Hormonal Acne: The Culprits Behind Your Skin Stress-image

Hormonal Acne: The Culprits Behind Your Skin Stress

Maintaining healthy skin isn’t always as simple as skinsperts and bloggers may make it sound. Sometimes no matter how much money you spend in the lotion aisle, or how many fads you try, your dreams of perfect skin don’t come true. Often the culprits behind your skin complaints are your hormones which can cause hormonal acne and other skin stresses.

The hormones in our body are balanced very meticulously, so even a small change can tip this homeostasis and produce a noticeable effect on your health. Any imbalances can affect your skin, so getting your hormones in check might be the only elixir. ⠀

We’ve broken down what exactly causes hormonal acne and how.  


How are your hormones and skin problems linked?

Your skin has many small glands, called sebaceous glands — that produce an oily substance called sebum. Sebum helps keep our skin supple, smooth, and healthy. These glands have also receptors for our sex hormones, particularly testosterone and oestrogen, meaning they are directly affected by the levels of these hormones.

The sebaceous glands are particularly sensitive to changes in androgen levels, especially testosterone. Although androgens are traditionally considered as ‘male hormones’, don’t let the name fool you, women have small amounts of testosterone in their bodies as well. They stimulate the production of sebum, which is why during puberty, when our bodies produce excess amounts of androgens, it can cause hormonal acne and other skin problems.

If androgen levels are higher than normal, there is more androgen binding to the sebaceous gland receptors, promoting more sebum production. This buildup of sebum causes visibly oilier skin and can clog the pores, resulting in inflammation. 

Those suffering from conditions that cause elevated androgens, such as polycystic ovary syndrome (PCOS), are more likely to experience acne, excessive facial and body hair growth (hirsutism), and skin darkening. Trans men who begin taking testosterone may also find this is a hormonal acne cause.

Hormones and skin during your menstrual cycle

Sebum production is also influenced by the menstrual cycle, specifically by the hormone oestrogen. Although the impact of oestrogen on the sebaceous glands is not fully known, it has been shown to suppress sebum production at high levels. Oestrogen levels are not constant and fluctuate during your cycle, you can read about the basics of the menstrual cycle here.  

Oestrogen is also associated with increased collagen production, skin thickness, skin hydration and wound healing. After the menopause, some women may find that the drop in oestrogen levels causes hormonal acne, and may also leave their skin dry, itchy, and saggy.

For some individuals, HRT ( hormone replacement therapy ) to reduce the symptoms of menopause can also cause hormonal acne. 

What causes hormonal acne?

As the name suggests, hormonal acne is caused by fluctuations in your hormones. Although seen mostly around puberty, it can affect individuals of all ages. 

Hormonal acne includes:

  • Blackheads: they are the type of comedones that are open at the surface of the skin and appear black because of the effect of oxygen. 
  • Whiteheads: they are the type of comedones that are closed beneath the skin surface.
  • Papules: they are small, raised, red bumps that occur due to inflammation or infection of the hair follicles. 
  • Pustules: they are small and red pus-filled pimples.
  • Cysts: they are large lumps, which are present under the skin. They contain pus and may be painful and tender to the touch. 

How to spot hormonal acne?

Hormonal acne usually erupts during puberty, often setting up base on the T-zone, which includes the forehead, nose and chin.

Adult hormonal acne is usually concentrated on the jawline, chin and bottom of your cheeks.

A flare-up usually occurs due to hormonal fluctuations due to:

  • Menstrual cycle;
  • Polycystic ovary syndrome (PCOS);
  • Elevated androgen levels;
  • Pregnancy;
  • Menopause.

How to treat hormonal acne?

If you think you are suffering from hormonal acne, Hertility Health’s at-home hormone tests can help you identify any hormonal imbalances and get to the root of your skincare problem.⠀

Armed with your results, you could visit your GP or can ask to be referred to a dermatologist. The treatment options for hormonal acne vary depending on the severity of the outbreak. You may be prescribed a variety of treatments ranging from dietary changes, lifestyle modification to prescription medication such as oral contraceptive pills, hormone blockers, and topical treatments like retinol.


Farage MA, Neill S, MacLean AB. Physiological changes associated with the menstrual cycle: a review. Obstet Gynecol Surv. 2009 Jan;64(1):58-72.

Thiboutot D. Acne: hormonal concepts and therapy. Clin Dermatol. 2004 Sep-Oct;22(5):419-28.

Wierckx K, Van de Peer F, Verhaeghe E, Dedecker D, Van Caenegem E, Toye K, Kaufman JM, T’Sjoen G. Short- and long-term clinical skin effects of testosterone treatment in trans men. J Sex Med. 2014 Jan;11(1):222-9.


Zoya Ali BSc, MSc

Zoya Ali BSc, MSc

Zoya is a scientific researcher with a Bachelor's degree in Biotechnology and a Masters in Prenatal Genetics & Foetal Medicine from University College London. Her research interests are reproductive genetics, fertility preservation, gynaecological health conditions and sexual health.

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