What Is Hormonal Acne?

Acne is a common problem during our adolescent years but often disappears with age and a good skincare routine. For those affected by hormonal acne, solutions are more difficult. Still, this type of acne is treatable with help from a dermatologist. Learn more about hormonal acne, its causes, and available treatments from Dermatology Associates of Central New York.

What Causes Hormonal Acne?

Hormonal acne, sometimes called nodulocystic acne or acne conglobata, can affect people of all ages, genders, and skin types. However, young women are most often affected. This acne is caused by imbalances in hormones, including estrogen, progesterone, androgen, and testosterone, due to:

  • Puberty
  • Menstruation
  • Menopause
  • Conditions that cause hormones to fluctuate, like polycystic ovarian syndrome (PCOS)

Elevated levels of cortisol, a hormone produced in response to stress, can also cause outbreaks. As hormone levels fluctuate, the skin becomes inflamed, oil production increases, and skin cells clog hair follicles. Additionally, bacteria that cause acne flourishes. As a result, hormonal acne appears.

Signs of Hormonal Acne

Just as the causes of hormonal acne vary from other types, so do its symptoms. If you notice any of the following signs, hormonal acne may be to blame for your breakouts:

  • Acne at the chin, jawline, sides of the face, and neck in adults
  • Acne at the forehead, nose, and chin (T-zone) in adolescents
  • Raised, reddened bumps that are painful or tender to touch
  • Chronic breakouts that appear monthly and/or coincide with your menstrual cycle
  • Acne that does not respond to most over-the-counter (OTC) topical treatments

How to Treat Hormonal Acne

Only a dermatologist can effectively treat hormonal acne. While OTC topical treatments don’t penetrate the skin deeply enough to resolve cysts, they can cause additional irritation and lead to further breakouts. Dietary changes are also likely to have minimal impact, although limiting sugar, dairy, red meat, and refined carbohydrates helps some hormonal acne sufferers.

After an examination of your skin and a review of your medical history, one of the dermatologists at Dermatology Associates of Central New York may suggest treatments that include:

Hormonal Birth Control

            Oral contraceptives can counteract acne-causing hormones, especially for patients who experience breakouts linked to their menstrual cycle. However, these medications are not appropriate for smokers and individuals with a history of high blood pressure, breast cancer, or blood clots.

Anti-Androgen Medications

            Overproduction of androgen can increase the production of oil and cause problems for hair follicles and skin cells. Androgen-suppressing drugs help stabilize the hormones and clear related acne.


While topical treatments are not ideal for most hormonal acne, retinoids provide an exception. Retinoids are derived from vitamin A and, when provided at prescription strength by a dermatologist, can offer improvement in your hormonal acne.


When hormonal acne resists other treatments, isotretinoin may help. This oral medication is also derived from vitamin A and helps reduce the amount of sebum produced by the oil glands. Women who are pregnant or trying to conceive should not take isotretinoin, although it has no long-term effects on fertility.

While these dermatologist-prescribed treatments are most effective for hormonal acne, some patients find success in supplementing their treatment with the following:

  • Using a gentle exfoliator, such as alpha-hydroxy acids (AHAs), glycolic acid, or salicylic acid
  • Products that include tea tree oil or green tea
  • Using non-comedogenic cosmetics to avoid clogged pores
  • Daily use of sunscreen, especially for patients using retinoids or isotretinoin

Always consult with your dermatologist about any treatments beyond prescribed medications.  

Get Help for Hormonal Acne

While hormonal acne is difficult to treat, help is available, and you don’t have to live with these uncomfortable, unsightly breakouts. If you’re experiencing hormonal acne, schedule an appointment with Dr. Amin Fazeli, M.D. Ph.D., FAAD, FACMS or one of the other experienced dermatologists at Dermatology Associates of Central New York. For more information, contact our Fayetteville, NY office.