By Mike Kocsis | 7 minutes read | Last updated: June 30, 2025 Categories: Hormone imbalance
Medically Reviewed by Dr. George Touliatos
Hormonal acne, also called adult acne, is a very common skin condition that affects 80% of individuals between the ages of 11 and 30. It occurs more commonly in women than men.
Hormonal acne develops because of fluctuations in hormone levels, particularly oestrogen, progesterone and testosterone hormones. That is why, in women, it is more commonly observed during puberty, periods, pregnancy and menopause – which are all stages where significant hormonal changes occur.
Although hormonal acne cannot be prevented, topical and oral treatments can still help prevent future breakouts and clear the acne completely.
This article explains everything you need to know about hormonal acne, including its signs, causes, treatments, and more.
What are the symptoms of hormonal acne?
Hormonal acne symptoms include different kinds of acne lesions. The following are listed in increasing order of acne severity:
- Whiteheads – Pale or white bumps, also known as closed comedones, form when oil or dead skin cells close off sebaceous glands or hair follicles.
- Blackheads – Black bumps, also called open comedones, are open clogged pores that allow the trapped oil and dead skin to oxidise upon exposure to air, which turns the surface dark.
- Papules – Small, solid, red or pink bumps.
- Pustules – When clogged pores get inflamed due to a bacterial infection, they form pus-filled, small acne lesions called pustules.
- Cysts – Large, painful, pus-filled lesions that leave acne scars.
Where does hormonal acne show up?
Hormone acne typically appears on:
- Face (most commonly on the lower part of the face – jawline and lower cheeks)
- Neck
- Shoulders
- Chest
- Back
What causes hormonal acne?
Hormonal acne is mainly caused by hormonal fluctuations.
Increase in hormones, such as androgens (like male hormone testosterone), progesterone and oestrogen, increases sebum production.
Sebum interacts with dead skin cells and clogs pores, creating an environment where acne-causing bacteria (Cutibacterium acnes) thrive.
If clogged pores are not treated on time, they can turn into hard nodules or pus-filled, inflamed, painful cysts.
Various lifestyle elements can also cause hormonal acne. These include:
- Stress
- Poor sleep quality
- Poor hygiene
- Poor diet
- Cosmetics and skin products containing acnegenic ingredients
- Certain medications, such as steroids
- Medical treatments like testosterone replacement therapy (TRT)
- Medical conditions such as polycystic ovary syndrome (PCOS)
In addition to hormonal changes and lifestyle factors, a family history of acne can also lead to acne no matter how much you try to prevent it.
How to know if you have hormonal acne?
Hormonal acne usually appears at the same time each month, meaning it may appear during, before or after periods in the same area.
Your dermatologist will look for signs of hormonal changes, such as excess facial or body hair, weight changes, oily skin, etc.
They will discuss your lifestyle and health to determine the contributing factors, which can be skincare products, medications you are taking, etc.
They may also conduct a few blood tests to check your hormone levels and design solutions to bring your hormone levels back to normal.
How to treat hormonal acne?
The treatment of hormonal acne in women and men depends on its cause and severity.
Mild hormonal acne can be treated with over-the-counter topical creams like retinoids and benzoyl peroxide. Moderate acne and severe acne require oral medications, birth control pills and hormonal therapies.
Here are the most commonly used treatments for hormonal acne:
- Topical retinoids (tretinoin, trifarotene, tazarotene, etc.)
- Topical antibiotics
- Azelaic acid
- Combined oral contraceptive pills such as norgestimate and drospirenone
- Oral antibiotics such as tetracyclines and erythromycin
- Anti-androgen medication
- Laser therapies
- Chemical peels
If you have mild acne, natural remedies may help you clear it. Some of the most effective ways to treat acne naturally are:
- Tea tree oil cleansers and toners
- Alpha hydroxy acids (AHAs) creams
- Topical green tea solutions
- Do not use harsh or exfoliating scrubs
- Avoid doing makeup frequently
- Do not scrub or pick pimples
- Use mild soaps and warm water
- Limit the intake of foods high in refined carbs, sugar, and milk
How soon after treatment will hormonal acne go away?
Hormone acne can take weeks to months to heal, depending on how severe it was initially and the nature of the treatment.
Hormonal treatments mostly show initial results in 4 to 6 weeks and noticeable results after 2 to 3 months.
Topical treatments may give visible results in 6 to 8 weeks and maximum effects in 3 months or more.
DIY remedies and lifestyle changes generally take longer to fix acne. With them, you can expect to see results in 2 to 4 months.
FAQs about adult acne
What does hormonal acne look like?
Hormonal acne can consist of whiteheads, blackheads, pustules, nodules and cysts depending on its severity.
Which hormone causes acne in females?
The following hormones generally cause adult female acne:
- Testosterone – it stimulates sebaceous glands to produce more sebum, which can result in acne.
- Oestrogen – a drop in oestrogen can let androgens dominate, triggering acne.
- Progesterone – an increase in progesterone levels can increase oil production.
Does hormone acne go away?
Yes, hormonal acne can go away but whether it fixes on its own or requires treatment depends on the underlying cause and age.
Severe acne or the acne that develops in adults generally requires treatment. On the other hand, mild acne or acne developed during puberty may go away on its own.
Do men get hormonal acne?
Yes, men can also develop hormonal acne. They especially experience it during puberty when testosterone levels increase significantly.
The wrap up
Hormonal acne is a common skin condition that affects millions of people worldwide. It mostly develops due to hormone imbalance and can go away either on its own or with medical treatment, depending on its cause and severity.
Treating acne on time can help you prevent severe acne flare-ups, permanent skin tissue damage or acne scars.
If you are experiencing hormonal acne symptoms, talk to your doctor to diagnose the cause and fix the problem on time.
References
Kim, H.J. and Kim, Y.H., 2024. Exploring acne treatments: From pathophysiological mechanisms to emerging therapies. International journal of molecular sciences, 25(10), p.5302.
Behayaa, H.R., Juda, T.M. and Mohammed, S.B., 2022. The effect of androgen hormones in acne pathogenesis: A review. Medical Journal of Babylon, 19(3), pp.345-349.
Mohsin, N., Hernandez, L.E., Martin, M.R., Does, A.V. and Nouri, K., 2022. Acne treatment review and future perspectives. Dermatologic therapy, 35(9), p.e15719.
Hu, T., Wei, Z., Ju, Q. and Chen, W., 2021. Sex hormones and acne: State of the art. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 19(4), pp.509-515.
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About the Author: Mike Kocsis
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Last update: June 30th, 2025
