A Deeper Look Into Hormonal Acne

An Examination of Hormonal Acne

What's Under The Skin

“Hormones are the cause of almost all acne no matter what age you are,” says Gary Goldfaden, MD, a Miami-based dermatologist in a recent Cosmopolitan Magazine article. “The hormones we’re talking about are primarily progesterone and estrogen, but you also have to consider cortisol, AKA the stress hormone. The interaction of these three are usually the cause behind the acne.”

While we tend to think of hormonal acne as only affecting women past their teen years, acne in all ages is linked to hormonal fluctuations which increase oil production.

Let’s discuss hormones. Women in Balance Institute provides the following definitions:


Estrogen stimulates the growth of tissue, such as development of breast and reproductive organs, and ensures their function. In the brain, it boosts the synthesis and function of neurotransmitters that affect sleep, mood, memory, libido, and cognitive factors such as learning and attention span.

Estrogen decreases the perception of pain, preserves bone mass, and increases HDL – the good cholesterol. It also preserves the elasticity and moisture content of the skin, dilates blood vessels, and prevents plaque formation in blood vessel walls.


Progesterone is made primarily by the ovaries. The adrenal glands, peripheral nerves, and brain cells produce lesser amounts. Progesterone ensures the development and function of the breasts and female reproductive tract. In the brain, progesterone binds to certain receptors to exert a calming, sedating effect. It improves sleep and protects against seizures.

Progesterone is also a diuretic. It enhances the sensitivity of the body to insulin and the function of the thyroid hormones. It builds bone and benefits the cardiovascular system by blocking plaque formation in the blood vessels and lowering the levels of triglycerides. Progesterone also can increase libido and contribute to the efficient use of fat as a source of energy.


Testosterone is manufactured in women by the ovaries and adrenal glands, enhances libido and sexual response. It strengthens ligaments, builds muscle and bone, assists brain function, and is associated with assertive behavior and a sense of well-being. The level of testosterone influences both stamina and restful sleep. It has a protective effect against cardiovascular disease in both men and women.


Cortisol is made by the adrenal glands. It regulates the immune response, stimulates the production of glucose, aids short-term memory, and helps the body adapt to stress by increasing heart rate, respiration, and blood pressure.

The level of cortisol increases early in the morning to prepare to meet the demands of the day. It gradually decreases throughout the day and reaches its lowest point late in the evening (a pattern known as “circadian rhythm”).

Why do hormones matter to skin?

During puberty when the hormones fluctuate, acne using appears across the T-zone. In adults, hormonal fluctuations result in breakouts along the lower-half of the face. The breakouts tend to be deeper in the skin, in cystic form. Even women in menopause can experience acne symptoms due to the drop in estrogen levels and the increase in testosterone levels.

Regardless of age, hormone fluctuations can cause the skin to be more inflamed, produce more oil, clog skin cells in hair follicles, and produce P-acne bacteria.

Best Methods To Treat Hormonal Acne

Some topical ingredients won’t be effective in treating more severe hormonal acne cases. It is possible to still try a regimen with AHA products to exfoliate the skin, or Retinol/Retinoids, and a hyaluronic acid serum for hydration. Oils should be avoided including in cleansing, SPF, moisturizing. Educate your client on proper face washing techniques, as keeping the skin as clean as possible is essential.

Light and laser treatments could work wonders for hormonal acne. Weekly blue LED light therapy treatments could be a good non-invasive way to begin treatment before working your way up to stronger laser therapies. A series of chemical peels could also be a good fit for someone with mild acne.

Whatever information you give to your client, you must emphasize that they cannot pick their skin. If they are pickers, see our advice on how to stop picking. They will only make their skin worse by trying to extract cysts.

Every client suffering from hormonal acne should pay close attention to diet. Recommend they cut out sugar, processed carbs, and dairy products. Recommend they see a nutritionist for additional advice.

If you’ve tried everything and your client still is not seeing results, recommend further hormone testing from their medical practitioner. Hormone therapies or oral contraceptives may be necessary.



Hormones 101