Why is my skin so oily?

Oily skin results from overactive sebaceous glands producing excess sebum, often triggered by hormones, genetics, or lifestyle factors. Managing it requires understanding your specific triggers, using appropriate skincare, and addressing underlying hormonal or metabolic imbalances through testing and targeted interventions.

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Understanding Sebum: Your Skin's Natural Oil

Sebum is the waxy, oily substance your skin naturally produces through sebaceous glands. While sebum plays a crucial protective role in maintaining skin barrier function and preventing water loss, excessive production leads to that frustrating greasy shine, clogged pores, and acne breakouts. Your sebaceous glands are most concentrated on your face, scalp, and upper body, which explains why these areas tend to be oiliest.

The amount of sebum your skin produces varies significantly from person to person and can fluctuate throughout your life. During puberty, sebum production increases by up to 500%, which is why teenage acne is so common. But oily skin isn't just a teenage problem. Many adults struggle with excess oil production well into their 30s, 40s, and beyond.

Primary Causes of Oily Skin

Hormonal Imbalances

Hormones are the primary drivers of sebum production. Androgens like testosterone and dihydrotestosterone (DHT) directly stimulate sebaceous glands to produce more oil. Even small fluctuations in hormone levels can trigger significant changes in your skin's oil production. Women often notice increased oiliness during menstruation, pregnancy, or when starting or stopping birth control pills.

Medical Conditions Associated with Oily Skin

Common medical conditions that can cause or worsen oily skin require specific testing for proper diagnosis.
ConditionKey FeaturesAssociated SymptomsTesting Recommended
PCOSPCOSElevated androgensIrregular periods, hirsutism, acneTestosterone, DHEA-S, LH/FSH ratio
Seborrheic DermatitisSeborrheic DermatitisMalassezia overgrowthFlaking, redness, itchingClinical examination, KOH test
Thyroid DisordersThyroid DisordersMetabolic dysfunctionWeight changes, fatigue, temperature sensitivityTSH, Free T3, Free T4, TPOAb
Cushing's SyndromeCushing's SyndromeExcess cortisolWeight gain, purple striae, muscle weakness24-hour urine cortisol, dexamethasone suppression

Common medical conditions that can cause or worsen oily skin require specific testing for proper diagnosis.

Conditions like polycystic ovary syndrome (PCOS) can cause elevated androgen levels, leading to persistent oily skin and acne. Similarly, hormonal changes during perimenopause and menopause can paradoxically increase oil production in some areas while causing dryness in others. Understanding your hormone levels through comprehensive testing can reveal whether hormonal imbalances are driving your skin concerns.

Genetic Factors

Your genetic makeup significantly influences your skin type and sebum production levels. If your parents had oily skin, you're more likely to experience it too. Genetics determine the size and activity level of your sebaceous glands, as well as how your skin responds to hormonal fluctuations. While you can't change your genes, understanding your genetic predisposition helps you develop more effective management strategies.

Environmental and Lifestyle Triggers

Your environment and daily habits play a substantial role in oil production. Hot, humid climates stimulate sebaceous glands to produce more oil, while air conditioning and heating can paradoxically trigger increased oil production as your skin tries to compensate for moisture loss. Stress is another major factor, as it triggers cortisol release, which can stimulate oil production and worsen acne.

Diet also influences sebum production. High-glycemic foods that spike blood sugar levels can increase insulin and insulin-like growth factor 1 (IGF-1), both of which stimulate oil production. Dairy products, particularly skim milk, have been linked to increased acne and oiliness in some studies, possibly due to hormones and bioactive molecules in milk.

Medical Conditions Associated with Oily Skin

Several medical conditions can cause or worsen oily skin. Understanding these connections helps identify when professional medical evaluation might be necessary. Here are the most common conditions linked to excessive oil production.

Seborrheic Dermatitis

This chronic inflammatory condition affects areas rich in sebaceous glands, causing redness, flaking, and excessive oiliness. It's thought to be triggered by an overgrowth of Malassezia yeast that feeds on sebum. The condition often affects the scalp, eyebrows, and nasolabial folds, creating a cycle of inflammation and increased oil production.

Hormonal Disorders

Beyond PCOS, other hormonal conditions can trigger oily skin. Congenital adrenal hyperplasia causes excess androgen production, leading to oily skin and acne. Cushing's syndrome, characterized by excess cortisol, can also increase sebum production. Thyroid disorders, both hyperthyroidism and hypothyroidism, can affect skin oil levels through their impact on metabolism and hormone balance.

