• Acne

Hormonal Acne: Causes, Treatment, and Prevention Tips

Medically reviewed and edited by Harmony Vance, APRN

Experiencing acne in your adult life can be a particularly frustrating experience – especially if your breakouts are painful and difficult to treat.

Dealing with hormonal acne can be more than just a skin care concern — it also involves understanding how your body works.

In this article, we’ll take an in-depth look at hormonal acne, its causes, treatments, and precautions you can take to minimize the severity of your breakouts.

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What is Hormonal Acne?

Hormonal acne is a skin condition that develops when hormones fluctuate in the body. These imbalances can play a significant role in the development and severity of hormonal acne.

Common characteristics of hormonal acne include deep cystic lesions as well as painful and inflamed pimples that typically occur around the chin or jawline.

Is hormonal acne different from a normal breakout?

Hormonal acne is slightly different from a normal breakout, primarily due to its underlying causes, persistence, and treatments.

Normal breakouts can be caused by a variety of factors, including genetics, diet, and stress. Hormonal acne is usually only caused by imbalances in the body.

If you have hormonal acne, you may also experience cyclical breakouts that worsen during a specific time — such as before menstruation. These breakouts may be more persistent compared to normal acne, which tends to resolve more quickly.

Hormonal acne is also treated differently than regular breakouts since cysts and lesions can be more challenging to get rid of.

While normal breakouts can typically be managed with over-the-counter (OTC) products and topical treatments, hormonal acne may require a more aggressive approach.

This might include prescription medication, potent skin care products, and even surgery.

Which Hormones Cause This Type of Acne?

Hormonal acne is primarily influenced by fluctuations in hormones called androgens. These include:

• Testosterone: This is a well-known androgen that plays a central role in the development of acne. It stimulates the sebaceous glands on the skin, which causes an excess of oil to build up and clog pores, leading to acne.

• Progestogens: These hormones are produced during the second half of the menstrual cycle and during pregnancy. Similar to testosterone, progestogens cause an increase in sebum (oil) on the skin, which can trigger acne.

• Estrogens: While estrogens are typically associated with positive effects on the skin, fluctuations or imbalances can contribute to acne development. Low estrogen levels — especially in relation to high androgen levels — can make it difficult for the skin to regulate oil, which leads to an increase in clogged pores and breakouts.

Different Hormonal Acne Triggers

Puberty

Puberty is an important transitional phase when the body undergoes various hormonal changes.

During this time, both girls and boys typically experience an increase in androgen hormone production, specifically testosterone.

These androgens increase the skin’s oil production, which leads to acne.

Hormonal acne that develops during puberty usually occurs in the T-zone, or the forehead, nose, and chin.

Menstruation

Hormonal acne may also be linked to menstruation, which makes it a monthly occurrence for some women.

In the days leading up to a period, there is an increase in progesterone and a decrease in estrogen, which causes a hormonal imbalance.

Due to this imbalance, excess sebum may be produced because your skin struggles to regulate oil.

When this happens, a buildup of sebum occurs on the skin, and oil — along with dead skin cells and bacteria — can become trapped in the pores more easily. This causes blemishes to form.

Hormonal acne that develops due to menstruation is typically quite mild and tends to resolve a couple of days after your period has ended.

Pregnancy

As the body prepares to support a growing fetus, significant hormonal changes occur.

Elevated levels of progesterone and other androgens increase the skin’s oil production, which may contribute to hormonal acne breakouts.

Although pregnant women may also experience clearer skin due to higher estrogen levels, others may find themselves dealing with moderate acne that can become severe.

If you are experiencing hormonal acne during pregnancy, it’s advised to use any traditional treatments — such as certain skin care products and aesthetic procedures — with caution.

This is because many products aren’t considered safe for pregnant women and may harm your unborn baby.

It’s recommended to speak with your healthcare provider about the best available acne treatments for pregnant women to ensure your safety.

Menopause

Menopause is another life stage marked by hormonal fluctuations. As estrogen levels decline, an imbalance develops, and the body experiences an increase in androgens.

When this happens, the skin produces more oil which can clog the hair follicles (pores) and contribute to menopausal acne.

These hormonal changes often cause breakouts in areas that aren’t typically affected during earlier stages of life.

This can be especially distressing for women who may have thought that they left acne behind in their teenage years.

Depending on your individual circumstances, you may experience mild to severe acne during menopause.

It can usually be treated with various prescription medications and replacement therapies. We will discuss these in more detail in the next section.

