Hormonal Health

Hormonal Acne: Causes & Treatments

Understanding the root causes of hormonal acne and evidence-based approaches to achieve clearer, healthier skin

December 4, 2024
14 min read
Blonde middle aged woman in white bathrobe sitting at table full of cosmetics, looking at mirror. checking her forehead for pimples and wrinkles, side view. Skin problems concept

What is Hormonal Acne?

Hormonal acne is primarily driven by fluctuations in hormones, particularly androgens like testosterone. Unlike typical teenage acne, adult hormonal acne often appears along the jawline, chin, and lower cheeks, and tends to be deeper, more cystic, and more persistent.

Common Locations

  • • Lower face and jawline
  • • Chin and around mouth
  • • Neck area
  • • Sometimes chest and back

Characteristics

  • • Deep, cystic bumps
  • • Painful to touch
  • • Slow to heal
  • • Cyclical with menstrual cycle

Root Causes of Hormonal Acne

Androgen Fluctuations

Rising testosterone and DHT levels increase sebum production and can trigger inflammatory responses in hair follicles. This is why breakouts often worsen before menstruation.

Insulin Resistance

High insulin levels can increase androgen production and inflammation. This is why diet, particularly high-glycemic foods, can impact hormonal acne severity.

Chronic Stress

Elevated cortisol levels from chronic stress can disrupt other hormones and increase inflammation, making acne worse and healing slower.

PCOS & Other Conditions

Polycystic ovary syndrome, thyroid disorders, and other hormonal imbalances can significantly contribute to persistent adult acne.

Evidence-Based Treatment Approaches

Topical Treatments

Retinoids

Tretinoin, adapalene - normalize cell turnover and reduce inflammation

Benzoyl Peroxide

Antimicrobial properties, reduces P. acnes bacteria

Azelaic Acid

Anti-inflammatory, helps with both acne and post-inflammatory hyperpigmentation

Niacinamide

Reduces sebum production and inflammation

Systemic Options

Hormonal Birth Control

Regulates hormones, reduces androgen activity

Spironolactone

Anti-androgen medication, blocks testosterone effects

Antibiotics

Doxycycline, minocycline - reduce inflammation and bacteria

Isotretinoin

For severe, treatment-resistant cases

Lifestyle & Dietary Considerations

Dietary Modifications:

  • • Reduce high-glycemic foods
  • • Limit dairy consumption
  • • Increase omega-3 fatty acids
  • • Consider anti-inflammatory foods
  • • Monitor individual trigger foods

Stress Management:

  • • Regular exercise (not excessive)
  • • Adequate sleep (7-9 hours)
  • • Meditation or mindfulness practices
  • • Stress-reduction techniques
  • • Consider therapy for chronic stress

When to Seek Professional Help

Hormonal acne often requires professional intervention for optimal results. Consider seeing a dermatologist or healthcare provider if:

  • • Over-the-counter treatments haven't worked after 2-3 months
  • • Acne is severe, cystic, or leaving scars
  • • You suspect underlying hormonal imbalances
  • • Acne is significantly impacting your quality of life
  • • You're considering hormonal treatments

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