Hormonal Acne: What Is It, Treatment & Causes

Battling pimples as an adult can feel unfair. It's like, ‘Wasn’t this supposed to be over during my teen years?’ Well, not quite. Especially if you’re battling bouts of hormonal acne, which most commonly appears in adult women ages 20 to 40.

And even the post-40 crowd is not necessarily in the clear, as there can be a resurgence of breakouts around menopause due to hormonal fluctuations in the body. 

Can't tell if you’re dealing with hormonal acne vs. more common acne? We can help. Read on to learn everything to get the scoop on hormonal acne.


What Exactly is Hormonal Acne?

Let’s separate fact from fiction — just what is acne in the first place? 

It seems so obvious, doesn’t it? Your acne breakout is due to your fluctuating hormones. After all, you can see the evidence as plain as the blemishes on your chin. And if only you could get those hormones under control. Then poof! No more acne, right? 

Well, not exactly. 

Though fluctuating hormones can most certainly trigger your acne, and a healthy hormonal balance can help improve your skin, acne is not a hormonal condition. Period. 

Despite what many people may think, acne is actually a genetic skin condition called retention hyperkeratosis. Let us explain. 

So, your skin sheds a layer of dead skin cells every day. However, this continuous shedding process isn't the same for those with acne. Acne-prone skin produces up to five times more dead skin cells than normal, causing a traffic jam because the excess dead skin cells stay stuck on the skin’s surface and clog your pores. The resulting plug (mixed with oil) forms blackheads. When infected with bacteria, a blemish occurs. 

Simply put, your acne-prone skin is perpetually clogging itself, and your unique blend of triggers (more on that later) aggravates the situation. 

That is why the myth of “all I have to do is balance my hormones, and I will get rid of my acne” is so dangerous — because it’s straight up false.

How to identify Hormonal Acne

Think your fluctuating hormones are triggering your acne? Here are a few of the top signs to look for:

  • Acne along your jawline, chin, and back. One telltale sign that hormones are triggering your acne is the location. When your jawline, chin, and back are flushed with constant or recurring acne, chances are your hormones are why. 

  • You’re no longer in your teens. According to the skin experts over at the American Academy of Dermatology, adult-onset acne is becoming increasingly common in women in their 30s, 40s, and even in their 50s. Studies show that up to 51 percent of women in their 20s, 35 percent in their 30s, and 25 percent of women in their 40s deal with acne. 

  • Tender or painful acne nodules. Unlike whiteheads and blackheads -- which come to a head -- an acne nodule (commonly referred to as a cyst) appears as a bump the size of a pencil eraser under your skin. The nodules almost always start off red due to inflammation and usually last for a couple of weeks. 

  • Stress. Guess what? The oil gland cells that produce sebum also have receptors for stress hormones like adrenaline and cortisol. That’s why you break out in times of prolonged or heightened stress. And both physical and psychological stress can have a similar effect. Whether you're cramming for exams, getting crushed at work, or your family is driving you crazy, stress increases your risk for acne. So unplug, do you, and chill out.


Causes of Hormonal Acne

When it comes to hormones triggering your breakouts, you can thank your androgens. Though they are commonly thought of as male hormones, anyone can have them. They are produced by your adrenal glands as well as the ovaries and testes. The most well-known androgens are testosterone. 

How do androgens trigger acne?

Good question. If you suppress estrogen (for instance, when you take hormone-balancing supplements or low-dose birth control pills) androgen production goes way up. That is because estrogen and androgens work like a teeter-totter; as one goes up, the other goes down. 

Here’s the issue: androgens can bind to oil gland cells in the skin, signaling the oil gland to produce much more sebum. This excess oil combines with your dead skin cells, bacteria, and debris in your pores, ultimately causing pimples to form. The more androgens, the more breakouts and the more you sabotage your skin. Even though you thought you were doing the right thing. 

Here are the primary pathways that hormones can mess with your skin:

Low Dose Birth Control Pills

Low dose birth control pills (along with morning-after pills and IUDs) lower estrogen, and in turn, elevate androgen levels. To prevent escalation in your acne, it’s really important to speak with your doc about selecting a form of birth control that is higher in estrogen and lower in androgen potency. 


Over-committed, overworked, stressed out? There is actually a confirmed link, believe it or not, between stress and acne. When you keep putting off opportunities to recharge and relax, your body can enter a constant hormonal state of “fight or flight,” which is controlled by your adrenal glands. Chronic, continual stress increased cortisol and androgen levels, and both can lead to an increase in oil production and *drum roll* acne. So, slow down. Take that well-deserved break. Your body will thank you. 

Polycystic Ovarian Syndrome (PCOS)

Some ladies are genetically predisposed to low estrogen and progesterone levels and high androgen levels. This hormonal imbalance causes them to skip menstrual periods and instead of their ovaries releasing eggs, tiny fluid-filled sacs called cysts are formed. Research indicates that a high percentage of women are unaware they have this syndrome.  


Acne during pregnancy is much more common than you think. In fact, about half of all women get pimples instead of the often discussed pregnancy “glow” during the first and second trimesters. It’s typically related to escalating levels of hormones, including progesterone, which can also increase the production of sebum in the skin’s oil glands.


Ever notice that your skin gets more spotty about a week before your period? During the latter phases of menstruation, if the released egg doesn’t become fertilized, progesterone and estrogen levels drop, which causes the onset of your period. These shifts in hormones, in turn, trigger acne. It’s life and it’s totally okay. 


Ah, puberty. When you hit puberty, androgens take off. For girls typically around 13 years of age, bumps, and spots begin bubbling up on the forehead. By age 15, acne appears on the cheeks, jaw, and chin, becoming inflamed along the way. Boys, on the other hand, tend to get acne all at once when they’re about 16, due to a massive spike in testosterone. As you know, a spike in androgens is responsible for a spike in sebum production — and acne.


How to Treat Hormonal Acne

Like most other kinds of acne, there are many ways to treat hormonal acne. No matter which way you approach it, the key is to decrease oil production and “unglue,” shedding skin cells to prevent pimples from forming. Other than finding ways to minimize stress, such as meditation and exercise, quality skincare products like the ones found at Topicals can help. 

Take the Like Butter Hydrating Mask, for instance. This thick, whipped mask is packed with powerful botanicals for skin so smooth, it’s like butter. All you have to do is apply a thin, even layer onto your clean damp skin, leave it on for a minimum of 20 minutes, and voila — you’re left with deliciously soft skin. Other than leaving your skin oh-so-soft, it also helps to fortify your skin’s damaged moisture barrier. Our Brightening and Clearing Gel Faded gently fades the look of your most stubborn marks, scars, and spots so that you can kick back and let your worries fade away.


Bottom Line

Hormonal acne is something we all end up facing at one point or another -- thankfully, Topicals can help! 

Topicals is much more than beauty and skincare; we are the new standard -- medicated botanicals. Using only ingredients and herbals that have been scientifically-proven and never any dyes or fragrances, it’s no wonder why so many people are turning to Topicals to support their skin!