The Role of Skincare Mistakes

Ironically, many attempts to control oily skin can make the problem worse. Over-cleansing strips your skin of natural oils, triggering a rebound effect where sebaceous glands produce even more oil to compensate. Using harsh, alcohol-based toners or skipping moisturizer entirely can have the same counterproductive effect.

Product buildup from heavy creams, silicone-based primers, or comedogenic ingredients can trap oil and bacteria, worsening the appearance of oily skin. Additionally, touching your face frequently transfers oils and bacteria from your hands, while using dirty makeup brushes or pillowcases can contribute to clogged pores and increased oiliness.

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Testing and Diagnosis Options

If you're struggling with persistent oily skin despite proper skincare, it may be time to investigate underlying causes through testing. A dermatologist can perform a visual examination and may use a sebumeter to measure oil production levels objectively. They might also recommend patch testing if contact dermatitis is suspected.

For hormonal causes, blood tests can reveal imbalances that contribute to excess oil production. Key markers include testosterone (total and free), DHEA-S, cortisol, thyroid hormones (TSH, T3, T4), and sex hormone-binding globulin (SHBG). Women may also benefit from testing LH, FSH, and estradiol to get a complete hormonal picture. Regular monitoring of these biomarkers helps track treatment effectiveness and adjust interventions as needed.

If you already have recent blood test results, you can get immediate insights into potential hormonal imbalances affecting your skin. Upload your results to SiPhox Health's free analysis service for personalized recommendations based on your biomarker levels.

Effective Treatment Strategies

Topical Treatments

The foundation of oily skin management starts with appropriate topical treatments. Salicylic acid (BHA) penetrates oil-filled pores to clear debris and reduce sebum production. Niacinamide helps regulate oil production while strengthening the skin barrier. Retinoids normalize skin cell turnover and can reduce oil production over time. Clay masks temporarily absorb excess oil and can be used 1-2 times weekly for oil control.

Oral Medications

For severe cases, oral medications may be necessary. Hormonal birth control can regulate androgen levels in women, reducing oil production. Spironolactone, an anti-androgen medication, blocks testosterone's effects on sebaceous glands. Isotretinoin (Accutane) dramatically reduces sebum production but requires careful monitoring due to potential side effects. These medications should only be used under medical supervision.

Lifestyle Modifications

Simple lifestyle changes can significantly impact oil production. Maintaining stable blood sugar through a low-glycemic diet reduces insulin spikes that trigger sebum production. Managing stress through meditation, exercise, or therapy helps control cortisol levels. Getting adequate sleep (7-9 hours) supports hormone balance and skin repair. Staying hydrated helps maintain skin barrier function without triggering compensatory oil production.

Building an Effective Skincare Routine

Creating a balanced skincare routine is essential for managing oily skin without causing irritation or rebound oiliness. The key is gentle consistency rather than aggressive treatment. Here's how to structure your routine for optimal results.

Start with a gentle, pH-balanced cleanser twice daily. Look for gel or foam formulations with ingredients like salicylic acid or tea tree oil. Follow with an alcohol-free toner containing niacinamide or witch hazel to balance oil production. Apply a lightweight, oil-free moisturizer even if your skin feels oily. This prevents dehydration that triggers excess oil production. During the day, use a broad-spectrum SPF 30+ sunscreen formulated for oily skin. Mineral sunscreens with zinc oxide can help absorb excess oil.

When to Seek Professional Help

While oily skin itself isn't harmful, certain signs indicate you should consult a healthcare provider. Sudden changes in oil production, especially if accompanied by other symptoms like irregular periods, hair loss, or weight changes, warrant investigation. Severe acne that doesn't respond to over-the-counter treatments, painful cystic breakouts, or scarring require professional intervention.

If oily skin significantly impacts your quality of life or self-esteem, don't hesitate to seek help. Dermatologists can prescribe stronger treatments and identify underlying conditions. Endocrinologists can address hormonal imbalances contributing to skin issues. Working with healthcare professionals ensures you receive appropriate treatment tailored to your specific needs.

Taking Control of Your Skin Health

Managing oily skin requires patience, consistency, and often a multifaceted approach. Understanding the underlying causes, whether hormonal, genetic, or lifestyle-related, empowers you to make informed decisions about treatment. Remember that what works for one person may not work for another, so finding your optimal routine may take some experimentation.

Regular monitoring of relevant biomarkers, maintaining a consistent skincare routine, and addressing lifestyle factors create a comprehensive strategy for managing oily skin. With the right approach, you can achieve balanced, healthy skin that looks and feels its best. The journey to clearer skin starts with understanding your body's unique needs and responding with targeted, evidence-based interventions.

