Understanding Hormonal Acne: The Hormones Behind the Breakouts
Acne is a common skin concern that can affect people of all ages, but when it’s driven by hormone fluctuations, it’s known as hormonal acne. Unlike typical acne caused mainly by bacteria or external factors, hormonal acne stems from the complex interplay of hormones that influence oil production, inflammation, and skin health.
What Is Hormonal Acne?
Hormonal acne is a form of acne that typically appears in areas like the jawline, chin, and lower cheeks—places sensitive to changes in hormone levels. It often affects teenagers going through puberty, but is especially common in adult women during their reproductive years. You might notice flare-ups around your menstrual cycle, pregnancy, or even during menopause.
The Hormone Connection: Who’s Involved?
Several key hormones play a major role in triggering hormonal acne:
Androgens (Testosterone and DHT): These “male” hormones are present in both men and women. When androgen levels increase, they stimulate the sebaceous glands in your skin to produce more oil (sebum). Excess sebum clogs pores, fueling the formation of acne lesions. Testosterone can also convert into dihydrotestosterone (DHT), a more potent hormone that further boosts oil production and inflammation.
Estrogen: Known as the “female” hormone, estrogen balances the effects of androgens by shrinking sebaceous glands and curbing oil production. When estrogen levels drop—such as before your period or during menopause—you may notice your skin becomes oilier and more prone to breakouts.
Progesterone: This hormone’s effect on acne is a bit more nuanced. Progesterone can increase sebum production and influence how androgens work, causing acne to worsen during certain phases of the menstrual cycle.
Insulin and IGF-1: High levels of insulin can increase androgen production and reduce hormone-regulating proteins in the blood, leading to more free testosterone and subsequently more oily skin and acne.
Cortisol: Known as the stress hormone, cortisol can indirectly worsen acne by disrupting hormonal balance and increasing inflammation.
How Do These Hormones Cause Acne?
When androgen levels rise, they signal the sebaceous glands to produce excess oil. This excess oil combines with dead skin cells, blocking hair follicles. The clogged follicles create a perfect environment for bacteria to thrive, triggering inflammation and the appearance of pimples, cysts, and sometimes painful bumps characteristic of hormonal acne.
On the other hand, estrogen acts as a calming influence by reducing oil production, which explains why some women’s skin clears up during pregnancy when estrogen is high, only to break out again postpartum when hormone levels shift.
When Does Hormonal Acne Usually Occur?
Puberty: A surge in androgens kick-starts oil production, causing many teens to develop acne.
Menstrual Cycle: Fluctuations in estrogen and progesterone cause cyclical breakouts.
Pregnancy and Menopause: Hormonal shifts during these times can trigger acne flares.
Polycystic Ovary Syndrome (PCOS): Women with PCOS often have elevated androgens, leading to persistent acne.
Stress: Elevated cortisol can upset the hormonal balance and worsen acne.
Managing Hormonal Acne
Understanding the hormonal roots of your acne is the first step toward effective treatment. Options can include:
Skincare routines targeting oil balance and inflammation
Hormonal therapies such as hormone balancing herbs and nutrients (not like birth control pills or anti-androgen medications).
Lifestyle changes to reduce stress and balance blood sugar
Final Thoughts
Hormonal acne is more than just a skin issue—it’s a reflection of internal hormonal shifts that influence how your skin behaves. By learning which hormones are involved and how they affect your skin, you can better understand your acne and find treatment approaches that address the root causes, not just the symptoms.
If you’re struggling with hormonal acne, know that you’re not alone, and effective solutions are within reach.
