What You Need to Know About Hormonal Acne

by NIKKI POPE, November 19, 2020

Acne is the most common skin condition in the United States, affecting as much as 50 million individuals. It's also one of the most burdensome, resulting in a whopping $1.2 billion in healthcare costs and lost productivity. 

One of the most prevalent types of acne in adults (and some youths too) is hormonal acne. As the name suggests, this skin condition is brought about by changes in hormone levels. 


This type of acne results from the hormonal fluctuations that occur due to: 

  • Menstruation
  • Menopause
  • Polycystic Ovarian Syndrome 

These conditions lead to an increase in androgen levels in the body. This hormone triggers or worsens acne by increasing or promoting: 

  • Oil (sebum) production in the skin
  • Skin cell buildup in the pores 
  • Inflammation 
  • Production of acne-causing germs (Propionibacterium acnes)

Stress can also lead to a flare-up of hormonal acne. Whenever you are stressed, your body produces more cortisol. This ‘stress’ hormone prods the skin to produce more oil. This sebum then ends up plugging your follicles, leading to another wave of hormonal acne. 


Although hormonal acne can be seen in adolescents and teens, it is more common in older people, typically from age 20 above. This condition is often seen in women, mainly because they suffer from a variety of hormonal events – from menstruation, childbirth, lactation, to menopause. 


Hormonal acne often follows a cyclical pattern, thus mirroring the monthly fluctuations in your hormone levels. They can manifest as blackheads, whiteheads, and pimples. In most cases, hormonal acne manifests as cysts – tender bumps that form underneath the skin.

In younger individuals, hormonal acne is often seen on the T-zone – the forehead, nose, and chin. 

As for adults, hormonal acne often affects the lower cheek, jawline, the sides of the face, and the neck. As to why this acne manifests on the said parts, experts attribute this to the increased number of oil glands in the said areas. 

Hormonal acne often occurs at the same place every time. This is due to the pores being already ‘stretched out’ by your previous bout of acne. 

Conventional Treatment 

Hormonal acne is often treated with medications that help balance the hormones in the body. These include:

Oral Contraceptives

Such pills usually contain ethinylestradiol together with either norgestimate, drospirenone, or norethindrone. Any of these contraceptives help manage the hormones that trigger acne, especially when they’re at their peak (i.e. the ovulation period during a woman’s monthly cycle).

While effective, oral contraceptives are not recommended for women with high blood pressure or a history of blood clots or breast cancer. Smokers are discouraged from taking contraceptives as well. 

Anti-Androgen Drugs

As androgen is the main culprit behind hormonal acne, drugs that suppress its production are often used for treatment. One good example is Aldactone, a ‘water pill’ that helps lower blood pressure. Apart from making you pee a lot, Aldactone can also help prevent excessive androgen production in the body. 


Retinoids are recommended for people who have a mild case of hormonal acne. This Vitamin A derivative is present in many lotions, gels, and creams that can be bought over-the-counter. 

As retinoids can make you more sensitive to sunlight, it’s important to wear sunscreen while you undergo this regimen. 






Natural Alternatives – Vitamin & Supplements

If you find the side effects of conventional acne treatments bothersome, you may consider going for more natural remedies: 

Green Tea 

Green tea is made from the leaves of the plant Camellia sinensis. As the second most consumed beverage in the world, it comes in many variants (green tea, black tea, white tea).

Green tea is perhaps one of the most popular products in the market, not only for its refreshing taste but for its health benefits as well. It is said to be the perfect drink for hormonal acne, given its high polyphenol content. These antioxidants account for green tea’s anti-inflammatory effects on the body. Add to that, these polyphenols also help reduce oil production on the skin. With these combined effects, a cup of green tea a day may help you achieve clear, blemish-free skin. 

Soy Isoflavones

Soy isoflavone is a remedy that helps decrease the production of androgen, a hormone that triggers hormonal acne. According to a study, 160 mg of soy isoflavones a day may help decrease the level of dihydrotestosterone in the body. This hormone, which is synthesized from androgen, result in inflamed hormonal acne. Because of this action, soy isoflavones may help reduce the number of zits after just 12 weeks.


Vitex Agnus-Castus, when taken before menstruation, may help decrease the levels of prolactin. This hormone can trigger an increased production of androgens, which in turn, prompts the development of hormonal acne.

According to a study, the German Commission recommends a daily dose of 40 mg for acne. 

Milk Thistle

Milk thistle or Silymarin is an herb that has long been used in treating liver and gall bladder diseases. Apart from such benefits, it is heralded for its strong antioxidative and anti-inflammatory properties – both of which may be useful against hormonal acne. While a study has shown that Silymarin works best when taken with Doxycycline for acne, taking it alone may be a plausible option for people with hormonal breakouts. 

Dietary Changes

Apart from taking the remedies mentioned above, you may help reduce your hormonal acne by improving your dietary habits. As mentioned, inflammation is one of the major factors behind acne. As such, it is important to avoid food sources that may trigger this in the body. These include: 

  • Refined carb sources, such as pasta, bread, and white rice
  • Dairy products 
  • Red meats
  • Sugary food 

More than just eliminating the said sources, it would help if you ate inflammation-fighting food daily:

  • Fatty fish such as tuna, mackerel, and sardines
  • Green leafy vegetables such as collards, kale, and spinach
  • Fruits such as oranges, tomatoes, blueberries, and strawberries
  • Nuts such as walnuts and almonds


Hormonal acne is a skin condition caused by hormonal changes in the body. It often occurs in adults, specifically women, due to the many hormonal fluctuations that take place in the female body. This can be remedied with the help of conventional treatment and herbal remedies such as Green Tea, Vitex, Milk Thistle, and Soy Isoflavones. Eating anti-inflammatory food sources may help reduce hormonal breakouts as well.