How To Stop Hormonal Acne

Acne is one of the most common skin conditions worldwide. Managing the condition can be tough, but many different treatment options are available to help people treat all kinds of acne, including hormonal. 

Depending on the severity of your hormonal acne, you can treat and prevent it with topical and oral medications, such as retinol, antibiotics, benzoyl peroxide, salicylic acid, and sodium sulfacetamide, or hormonal therapy, like the contraceptive pill. However, there are also some lifestyle changes and natural remedies you can incorporate into your routine to try and prevent hormonal acne. 

Acne breakouts can take a significant toll on mental health. However, since acne is one of the most common skin conditions worldwide, affecting approximately 650 million people, it is nothing to be ashamed of.17 Acne is your body’s way of telling you that something might not be right. It is important to recognise what type of acne you have, its causes, and how it can be treated. One of the common causes of acne is a hormone imbalance that results in a breakout of hormonal acne.

What is hormonal acne?

Interestingly, ‘hormonal acne’ is not a term used in the scientific and medical community. Instead, it is referred to as simple acne, or acne vulgaris, with hormonal pathogenesis.5 However, ‘hormonal acne’ is a term widely used by the general public and can be repeatedly seen in magazines and online articles. As the term suggests, hormonal acne is usually a way for our body to warn us of an internal hormone imbalance. 

Acne is caused by an increased secretion of sebum, an oily substance produced by sebaceous glands.8 In normal quantities, sebum serves as a ‘natural oil’ that moisturises and protects our skin. However, when it is produced in excess, sebum, along with cell debris such as our dead skin cells and acne-causing bacteria, plugs the hair follicles, leading to their inflammation which then causes acne. Hormone imbalance can aggravate the follicular clogging and sebum secretion leading to more pronounced acne.23

Who can hormonal acne affect?  

It is a common misconception that hormonal acne only affects those going through puberty. This type of acne is indeed highly prevalent among adolescents (up to 85%) due to hormonal shifts associated with puberty, but hormonal acne can also affect adults in their 30s and 40s, in which case it may be referred to as adult acne.2,5 It is more common in women than men and has been associated with menstruation, menopause, polycystic ovary syndrome (PCOS), and increased androgen hormone production, such as testosterone.1, 20

Fungal acne vs hormonal acne?

Fungal and hormonal acne are easily confused as both affect the hair follicles. However, fungal acne is caused by a yeast overgrowth that clogs and infects hair follicles, causing inflamed pimple-like bumps, sometimes filled with pus, on your skin. Fungal acne can be itchy and appear on the upper back, neck, chest, chin, and forehead. Strangely, fungal acne is not actually acne; it simply resembles an acne breakout. The proper term for fungal acne is Malassezia folliculitis.7,21 Hormonal acne, on the other hand, results from increased sebum secretion that clogs pores and leads to acne breakouts with blackheads, whiteheads, papules, and even cystic acne.10    

What causes hormonal acne?

Hormonal acne results from excess sebum, bacteria, and cell debris clogging follicles. Let’s look at some factors in and out of your control, respectively, that can affect sebum secretion and subsequently cause follicle clogging and acne breakouts. 8,23

Causes of hormonal acne that you can control:

  • Levels of emotional stress: increased emotional stress has been linked to increased acne.27,29
  • Sleeping habits: poor sleeping habits, such as insufficient sleep, have been linked to worse acne breakouts. 
  • Cosmetic make-up use: limiting excessive and frequent use of make-up has been shown to improve acne.24,25
  • Choice of skin care: the correct choice of skin care products is very important for managing acne..3

Causes for hormonal acne that you can’t do anything about

  • Natural changes in hormone levels: these can happen due to menstruation, menopause or pregnancy. 
  • Underlying medical conditions that cause hormone imbalance: PCOS and other ovarian syndromes lead to increased testosterone production, causing excessive sebum secretion.28
  • Hormonal acne as a side effect of medication: some medications can trigger hormonal acne or make already existing acne worse.6
  • Genetic factors: research shows that people with a family history of acne vulgaris have a higher predisposition for acne.18

What are the symptoms of hormonal acne?

Hormonal acne usually causes breakouts, which consist of blackheads, whiteheads, cysts, papules, pustules and nodules.5,23 Blackheads and whiteheads are not typically painful. However, if they become inflamed, they can cause significant pain and discomfort. Untreated or severe acne can lead to scarring and lesions. In adolescents going through puberty, hormonal acne usually presents on the forehead, nose, and chin. In older individuals, acne is generally in the lower part of the face, such as the jawline and cheeks. Hormonal acne is typically seen on the face due to high sebum levels in this area, but the shoulders, neck, back, and chest can also be affected.16  

What can make hormonal acne worse?

