Hormonal acne is exactly what it sounds like- acne tied to fluctuations in the hormones. It is although typically associated with hormone fluctuations during puberty, hormonal acne can affect adults of any age. It is most common in women. A number of factors contribute to this including menopause and menstruation. According to the estimation, around 50% of women ages 20 – 29 have acne. It affects 25% of women ages 40 – 49.

Hormones are generally not a factor in adult acne, hormone imbalances can contribute to acne in adults with underlying medical conditions. In other cases, adults with acne might not have any considerable hormonal issues. This makes diagnosis and treatment challenging. 

Characteristics Of Hormonal Acne 

During puberty hormonal acne mostly appears in the T- zone. This includes your forehead, nose, and chin. Hormonal adult acne forms on the lower part of your face. This includes the bottom of the cheeks and around the jawline. For some people, it takes the form of blackheads and whiteheads, small pimples that come to a head or cysts. 

Cysts form deep under the skin and do not come to head on the surface. These bumps are tender to touch most often. Hormonal acne is due to influxes of hormones from-

  •     Menstruation
  •     Menopause
  •     Polycystic ovarian syndrome
  •     increased androgen levels

These hormone fluctuations might aggravate acne issues by increasing –

  •     Overall skin inflammation
  •     Oil sebum production in the pores
  •     Clogged skin cells in hair follicles
  •     Production of acne-causing bacteria Propionibacterium acnes.

Traditional Treatments 

Unless the hormonal acne is mild, over the counter (OTC ) products are not usually successful. As hormonal acne takes the form of cystic bumps. These bumps occur deep under the skin out of reach of most topical medications. Oral medications work from the inside out to balance your hormones and clear up the skin. Common options include oral contraceptives and antiandrogen drugs. 

Oral Contraceptives 

Oral contraceptives used for Acne treatment contain ethinyl estradiol plus one of the following –

  •     Drospirenone
  •     Norgestimate
  •     Norethindrone

These ingredients together target the hormones that can contribute to acne. This can be helpful during peaks and hormones during ovulation. Oral contraceptives may not be an option if you have a history of blood clots, breast cancer, or high blood pressure. You also should not go for these if you smoke.

Anti-androgen Drugs 

Anti-androgen drugs work when reducing the male hormone androgen. Both women and men have natural levels of the hormone. Excess of androgen can contribute to acne issues by interfering with the hair follicles that regulate skin cells and increase oil production. Spironolactone is although used to treat high blood pressure, it has antiandrogen effects. In other words, it prevents your body from producing more androgen and stabilizes your hormone levels. 


If your hormonal acne is mild, you may use topical retinoids. Retinoids are obtained from vitamin A. Many retinoid gels, creams, and lotions available over the counter. You may like to see your doctor about a prescription-strength formulation. A prescribed product is the most effective way to keep the skin consistently clear. If you add a topical retinoid to regimen then it is important to apply sunscreen daily. Retinoids may increase the risk of sunburn.

If your acne persists, consult your doctor or Dermatologist about a long term treatment plan. They can revise the current regimen and incorporate different treatments to maximize the results.