Hormonal Acne Explained

Medically Reviewed By Amanda Caldwell, MSN, APRN-C
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Hormonal acne involves acne occurring into adulthood. It results from hormone fluctuation, which causes sebum production, inflammation, and breakouts. Hormonal acne includes blackheads, whiteheads, cystic acne, and more. Acne is a common condition. While it is most prevalent in teenagers and young adults, people can continue to experience acne into their 40s and 50s.

This article will discuss hormonal acne and its causes, symptoms, and treatment.

What is hormonal acne?

A person with acne painting
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The phrase “hormonal acne” generally refers to adulthood acne resulting from hormone fluctuation. However, hormones influence all types of acne.

Acne results from an overproduction of sebum in the skin. Sebum is an oily substance that can collect in pores and trap dead skin cells and bacteria. This substance blocks the pores and causes inflammation, leading to acne breakouts.

What are the causes of hormonal acne?

Fluctuations in hormone levels within the body can cause hormonal acne. Androgens, which are the hormones in males that include testosterone and dihydrotestosterone, promote sebum production and lead to breakouts. Changes in estrogen levels during menstrual cycles in females may also cause or worsen acne.

Some other possible causes of hormonal acne include:

  • Genes: A family history of acne may increase your risk of developing acne.
  • Polycystic ovary syndrome: Elevated androgen levels associated with this condition can contribute to acne.
  • Testosterone therapy: Testosterone creams, ointments, and injections for people with low testosterone may promote the development of acne.
  • Medications: Some medications list acne as a side effect.

What does hormonal acne look like?

Hormonal acne

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Whiteheads

Whiteheads are raised and can be either flesh-colored or white.

ARTFULLY PHOTOGRAPHER/Shutterstock

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Blackheads

Blackheads form when dead skin cells and oil collect in a pore and react with oxygen.

ThamKC/Shutterstock

Acne,Skin,Problem,On,Woman,Surface,Skin,Background

Cysts

Cystic acne reaches deep into the skin and can become swollen and painful.

TLaoPhotography/Shutterstock

Acne can produce several types of lesions, depending on the material blocking your pores.

  • Whiteheads are pus-filled pimples that are red or discolored, raised, and may have a white dot in the center.
  • Blackheads are small and dark, appearing as though dirt collected in the pore.
  • Cysts are large pimples that contain a lot of material. These can be painful and can affect your appearance.
  • Nodules are large pimples that are deep below the skin.
  • People with darker skin tones may see dark spots, called hyperpigmentation, and thickened, raised scars where acne lesions healed.

How do doctors diagnose hormonal acne?

Dermatologists typically diagnose hormonal acne through a visual examination. Although, fluid cultures or tissue biopsies may be necessary to rule out other conditions. They may also ask about your family history, menstrual cycles, and medications.

Talk with your doctor if a lesion does not heal, begins draining, or grows.

What are the treatments for hormonal acne?

Depending on the severity, treatments for hormonal acne can vary. Your dermatologist can make recommendations based on your particular situation.

Topical treatments

Some topical treatments are available without a prescription, while others require physician approval. Topical treatments may include:

  • Benzoyl peroxide: This medication removes surface bacteria and may cause dryness.
  • Salicylic acid: This dissolves dead skin cells and helps remove cellular debris that can clog pores.
  • Retinoids: These are vitamin A derivatives that break up oily deposits.
  • Antibiotics: In some cases, you may need to apply antibiotic creams to your skin to decrease bacteria.
  • Azelaic acid: This is a natural acid in grains that helps remove dead cells and oil.
  • Clascoterone: Two 2020 studies found that 1% clascoterone cream might be beneficial in treating acne.

Some products are available as combinations of the above. You may be able to use two or more products together, but be sure to follow your doctor’s recommendations.

Oral medications

Some acne medications are available in oral form. These can include:

  • Oral contraceptives: Contraceptives containing estrogen may help suppress the effects of androgens on sebum production.
  • Antibiotics: Doctors may prescribe antibiotics to treat more severe forms of acne.
  • Oral retinoids: Isotretinoin and tretinoin are prescription retinoids that help decrease acne. It is important not to take these medications during pregnancy, as they are dangerous to a developing fetus.
  • Other hormone therapies: Spironolactone, cyproterone acetate, and flutamide block the action of androgens to help treat acne.

Natural treatments

People seeking to manage hormonal acne may consider natural products. Please note that the data on these products, such as tea tree oil or vitamin supplements, are limited and inconsistent. Talk with your doctor before starting any at-home treatments or supplement regimen.

Can you prevent hormonal acne?

While hormonal acne may not be entirely preventable, there are things you can do to minimize breakouts. Measures that decrease oily sebum on the skin may be effective in maintaining clearer skin. It is also important to maintain your skin’s health with moisturizing and a gentle cleansing regimen.

Diet

A balanced diet with minimal oils and plenty of vitamin-rich fruits and vegetables may help. There is some controversy about how this affects acne, but a nutritious diet benefits the entire body.

Skin care products

Cosmetics, moisturizers, and sunscreens labeled “non-comedogenic” may help manage acne. The term “non-comedogenic” means the ingredients in these products will usually not clog your pores. Using gentle cleansers instead of harsh facial scrubs can also help you avoid inflammation.

Lifestyle changes

According to the American Academy of Dermatology Association, stress can contribute to breakouts by stimulating hormone production. Taking steps to relieve stress and getting adequate rest may help manage your acne.

What is the outlook for people with hormonal acne?

The outlook for people with hormonal acne is usually good. Managing breakouts, diminishing inflammation, and eliminating scarring and dark spots are possible with proper treatment. Contact your dermatologist for a more comprehensive care plan if over-the-counter (OTC) treatments are ineffective for you.

Discuss any natural supplements you wish to use with your doctor.

Frequently asked questions

These are a few other commonly asked questions about hormonal acne. Amanda Caldwell, MSN, APRN-C reviewed the answers.

When should I call my doctor about hormonal acne?

Talk with your doctor if your acne is persistent, draining, or very painful. These symptoms may indicate an infection or another underlying condition.

Will my hormonal acne go away on its own?

Because your hormones fluctuate throughout your life, mild acne may resolve on its own. More serious cases of acne may require medical treatment.

Is acne contagious?

While acne itself is not contagious, some bacteria that contribute to it may be infectious.

Summary

Hormonal acne occurs when fluctuations in hormone levels increase sebum production, clogging your pores and causing inflammation. People with hormonal acne may experience whiteheads, blackheads, cystic acne, or nodules.

Treatments for hormonal acne may include OTC or prescription medications. These medications can come in oral or topical form. With proper treatment, many cases of hormonal acne are manageable.

Talk with your dermatologist if you experience severe or persistent acne. They can help you determine possible causes and potential treatments.

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Medical Reviewer: Amanda Caldwell, MSN, APRN-C
Last Review Date: 2022 Jul 25
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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