Ask a Dermatologist: How to Tell If Your Acne Is Hormonal

According to experts.

hormonal acne

While there are a ton of things that may be causing your breakouts, many of them can be controlled by changing up your skincare routine. One reason for acne that can’t be so easily controlled, though? When your hormones are the culprit. Unfortunately, along with stress, this is a common cause of acne and blemishes in adult women—and often it can be difficult to tell the difference between hormonal acne and other breakouts. "Hormonal acne, of course, is linked to your hormones," says Michele Green, M.D., a New York City-based board-certified dermatologist. It’s our estrogen, progesterone, and testosterone fluctuations that cause this type of acne."

While regular breakouts can also be caused by a fluctuation in hormones, hormonal acne in particular is a repeated return of acne due to regular hormonal imbalances. Usually, it's because such hormones can cause an influx of oil in your skin, which leads to clogged pores. According to Daniel P. Friedmann, M.D., FAAD, a board-certified dermatologist at Westlake Dermatology in Austin, Texas, “An increase in androgenic hormones [i.e., testosterone] can easily increase skin oil production." Below, find more on what causes hormonal acne, how to spot it, and how to treat it.

Meet the Expert

Daniel Friedmann, M.D. is a fellowship-trained, board-certified dermatologist and phlebologist at Westlake Dermatology and Clinical Research Director of the Westlake Dermatology Clinical Research Center. Friedmann is a fellow of the American Academy of Dermatology and the American Society for Dermatology Surgery, as well as a member of the American Academy of Cosmetic Surgery, American College of Phlebology, and the American Society for Laser Medicine and Surgery.

What Causes Hormonal Acne

Our hormones are always in flux. Whether it’s because of your menstrual cycle, your birth control, your diet, your stress levels, your sleeping patterns, or even your environment, there are tons of factors at play—and each one can influence how much of a certain hormone your body produces (or doesn’t produce). Estrogen, progesterone, and testosterone are specifically what we’re talking about when we reference “hormonal acne,” but studies have shown stress hormones like cortisol can also affect our skin’s oil production, which can cause breakouts and acne.

According to Sonia Vaidian, M.D. of EHE Health, hormonal acne can also be triggered by hormonal changes during pregnancy, menopause in women, or puberty in both male and female adolescents." It’s totally common, and not necessarily something to worry about. That said, if it's happening more than usual (and no longer aligning with your menstrual cycle) something else could be at play. "Hormonal acne is portrayed as a cycle pattern, the same as women’s monthly menstruations," Vaidian says. If there's been a sudden switch, it's worth getting your hormones checked with your personal doctor.

Where it's Located

Although this can vary, Dr. Green says hormonal acne tends to occur in the same spot due to oil production patterns. So, if you’re noticing a blemish keeps reappearing on your chin month after month, there’s a good chance it has to do with your hormones. “[Hormonal breakouts] tend to appear around the chin and jawline because the sebum level is higher than other parts of the face,” Dr. Green explains. “When your hormones fluctuate, it causes your body to stimulate the oil glands—and a lot of them are located in that area."

Meet the Expert

Dr. Michele Green is a board-certified dermatologist with an MD from Mount Sinai Medical School in NYC. Green worked for global skin care brands, L'Oréal, Johnson and Johnson, Bioré, and RoC on the research, development, and safety testing of worldwide product launches. She has published articles in professional journals including The Journal of American Academy of Dermatology and Cosmetic Dermatology.

How to Help

There are a few things you can do to take care of your skin and help hormonal spots heal quickly. According to Dr. Green, retinoids are a good option to help clear your skin. “Even if you have moderate acne, retinoids help by eliminating dead skin cells off your face, and they work at a steady rate so that the dead skin cells don’t stick together and cause blockage,” she explains. Dr. Vaidian, suggests a skincare system that will control oil production: “Wash your face twice daily with an antibacterial facial cleanser and follow up using a toner and lightweight, oil-free moisturizer,” she says.

Of course, no matter the method you choose, it's important to recognize the issue likely won’t entirely disappear until the underlying causes—the hormone fluctuations—are addressed. In addition to a skincare routine, Dr. Green suggests oral medication to help keep things in balance. "Antiandrogen supplements (i.e. spironolactone) can help reduce excess androgen levels, which is a causative of hormonal acne,” she explains. Additionally, she recommends talking to your doctor about any other symptoms you may be having that could be related to hormones—exhaustion, hair loss, etc.—so that your situation can be assessed as accurately as possible.

FYI: Here are some hormonal acne remedies that work.

Article Sources
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  1. Harvard Health Publishing. Adult acne: understanding underlying causes and banishing breakouts. Updated September 23, 2019.

  2. Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin agingInflamm Allergy Drug Targets. 2014;13(3):177-190. doi:10.2174/1871528113666140522104422

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