Understanding Hormonal Acne Triggers and Treatments
- Rachel
- Mar 23
- 5 min read
Updated: May 19
Dealing with hormonal acne the last few months has really pushed me over the edge. I've gone through periods in my life where I've had cystic acne, especially in my early 20s, but never has it been this incessant. I need it to stop. Hormonal acne is so frustrating because it's not your fault—it's not about what you've put on your face or about your diet (given you don't eat horribly). While good habits can help with the overall life cycle and intensity of breakouts, most women have little to no control over their hormones.
Even when I've tried to do everything right—like getting my hormones checked, taking supplements, and gearing my diet specifically toward female hormonal health—what's happening internally is such a mystery. It has left me feeling like I'm tackling this alone.
If sharing what I've learned and the practical steps I take to decrease my breakouts helps even one woman, I'll be happy.
What Is Hormonal Acne?
Hormonal acne is often caused by fluctuations in hormones. Though there are many different types of hormones, typically it's androgens like testosterone and DHT that affect oil production and lead to breakouts. These breakouts tend to appear on the lower face, jawline, and neck—areas sensitive to hormonal changes.
A vast number of people will experience hormonal acne during periods of hormonal changes—puberty, menstrual cycles, pregnancy, and menopause. Polycystic ovary syndrome, also known as PCOS, is a condition that can trigger this type of acne because it affects hormonal balance (or imbalance).
Why Does Hormonal Acne Happen?
Hormonal acne occurs because hormones influence the skin’s oil glands. Here’s how:
Increased Androgens: Androgens are a type of steroid hormone that stimulate production in whatever they are attached to. When there is an overabundance of androgens (especially in women), they bind to sebaceous glands and signal them to produce more sebum. Excess sebum mixes with dead skin cells and clogs pores.
Inflammation: Hormonal changes can increase inflammation in the skin, making acne lesions red, painful, and swollen.
Bacterial Growth: Everyone has acne bacteria on their skin; it's part of our skin's natural and healthy microbiome. When excess oil clogs our pores, it creates an environment where acne-causing bacteria (Cutibacterium acnes) thrives.
Skin Cell Turnover: Hormones can affect how quickly and efficiently skin cells shed. An increase in shedding might seem beneficial, but coupled with the increase in oil, our skin cells become more sticky and build up within the pores and follicles.
Combining all these factors creates the characteristic pimples, nodules, and cysts we associate with hormonal acne.
Common Triggers of Hormonal Acne
Understanding what triggers hormonal acne helps in managing it effectively. Some common triggers include:
Menstrual Cycle: Many women, myself included, notice acne flare-ups a week before their period due to hormone fluctuations and an increase in androgens (testosterone—boo).
Stress: Stress increases cortisol, which can worsen acne by stimulating oil production.
Diet: High-glycemic foods cause insulin sensitivity, and dairy contains IGF-1 (Insulin-like Growth Factor-1), both of which may contribute to an increase in hormonal acne breakouts if you're already experiencing hormonal imbalances.
Medications: Certain drugs, like steroids or hormonal contraceptives, can influence acne. Speak with your doctor if you believe this could be affecting your skin.
Underlying Health Issues: Conditions like PCOS cause hormonal imbalances that lead to acne. This can be hard to detect because the ovarian cysts can fluctuate depending on where you are in your cycle.
How to Reduce Hormonal Acne
I've done a ton of research and have tried many things myself over the past years. Here are the things I've found that help me:
1. Maintain a Consistent Skincare Routine
Use gentle cleansers twice daily to remove excess oil and dirt without stripping the skin. I have the Glymedplus Idyllic cleanser that uses mandelic acid, which I LOVE. It keeps my skin bright, soft, and even hydrates.
Choose non-comedogenic moisturizers to keep skin hydrated, and incorporate hydrating masks, serums, and/or toners throughout the week.
Incorporate products with ingredients like salicylic acid or benzoyl peroxide to unclog pores and reduce bacteria. If you're sensitive, try an azelaic acid or mandelic acid product instead. When I start to feel a cystic pimple coming on—you know when you can feel it underneath the surface before there's even a bump?—I treat the area with benzoyl peroxide as soon as I can, and no more than 2-3 days in a row. Otherwise, I risk stripping and drying out the skin, which can cause more inflammation and prolong or worsen the breakout. After those 2-3 days, I go straight into hydrating, whether it's a serum directly on the area a few times a day or a hydrating night mask. This helps with healing quickly and decreasing inflammation.
Avoid harsh physical scrubs or over-washing, which can irritate the skin and worsen acne. We want to treat underneath the surface with gentle products and always balance with hydrating and nourishing products.
2. Manage Hormone Levels
Consult a healthcare provider if you suspect hormonal imbalances. They may recommend hormonal treatments such as birth control pills or anti-androgen medications.
For women with PCOS, managing insulin resistance through diet and medication can improve acne.
Stress management techniques like meditation, exercise, or therapy can help regulate cortisol levels.
3. Adjust Your Diet
Limit high-glycemic foods such as white bread, sugary snacks, and sodas. As a devout sweets girl, this one has been the most difficult for me. But we learned above that these trigger insulin, which can stimulate oil production and contribute to breakouts.
Reduce dairy intake if you notice it worsens your acne—don't forget about that IGF-1, another hormone that lends itself to more breakouts.
Focus on a balanced diet rich in fruits, vegetables, whole grains, and proteins. Learn to love foods that love you back, and don't beat yourself up for treating yourself once in a while.
4. Consider Professional Treatments
Seeing a dermatologist for Tretinoin or a doctor for medication can be very helpful for those dealing with severe acne.
Facials like my Decongestion Facial help to reduce oil and built-up skin cells, hydrate to decrease inflammation, and during the treatment, we use a device that specifically helps heal and speed up the life cycle of your breakouts. It's efficient, and you're left with glowing, beautiful skin!
Conclusion
It's difficult to work with hormonal acne, but you don't have to go at it alone. There are many resources online, and I truly believe there's a lot you can do on your own. It takes some work, but you can work with your body.
By the way, I would love to hear any tips you have that help your breakouts, so let me know in a message or comment!
Thank you for reading and being here.
xo rach
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