How to Treat Hormonal Acne: A Comprehensive Guide for 2023

Imagine this: you’ve gone through puberty and the stubborn acne that comes with being a teenager, but now you’re stuck with annoying pimples that seem to pop up at specific times of the month. This frustrating phenomenon is known as hormonal acne. Right around your period, acne can start flaring up everywhere on your face, including your jawline, cheeks, and forehead. As if that weren’t enough, hormonal acne can cause deeper pimples and cysts that can last longer than your average pimple.

The good news is: You have options to help stop and treat acne. Let’s look at the causes of hormonal acne, how to spot it, and how to treat it with available acne treatments. Don’t worry if you have sensitive skin! You have choices too.

What Is Hormonal Acne?

Hormonal acne is acne that is caused/triggered by hormones, for someone with ovaries, this is usually related to your monthly cycle.

Hormonal acne is a type of inflammatory acne, meaning you can get red, swollen, and even painful blemishes on your skin. These pimples, which can grow into pustules, nodules, or cysts, contain bacteria, dead skin cells, and excess oil.

Hormonal acne can happen anywhere on your body but as an adult, it most commonly appears on your chin, jawline, and lower part of your cheeks. As a teenager, it most commonly happens in your T-Zone (your forehead, nose, chin).

What Causes Hormonal Acne?

Acne breakouts are often the result of excess oil production of the sebaceous glands. The oil (sebum) helps keep your skin and hair moisturized but too much blocks your pores.

Medications

Medications, such as steroids, can sometimes cause hormonal acne; nevertheless, be sure to talk to your doctor if you think any medication you’re currently taking is causing acne breakouts.

Hormonal Changes

Fluctuating hormone levels around the time of your period, plus irregular periods, pregnancy, menopause, or discontinuing birth control, are the most common causes of hormonal acne.
If you have a family history of acne or a pre-existing medical condition like Polycystic Ovary Syndrome (PCOS), you may also experience hormonal acne.

All these events cause sudden changes in your body’s hormone levels that can cause acne.

Lifestyle Changes

There are some things you can do to control your hormonal acne. Stress, lack of sleep, and using hair and skin products containing oil can cause acne or make your acne worse. Reducing stress, improving the length and quality of sleep, maintaining a healthy diet, and exercising more can help. Specifically, if you want to change your skin and hair products to those that won’t clog pores, look for products labeled “non-comedogenic.” These products are often “oil-free” and contain ingredients that won’t clog pores, which helps to prevent breakouts.

What Does Hormonal Acne Look Like?

Hormonal acne can appear as whiteheads, blackheads, pimples, pustules, and/or cysts.

Blackheads and whiteheads are closest to the skin’s surface, meaning they’re the easiest to treat. Blackheads form when excess oil and dead skin cells clog pores, commonly on or around the nose. The clog turns dark as it’s exposed to air. Whiteheads, on the other hand, are white or yellowish bumps topped off by oil and dead skin cells.

Papules and pustules tend to be bigger, more painful pimples caused by infection and inflammation of the pore. Papules are raised bumps with no head and feel rough to the touch. Pustules are filled with pus and eventually look like giant whiteheads surrounded by an angry inflammatory red ring.

Cysts are similar to pustules, except they are deep in the skin and can be large and painful, and often cause scars.

What to Take for Hormonal Acne?

Treatments for hormonal acne can vary based on the severity of your acne. Different treatments for hormonal acne can help reduce your skin’s oil production, stop pimples from forming, and reduce painful inflammation.

Oral Contraceptives

On top of all their other perks, like preventing pregnancy and regulating your cycle, birth control pills , can be your best friend in treating hormonal acne. While the FDA has only approved 3 specific oral contraceptives to treat hormonal acne, research has shown that all combined birth control pills help treat acne.

If you’re not currently on birth control but think it might be a good fit for you, be sure to talk to the expert doctors at Pandia Health about your options.

Topical Retinoids

Retinoids are topical treatments that contain retinoic acid or tretinoin, available as topical creams, gels, and lotions (think the brand names Differin or its twin Adapalene). These medications help to prevent hair follicles from becoming clogged so that pimples won’t form.

To use Adapalene gel, Tretinoin, or Differin, simply clean the affected area using a gentle cleanser and dry it thoroughly. Next, apply a thin layer of the retinoid and gently rub it into the skin before bedtime. Be sure not to combine retinoids with other over-the-counter topical acne medications, (like benzoyl peroxide or salicylic acid) at the same time of day, because peroxide or acid can kill the action of the retinoid. Then you are wasting your money if you kill the retinoid with acid or peroxide.

Spironolactone

Like oral birth control, Spironolactone is a seemingly unrelated oral acne medication. Originally intended to treat high blood pressure and kidney disease, it is also effective for acne. Studies have shown that Spironolactone can reduce acne by 50-100%!

Spironolactone works by blocking androgen receptors in the body, stopping skin cells’ response to “male” androgen hormones, and decreasing circulating androgens.

While Spironolactone doesn’t have many side effects, it can cause breast tenderness and dizziness from low blood pressure. It’s also a diuretic, meaning you’ll urinate more frequently. Make sure you drink at least 8 glasses of water a day if you are taking this medication.

Salicylic Acid

Salicylic acid removes dirt and excess oil from your skin, dissolving the debris that clogs pores and decreasing the redness and swelling of acne breakouts.

Adding salicylic acid to your skincare routine can also decrease the excess oil your skin produces that causes acne.

Use Benzoyl Peroxide

Benzoyl peroxide works by killing bacteria that cause acne. It can also help people with oily skin by removing excess oil and dead skin cells, which can clog pores. Many acne cleansers, creams, and gels contain benzoyl peroxide as an active ingredient and are available without a prescription.

Natural products

If natural remedies are more your thing, seek skin care products with aloe vera, azelaic acid gel, green tea extract, tea tree oil, and zinc.

Change Your Diet

You might have heard the old myth that eating greasy foods causes acne. However, there’s not enough research or proof to say there’s a direct link between acne and diet.

Some studies suggest that a low-glycemic diet may help to reduce acne. Low glycemic foods include fresh vegetables, some fresh fruits, beans, and steel-cut oats. This type of diet may also help reduce PCOS symptoms.

There are limited randomized control trials (the gold standard of scientific research) looking at the connection between diet and acne. Some studies have found that limiting dairy intake and increasing omega-3 fatty acids, antioxidants, zinc, vitamin A, and dietary fiber can help improve acne. While the evidence linking diet and acne is pretty murky, some evidence shows that high glycemic diets can exacerbate acne.

Next Steps to Treat Hormonal Acne

We know hormonal acne is a tricky beast, and there’s only so much you can do at home to help. However, there’s no shame in reaching out to your doctor, dermatologist, or the expert doctors at Pandia Health for help. Remember, almost everyone has had some form of acne at some point in their lives.

Pandia Health offers online acne treatment! Now you can get prescription acne treatment delivered directly to you! Just fill out our quick health questionnaire, and our expert doctors will evaluate your health history and photos of your problem area(s) for only $35 per doctor’s evaluation. Then, our expert doctors can help find the optimal treatment that’s right for you. Your insurance plan may cover your acne medications, or you can pay as low as $30/month for medication without insurance.

Disclaimer: This article is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your healthcare provider before starting or changing acne treatment.