Hormonal acne can cause breakouts at every age, especially among women. While most associate hormonal breakouts with puberty, they rarely fade as you reach adulthood. Roughly 91 percent of acne-prone women note that they get a breakout in the week before their menstrual cycle, and 15 percent of women in their 50s still get menopausal acne.

Hormonal acne, unlike other acne forms, is persistent but dependent on the body’s phase. There may be times when your skin is clear and other times when your face is crowded with angry zits. Your hormones play an important part here, and this blog will tell you their role for every age group.

What Does Hormonal Acne Look Like?

Hormonal acne usually appears on the lower area of your face and below. This includes the jawline, neck, chin, chest, shoulders, and back. These areas are packed with androgen receptors, which means they will react immediately to hormonal changes and trigger sebum production. 

Blackheads and whiteheads are common in adults, as are papules and pustules. But deep and painful cysts that linger for a long time and leave dark spots in their wake are usually a telltale sign of hormonal acne. These inflamed bumps are located deeper in the skin layers and are particularly painful to the touch.

Hormones Involved in Hormonal Acne

Our body has more than 50 hormones that regulate and control our biological processes. However, only a handful of them are connected to hormonal acne breakouts. The main drivers are the following: 

• Androgens: Hormones like testosterone or THC activate the sebaceous glands and boost sebum production. The excess sebum clogs the pores and creates an environment where bacteria thrive. 
• Progesterone: Progesterone fluctuations increase sebum production. A rise in progesterone activates the oil glands, whereas a sharp drop causes the androgens to become dominant (thus triggering sebum).
• Estrogen: Fluctuations of estrogen (drops, in particular) lead to an imbalanced ratio with androgens and progesterone. This promotes excess oiliness and acne breakouts.
• Cortisol: The stress hormone stimulates sebaceous gland activity and increases sebum production. This causes inflammatory acne to appear in areas like the T-zone.

Understanding these hormones help you develop a treatment to address acne. For example, hormonal treatments can assist with androgens, estrogen, and progesterone, whereas stress management can help with cortisol reduction.

Hormonal Acne Through Life Stages

Hormonal acne manifests slightly differently, depending on the life stage you’re in. Various hormones can take the wheel, causing you to experience breakouts. Here’s what you can expect:

Puberty

Androgens like testosterone peak during adolescence, irrespective of gender. This increases oil production in the facial area, commonly leading to whiteheads, blackheads, papules, and pustules in the T-zone. Testosterone surges usually lead to acne located on the forehead, nose, and chin. 

Adulthood

Some adults reach adulthood, and their hormone levels stabilize, but others keep getting breakouts. Most of the time, these breakouts flare predictably with the menstrual cycle or are worsened by lifestyle. 

Pollution is also known to worsen hormonal acne symptoms, as it disrupts the endocrine system. This is why men and women living in big cities experience frequent breakouts on the lower third of their face. 

Pregnancy and Postpartum

Pregnancy is known to give you a “glow,” but this only happens somewhere in the second trimester. In the first stage, the sharp rise in estrogen and progesterone “shocks” your body, which usually responds by triggering more sebum production. This can cause pimples and inflamed pustules to show up on the lower half of the face. 

The hormones rebound after giving birth, and the fluctuation once more can send the body into sebum-producing mode. 

Perimenopause and Menopause

As women get closer to menopause, estrogen levels start to decline, creating an unbalanced ratio with the androgens. It’s a reverse version of puberty, frequently causing painful cystic acne breakouts. They usually appear on the jawline, lower cheeks, and chin, and resist standard skincare. Most will need personalized treatment to promote healing and prevent scarring. 

How to Address Hormonal Acne

Hormonal acne is treated after a thorough evaluation with the provider. Dr. Ariel Ostad will create customized treatment plans to address the hormone imbalance or excess oil production. 

Common acne treatments include: 

• Medical-Grade Skincare: Gentle acne regimen sets strengthen the skin barrier and regulate sebum production. Retinol and salicylic acid-based products increase cell turnover and lower inflammation.
• Oral Medication: Antibiotics are often prescribed to reduce acne-causing bacteria in existing flares. Treatments like isotretinoin (Accutane) reduce the sebaceous gland activity, stopping excess sebum.
• Laser Treatments: Procedures like AviClear™ target the sebaceous glands and stop them from overproducing sebum. Lasers such as CUTERA® are also effective for destroying acne-causing bacteria and helping the skin resist new breakouts.  
• Hormonal Therapy: When there’s a hormonal imbalance caused by a health condition, hormonal therapy can help restore the balance. 

Each person may experience hormonal acne differently, so treatment approaches are usually customized. Combination treatments are a good option to maximize the results.

Treat the Root of Your Hormonal Acne Today!

Hormonal acne is troublesome, but not impossible to deal with. With the right treatment, you can stop the hormones from affecting the skin and prevent breakouts. Schedule an appointment with Dr. Ariel Ostad and find out how to obtain clear skin!

For more information about hormonal acne and how to treat it, contact Dr. Ariel Ostad at 212-517-7900. He can determine the cause of your acne and set up a suitable treatment plan. Fill out the online contact form, and we’ll get in touch with you soon!