What Is Hormonal Acne and How Do You Treat It?
Experts break down what hormonal acne actually is, how it manifests, and how to treat it with products, diet, and lifestyle choices.
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If you've ever noticed an increase in acne whenever you're near your period, chances are that your hormones are fueling the pimples on your face. Even if you stick to your skincare routine and maybe throw in an AHA or BHA to clear your pores and slough away dead skin cells, it can seem as if nothing you do can prevent breakouts during that time of the month.
We understand how frustrating it can be to navigate hormonal acne, especially if you've always heard that there's nothing that can be done about it other than to power through. So, we tapped three skincare experts to break down everything there is to know about hormonal acne, from where it tends to manifest, what age demographic experiences it more, and how to treat it. Their answers, below.
What is hormonal acne?
"Hormonal acne is when breakouts form in adulthood that are tied to fluctuations in hormones – this can mean blackheads, whiteheads, and painful under-the-skin cysts," explains esthetician and founder of her eponymous skincare brand, Renée Rouleau.
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What causes hormonal acne?
In a nutshell, hormonal acne is caused by fluctuations in hormones which stimulate our sebaceous glands and produce excess oil. "During the pre-period hormonal shift, oil in the skin can get thicker – at the same time, increased progesterone causes water retention, which makes the pore lining narrower. The thicker oil attempting to get into a thinner opening creates an ideal environment for breakouts," Rouleau explains.
While this alone may cause a breakout to appear, Dr. Joshua Zeichner, M.D., a board-certified dermatologist and director of cosmetic & clinical research in dermatology at Mount Sinai Hospital in New York City, says that there may be other contributing factors, such as diet and stress. In regards to diet, he points out that foods with a high glycemic index raise blood sugar, promote inflammation, and are associated with acne breakouts — this includes foods with high sugar or starch levels.
And while we know the importance of wellness for the body and soul, he also says it has an impact on your skin. "The same hormones that prepare our bodies to deal with stressful situations also have and impact on our oil glands," the dermatologist says. "It has been well documented that emotional stress, like a school exam or a deadline at work, is associated with acne breakouts."
Where does hormonal acne manifest?
"Hormonal acne classically presents as cystic — red, inflamed, painful — acne on the jawline, chin, between the eyebrows, on the chest, on the back, and/or on the buttock," explains Dr. Elyse Love, M.D., a board-certified dermatologist in New York City. She explains that hormonal acne presents itself differently from person to person— it may only manifest on the face for some, while for others it may only manifest on the body.
In terms of age, Rouleau says it can affect anyone from teenagers all the way up to people in their 50s, adding that hormones affect the skin differently throughout a person's lifespan. And, while hormonal acne can appear anywhere on the skin, there are some patterns depending on age. "Teenagers tend to have hormonal acne on the T-zone — forehead, nose, and chin. Into your 20s and 30s, hormonal acne commonly shows up on the chin and jawline as cystic, painful bumps," she says.
Can you prevent hormonal acne?
Since you can't stop your hormones, lifestyle tweaks are the best way to prevent these types of breakouts. Below, find some of Rouleau's best advice for preventing it:
Take Vitamin B6. Start one week before your menstrual cycle begins. "This supplement helps ease PMS symptoms by improving metabolic function and hormone metabolism, as well as increasing serotonin to help cope with stress," she says.
Eliminate dairy intake. The esthetician points out that breakouts along the jawline are typically a sign of excess dairy in a person's diet. "The theory is that the hormone levels in milk from pregnant cows play a role in excess sebum production, producing acne," she explains. To see results, Rouleau says to cut out dairy for at least three weeks.
Take oral probiotics. "Breakouts can sometimes occur due to changes in our gut bacteria, which inflames the skin. Oral probiotics can help regulate bacteria and reduce oil levels in the gut," she says. (We love OLLY's Probiotic Gummies.)
Track your routines. Finding potential patterns and triggers can be easier when you see a calendar of your daily habits and lifestyle choices, such as diet, stressors, and sleep. Rouleau suggests doing this for three months to get a clear picture.
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What's the best way to treat hormonal acne?
Ah yes, the question we've all been waiting for. However, there's no one-size-fits all treatment as we all have different skin types and unique concerns. So, to best understand how to treat your hormonal acne, we recommend consulting with a board-certified dermatologist. Rouleau even suggests seeing a gynecologist as they have the deepest understanding of hormone levels and can help assess your acne and its links within the body.
As far as products go, Dr. Love says that the skincare ingredients that typically treat acne, such as benzoyl peroxide and retinoids, may not be the solution for hormonal acne. Instead, she says that more specific therapies that specifically target hormone regulation, such as spironolactone, are advisable.
However, that definitely does not mean that traditional acne-fighting ingredients and products don't work — it's just about how to use them. "Rather than spot treating pimples after they have developed, it is best to treat the entire area that tends to break out. This way you can stay ahead of it rather than playing catch-up," says Dr. Zeichner. He suggests looking for over-the-counter products that contain ingredients like benzoyl peroxide, salicylic acid, sulfur, or adapalene to treat hormonal acne.
Dr. Love recommends CeraVe's Acne Foaming Cream Cleanser with benzoyl peroxide and Avène's Cleanance NIGHT Blemish Correcting & Age Renewing Cream. "These products both contain classic inflammatory acne fighting ingredients, but they are designed for sensitive skin tolerability," she explains. Dr. Zeichner recommends JORI's Daily Leave-On Acne Treatment Mask as it "treats acne with special micronized form a benzoyl peroxide that allows it to get deep into the poor where acne begins." For more of a spot treatment, Rouleau recommends her brand's Anti Bump Solution — "it's specifically formulated for cystic acne, and has even replaced the painful cortisone shots that people sometimes turn to for hormonal acne," she explains.
If after at least a month of consistent use without results, Dr. Zeichner recommends seeing a board-certified dermatologist who may prescribe oral alternatives or in-office laser treatments, such as AviClear, which he explains targets oils glands to treat acne.
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