysfunctions in the HPA (Hypothalamus­pituitary­adrenal) axis. Consequently the hormones are out of balance and high testosterone levels can occur.
  • Accutane is a prescription drug which shrinks the glands that produce oil in the skin.
  • Topical skin cleansers, such as Proactive and Exposed, dry out the skin in an effort to reduce the sebum (oil in the hair shaft) and to kill the bacteria in the skin.

The best known treatment for acne involves retinoid drugs, which are derivatives of Vitamin A. Vitamin A works by encouraging the regeneration of keratin in the skin.. However, if your thyroid is sluggish, you won’t be able to effectively convert carotenoids to Vitamin A, no matter how many carrots you eat. (And there’s a feedback loop between the two: if you’re low on Vitamin A, you won’t be able to effectively convert T4 into the more active T3.

Is Cystic Acne Related To Hashimoto’s? Yes and No

As a Functional Diagnostic Nutrition Practitioner, I look for underlying causes of symptoms. When we find out that our immune system is attacking our own body, as it is the case with Hashimoto’s attacking the thyroid tissue, we need to dig deeper. We can find out with a gene test if we have a genetic predisposition and what is causing to pull the trigger, so to speak, for the body to attack itself.

Those triggers could be:

  • An Epstein Barr virus infection
  • Imbalance of the gut bacteria
  • Insulin resistance
  • Stress – External and Internal stressors

Stress on the body causes Metabolic Dysfunction of the HPA and HPT(Hypothalamus­Pituitary-Adrenal and HP Thyroid) axis. In other words, the hormone regulation is out of balance. The balance can be found in Cortisol / DHEA ratio, or Testosterone/Estrogen ratio for example. In order to find out the cause of HPA and HPT axis dysfunction we need to find the stressors for each individual.

In regard to Cystic Acne, we saw that insulin resistance is a driving factor. Digging deeper we find that:

  • foods high in sugar
  • inflammatory processes
  • the ability of the pancreas to secrete insulin
  • obesity
  • prescription drug usage
  • genetic susceptibility

all play a role in insulin resistance.

As mentioned above, hormone imbalance is another cause of cystic acne. When one suffers from hypothyroidism, such imbalances often occur. Fran Kerr of has these thoughts:

When we have hypothyroidism we can develop low progesterone – this is where the acne connection comes in. In many cases low progesterone levels leads to cyclic acne, cystic acne and PMS.


We all know the importance of having sufficient T3 in our bodies. T3 is responsible for most metabolic activity, and balancing the level of this hormone is very important for those with thyroid issues. Adequate amounts of T3 are also necessary for skin health:

For a woman’s skin to heal properly she needs sufficient levels of T3, the active form of thyroid hormone, in the blood. Check out my articles on Thyroid Issues (Blog)

Solutions for Cystic Acne

  • The elimination of refined sugars and processed foods will help balance the blood sugar level. Dietary changes are the best methods of controlling acne outbreaks. You will need to watch how much sugar, caffeine, and chocolate you consume. It is also best if you limit your intake of fried foods. Replace these foods with plenty of water, fresh fruits and vegetables that help to purify the skin.”
  • Heal the gut lining / the mucosal barrier with healthy, whole foods, and spore-based probiotic Megaspore.
  • Find out your food sensitivities. A simple way is to go on an elimination diet.
  • External stress reduction in the form of meditation, turning off the internet connection at night.
  • Internal stress reduction: find out if you have a virus or parasite infection.
  • Find out if your body is able to detoxify your liver and cells in the body on a regular basis.


As you can see, it is possible that Hashimoto’s Thyroiditis could indirectly cause Cystic Acne, but not everyone who has Hashi’s will develop acne. When we experience a new symptom, whether it is fatigue or acne, we always need to look deeper for underlying causes. Those causes are different for each and every one of us.

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The information provided on this website is not meant to substitute professional medical advice. Consult your health care provider in regard to supplementation, especially if you are on any kind of medication.