Hormones and Skin: Frequently Asked Questions

Didn't have time to watch the full conversation? Here's what Gabby and I covered, in her words as closely as possible.

What's the actual connection between hormones and skin?

You have about 50 different hormones in your body, not just estrogen, progesterone, and testosterone, and together they influence your metabolism, mood, and a lot more. When it comes to skin specifically, Gabby points to four main culprits: estrogen, testosterone and other androgens, cortisol, and insulin. As she put it during our talk, “the way that your skin looks on the outside is a reflection of what is going on inside of your body.”

Why is my skin suddenly thin, crepey, or more sun-damaged looking?

The two most common reasons are chronic dehydration, which is the easier fix, or low estrogen, which is common around menopause as both estrogen and progesterone start to decline. But Gabby was clear that low estrogen isn't only a menopause issue: over-exercising (it can interfere with regular ovulation), eating disorders like anorexia or bulimia, low pituitary gland function, premature ovarian failure, and even chronic kidney disease can all cause estrogen to drop well before its time.

How can I raise low estrogen naturally?

Gabby's go-to options are chasteberry, evening primrose oil, and black cohosh, along with foods rich in phytoestrogens like organic soy and ground flaxseed. If you're around menopausal age, she recommends talking to your doctor about bioidentical (never synthetic) hormone replacement therapy. One caveat: mention any herbs to your doctor first if you're on other medications, so there's no contraindication.

What causes skin tags and dark, velvety skin patches?

Those dark, velvety patches, medically called acanthosis nigricans, are most often driven by insulin resistance, and they're common in people who are overweight or dealing with pre-diabetes or type 2 diabetes. They also show up frequently in women with PCOS, since PCOS and insulin resistance tend to travel together. Skin tags share a lot of the same root causes, mainly insulin imbalances, though low estrogen can contribute too: as skin thins, folds of skin rub together, and that friction can create tags. In some cases, medications used to manage hormones (like the birth control pill) can trigger dark patches as well, and those tend to resolve once the underlying cause is addressed.

Are skin tags dangerous, and can they be removed?

No, skin tags are completely harmless on their own, they're really just a small collection of collagen. They can be removed quickly and easily (in our conversation, one of our team members shared that hers were removed in a simple in-office procedure, with barely a trace left behind). The more important step is addressing whatever's causing them, whether that's blood sugar or low estrogen, so new ones don't keep showing up.

How do doctors actually diagnose PCOS?

Gabby explained that doctors typically look at three factors, and checking two out of three is enough for an official diagnosis: irregular, heavy, or missed periods from missed ovulation; signs of higher-than-normal androgens like abnormal hair growth or male-pattern hair loss (confirmed through blood work); and 12 or more cysts visible on an ovarian ultrasound. It's a genuinely tricky condition to diagnose — some women with PCOS don't have any cysts at all, while plenty of women without PCOS have a handful that don't add up to a diagnosis.

Why is my skin suddenly oily or breaking out, even well past my teenage years?

A very common trigger is coming off the birth control pill: the pill lowers testosterone (and oil production) while you're on it, so stopping often causes a rebound in oil and breakouts. The good news is that usually settles down within a few months, once your body re-establishes its own hormonal rhythm. Other causes include PCOS and elevated androgens, normal monthly hormone fluctuations, pregnancy, and stress, since stress raises cortisol, and cortisol can increase oil production too.

What's actually behind the “pregnancy glow,” or the glow some women notice around ovulation?

Around ovulation, Gabby says the glow is your body's biology at work. During pregnancy, it comes down to progesterone: levels typically run around 30 milligrams during the luteal phase of a cycle, and climb to roughly 300 milligrams by the third trimester. Gabby calls progesterone “the chill hormone” — it's behind that fuller, more relaxed feeling as much as the glow itself. On the flip side, low progesterone is linked to a higher risk of miscarriage, which is part of why bioidentical progesterone is sometimes used to help support pregnancies.

Is my skin really connected to my gut and liver?

Yes. Gabby doesn't just look at the surface of the skin, she looks at gut health and the body's pathways of elimination: your liver, large intestine, and kidneys. Estrogen, for example, gets processed by the liver and eliminated through your intestines; if you're not going to the bathroom regularly, it can actually get reabsorbed and contribute to estrogen dominance. She's also careful about toxic cosmetic ingredients like parabens, benzophenones, BPA, and phthalates, all of which can affect your hormones, gut, and liver.

What foods actually support healthy hormones and skin?

Vitamin D-rich foods top the list (or roughly 5,000 IU a day if you're not getting much sun). Ground flaxseed and organic, ideally fermented soy like tofu or tempeh are great phytoestrogen sources. Grass-fed meat, eggs, avocado, and walnuts all came up, along with fiber generally, since fiber helps your body actually eliminate excess hormones instead of recirculating them. Beets got a specific mention on our call: they're rich in iron and fiber, and several people said their skin visibly improved once their digestion did.

What's the best way to actually cut back on sugar?

Gabby pointed out that research on rats has shown sugar can be more addictive than cocaine, so struggling with it isn't a willpower problem. Her advice: shift toward a whole-food diet, shop the outer aisles, and read labels — sugar hides in salad dressing, pasta sauce, barbecue sauce, cereal, and yogurt. She's also cautious about artificial sweeteners: your brain still expects calories that never show up, which can leave you hungrier and prone to overeating later. And surrounding yourself with other people who are also cutting back genuinely helps.

What about hair thinning or hair loss?

Gabby's first instinct is to check androgen levels and get a thyroid panel done — thyroid issues are a commonly overlooked cause of hair thinning, and it's worth ruling out before assuming it's “just genetic.”

Note: this Q&A is a recap of a live conversation and is meant for general education, not personal medical advice. If any of this sounds like you, it's worth bringing to your own doctor or a certified nutritional practitioner.