Polycystic ovary syndrome (PCOS)

PCOS is a hormonal disorder that can lead to various symptoms, including hormonal acne.

Individuals with PCOS often have higher androgen levels, which can contribute to frequent breakouts. PCOS-related acne is typically noticeable along the jawline and chin.

If you have PCOS, you might also experience other symptoms, such as irregular periods, abdominal pain, and weight gain.

In most cases, acne alone won’t indicate PCOS, but if you’re concerned about your health, you should make an appointment with your healthcare provider.

What is the Best Way to Treat Hormonal Acne?

Hormonal acne can be stubborn and challenging to treat due to its underlying causes. However, there are several treatment options available to help you manage hormonal breakouts.

Retinoids

Topical retinoids — such as adapalene and tretinoin — are derivatives of vitamin A designed with a number of benefits for the skin.

Research even suggests that retinoids are one of the most effective treatments for acne on the market.

They help to promote the skin cell turnover process to remove dead cells and bacteria from the complexion. This helps to unclog pores and treat acne, promoting clear and healthy skin.

Retinoids can also reduce inflammation and promote healing, which helps them minimize the appearance of scars caused by hormonal acne.

Although retinoids are a great treatment option, they can also cause unwanted side effects like skin irritation and dryness. This can make hormonal acne worse and trigger more frequent breakouts.

That’s why it’s recommended to use a topical retinoid under the guidance of a dermatologist.

Retinoids are also not safe for pregnant women to use, so speak to your doctor about alternative options if you are expecting.

Oral contraceptives

Women who experience hormonal acne may be able to treat breakouts with an oral contraceptive — also known as birth control pills.

These contraceptives contain synthetic forms of estrogen and progestin hormones that can help regulate any imbalances.

This also reduces the production of androgens, which decreases excess oil production that contributes to acne.

Antiandrogen drugs

These medications work by blocking the effects of androgens on the skin.

Drugs like spironolactone are commonly prescribed for hormonal acne because they help to reduce sebum production while minimizing the appearance of pores.

Over time, this can clear the blemishes caused by hormonal imbalances.

If you are taking anti-androgen drugs, it’s important to have regular follow-ups with your doctor to monitor your dosage and adverse reactions.

Natural remedies

Natural remedies — like tea tree oil — often have antibacterial and anti-inflammatory properties, which can reduce breakouts.

However, it’s important to use natural remedies under the guidance of a healthcare professional.

It’s also vital to note that these remedies are typically less effective than prescription treatments, especially for stubborn forms of acne like hormonal breakouts.

Lifestyle changes

Lifestyle modifications can complement your medical treatments for hormonal acne. These changes may include:

• Using gentle skin care products with acne-fighting ingredients

• Managing stress through relaxation techniques

• Getting more physical exercise

• Improving your quality of sleep

• Eating a balanced diet rich in nutrients

It might also be a good idea to speak with your doctor about your lifestyle habits.

This can help them to determine if anything you’re doing may be worsening hormonal imbalances and what you can do to manage it.

Can You Prevent Hormonal Breakouts?

Hormonal acne is usually influenced by factors out of our control, so it can be challenging to try and prevent this skin condition.

Taking certain precautions may help you minimize the severity of your breakouts, which can help you avoid complications like scarring. This includes:

• Maintaining a consistent skin care routine

• Cleaning your face after excessive sweating

• Drinking enough water

• Avoiding picking or touching pimples

Speaking to your doctor about hormone awareness may also help you understand your breakouts and determine what you can do to reduce them.

When Should You See a Doctor about Hormonal Acne?

If you are experiencing significant or persistent hormonal acne that is impacting your quality of life, it’s recommended that you make an appointment with your dermatologist.

While occasional breakouts are normal, seeking medical attention becomes important when your acne is causing emotional distress, scarring, or doesn’t respond to OTC treatments.

A dermatologist can help you accurately diagnose the cause of your acne and tailor a treatment plan specific to your needs. You can also reach out to the professionals at LifeMD for help.

Where Can You Learn More About Hormonal Acne and Similar Skin Conditions?

If you’re concerned about your hormonal acne or want to know more about this condition, LifeMD is here to help.

Licensed medical professionals can provide information about hormonal acne and guidance on managing your breakouts without irritating your skin — all from the comfort of your home.

Make an appointment with LifeMD now to get started.

Harmony Vance, APRN

Harmony is a family nurse practitioner and has been caring for patients for over 20 years through various roles in the medical field. She graduated in 2018 with a Master's Degree and a focus on family care.

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