References

  1. Endly, D. C., & Miller, R. A. (2017). Oily Skin: A review of Treatment Options. Journal of Clinical and Aesthetic Dermatology, 10(8), 49-55.[PubMed]
  2. Sakuma, T. H., & Maibach, H. I. (2012). Oily skin: an overview. Skin Pharmacology and Physiology, 25(5), 227-235.[PubMed][DOI]
  3. Rocha, M. A., & Bagatin, E. (2018). Adult-onset acne: prevalence, impact, and management challenges. Clinical, Cosmetic and Investigational Dermatology, 11, 59-69.[PubMed][DOI]
  4. Zouboulis, C. C., & Degitz, K. (2004). Androgen action on human skin - from basic research to clinical significance. Experimental Dermatology, 13(4), 5-10.[PubMed][DOI]
  5. Pochi, P. E., & Strauss, J. S. (1974). Endocrinologic control of the development and activity of the human sebaceous gland. Journal of Investigative Dermatology, 62(3), 191-201.[PubMed][DOI]
  6. Makrantonaki, E., Ganceviciene, R., & Zouboulis, C. (2011). An update on the role of the sebaceous gland in the pathogenesis of acne. Dermato-endocrinology, 3(1), 41-49.[PubMed][DOI]

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Frequently Asked Questions

How can I test my hormones at home?

You can test your hormones at home with SiPhox Health's Hormone Focus Program. This CLIA-certified program includes comprehensive hormone testing including testosterone, cortisol, DHEA-S, and other key markers that influence skin health and oil production.

Can diet really affect how oily my skin is?

Yes, diet significantly impacts sebum production. High-glycemic foods and dairy products can increase insulin and IGF-1 levels, which stimulate oil glands. Reducing sugar, refined carbs, and dairy while increasing omega-3 fatty acids and antioxidants can help balance oil production.

Why does my skin get oilier during my period?

Hormonal fluctuations during your menstrual cycle directly affect sebum production. Progesterone levels rise after ovulation, stimulating oil glands. Additionally, the relative increase in androgens compared to estrogen right before your period can trigger increased oiliness and breakouts.

Is it normal for skin to become oilier with age?

While skin typically becomes drier with age, some people experience increased oiliness during hormonal transitions like perimenopause. This occurs due to declining estrogen levels, which can make androgens relatively more dominant, stimulating oil production in certain areas while other areas become dry.

Should I moisturize if I have oily skin?

Yes, moisturizing is essential even for oily skin. Skipping moisturizer can trigger your skin to produce more oil to compensate for dehydration. Choose lightweight, oil-free, non-comedogenic moisturizers with ingredients like hyaluronic acid or glycerin that hydrate without adding oil.

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Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
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Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

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Advisor

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In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

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View Details
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Health Programs Lead, Health Innovation

Dr. Tsogbayar leverages her clinical expertise to develop innovative health solutions and evidence-based coaching. Dr. Tsogbayar previously practiced as a physician with a comprehensive training background, developing specialized expertise in cardiology and emergency medicine after gaining experience in primary care, allergy & immunology, internal medicine, and general surgery.

She earned her medical degree from Imperial College London, where she also completed her MSc in Human Molecular Genetics after obtaining a BSc in Biochemistry from Queen Mary University of London. Her academic research includes significant work in developmental cardiovascular genetics, with her thesis publication contributing to the understanding of genetic modifications on embryonic cardiovascular development.

View Details
Pavel Korecky, MD

Pavel Korecky, MD

Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
Paul Thompson, MD

Paul Thompson, MD

Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in fourteen languages.

View Details
Ben Bikman, PhD

Ben Bikman, PhD

Advisor

Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

View Details
Tash Milinkovic, MD

Tash Milinkovic, MD

Health Programs Lead, Heart & Metabolic

Dr. Natasha Milinkovic is part of the clinical product team at SiPhox Health, having graduated from the University of Bristol Medical School. Her medical career includes rotations across medical and surgical specialties, with specialized research in vascular surgery, focusing on recovery and post-operative pain outcomes. Dr. Milinkovic built her expertise in emergency medicine as a clinical fellow at a major trauma center before practicing at a central London teaching hospital throughout the pandemic.

She has contributed to global health initiatives, implementing surgical safety standards and protocols across rural Uganda. Dr. Milinkovic initially joined SiPhox Health to spearhead the health coaching initiative and has been a key contributor in the development and launch of the Heart and Metabolic program. She is passionate about addressing health disparities by building scalable healthcare solutions.

View Details