There is a range of factors that can exacerbate your hormonal acne: 

  • High air pollution12
  • Emotional stress29
  • Humid environment4
  • Skin-picking29
  • Inappropriate choice of medication3

Traditional treatments for hormonal acne

The course of hormonal acne is different for every person, and treatment choice largely depends on the severity and presentation of the breakouts and lesions. Fortunately, plenty of available medications can treat hormonal acne, varying from topical medication to hormone therapy. 

Most treatments for mild hormonal acne include over-the-counter drugs but can also incorporate medication prescribed by your GP or dermatologist. Topical medication, such as gels or creams, are the most common choice for the treatment of mild acne and can include one or a combination of the following ingredients:23

  • Retinoids, such as tazarotene, tretinoin, and adapalene, are considered the first-line treatment. This ingredient not only unclogs the already clogged follicles but also prevents future follicle clogging and therefore, the formation of blemishes.22
  • Antibiotics, such as erythromycin and clindamycin, are prescribed to treat inflammatory papules and lesions by reducing the bacteria that trigger inflammation.
  • Benzoyl peroxide has antibacterial properties but can also reduce inflammation and prevent the formation of new blemishes.
  • Salicylic acid has anti-inflammatory properties and prevents the formation of new blemishes by breaking down dead skin cells. It is incorporated into many skincare products, including toners, serums, and cleansers. Salicylic acid is a popular ingredient in the skincare industry and is utilised for exfoliation and pore cleansing.  
  • Sodium sulfacetamide has an antibacterial agent that explicitly targets P.acnes.
  • Azelaic acid is used to treat blemishes and inflamed acne due to its anti-inflammatory and antibacterial properties.
  • Dapsone has anti-inflammatory and antibacterial properties and is used to treat inflamed acne.13

Retinoids and antibiotics can also be taken orally. 

For more severe acne, it is highly advised that you consult your GP, who will prescribe you medication (either oral, topical or a combination of both) tailored to your requirements. Potential treatment options for more severe acne among women include hormonal therapy, which aims to decrease androgen levels. 

  • Oral contraceptives (also known as ‘pill’ or ‘birth control pill’) work by blocking ovarian and adrenal production of androgens. The pill is an effective treatment for different types of acne, from blackheads to cystic acne. Your healthcare provider will examine your medical history, blood test results, and other required tests to determine the dose and type of oral contraceptive necessary. This treatment option might not be suitable for people with high blood pressure or breast cancer, so it is crucial to provide all the necessary medical information to your doctor.1,23
  • Antiandrogen drugs work by blocking androgen receptors preventing excessive production of androgen hormones. One of the commonly prescribed antiandrogen drugs is spironolactone. It is effective in reducing acne and clearing skin.1

How to treat hormonal acne naturally

Alternatively, there are also a number of things you may do to help treat mild acne naturally: 

  • Eat a healthy diet. 
  • Reduce your stress levels, as decreased stress has been shown to decrease the number of breakouts and degree of acne inflammation.6
  • Improve your sleep quality.24
  • Take vitamin supplements. Vitamin A, for example, has been shown to increase the breakdown of dead skin cells and prevent them from clogging the follicles. However, it is important to talk with your GP before introducing supplements to your diet as some active ingredients might not be suitable for you, and can aggravate your acne. 
  • Introduce herbal medicine to your acne treatment.26
    • Green tea extract has been shown to be beneficial for acne treatment when applied topically. It reduced inflammation without producing any side effects.11
    • Tea tree oil has been shown to be effective in treating acne due to its anti-inflammatory and antimicrobial properties.15

When to seek medical attention

If you have tried multiple medications to clear your acne and nothing has helped, you should consult your GP or dermatologist. You should also seek medical attention if your acne worsens or you experience any pain, soreness or discomfort. The sooner you seek medical attention, the sooner you can start treatment and clear your skin. 


Hormonal acne is a common condition, whereby a hormone imbalance triggers an acne breakout. It is common among adolescents during puberty but can also affect adults in their 30s and 40s, especially women. It can have numerous causes and present as blackheads, whiteheads, cystic acne, papules, pustules, and nodules. The acne treatment depends on the severity and extent of a person’s acne and can include topical or oral medications and hormonal therapy, such as the birth control pill. Therefore, it is crucial to identify the root cause of hormonal acne to treat it accordingly. 


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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Anna Mazepa

Masters of Science - MSc Clinical Neuroscience/ University College London

Anna is a master’s graduate with interest in psychology and neuroscience. Since starting her undergraduate psychology degree, she has been passionate about scientific writing. Anna has been involved in the execution of multiple research projects during her academic journey and has written numerous scientific essays. She continues to be engaged in scientific and medical writing as she works towards becoming a Clinical Psychologist.

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