Hormonal acne can feel particularly frustrating because it often appears when you least expect it. You may have had relatively clear skin for years, only to start experiencing recurring breakouts around your chin, jawline or lower face.
Unlike the occasional blemish, hormonal acne can be persistent, cyclical and deeper beneath the skin. It can also appear at different stages of adult life, including your 20s, 30s, 40s and during perimenopause and menopause.
At Skin Pharmacy we will explain what hormonal acne is, why it happens, how to recognise it and what you can do to support clearer, healthier-looking skin.
What is hormonal acne?
Hormonal acne is acne that is influenced by changes in hormone activity, particularly androgens such as testosterone.
At a biological level, hormonal acne is still acne. Pores can become blocked with sebum and dead skin cells, inflammation develops, and spots appear. What makes it "hormonal" is the influence hormones have on this process, particularly on the amount of oil your skin produces.
Androgens can stimulate the sebaceous glands, encouraging them to produce more sebum. When excess oil combines with dead skin cells, pores can become congested, creating an environment where blemishes can develop.
Hormonal acne is particularly common in adult women, but it isn't exclusive to women. It can affect anyone experiencing hormonal fluctuations or increased androgen activity.
What does hormonal acne look like?
Hormonal acne doesn't always look dramatically different from other types of acne, but there are some patterns that can provide clues.
It commonly appears on the lower third of the face, particularly around the:
- Chin
- Jawline
- Lower cheeks
- Neck
Breakouts can include blackheads, whiteheads, papules and pustules, but hormonal acne is often associated with deeper, more tender spots that can feel painful beneath the skin.
Another characteristic is recurrence. You may find that breakouts repeatedly appear in the same areas or seem to follow a predictable pattern.
For some people, this pattern is linked to their menstrual cycle, with breakouts appearing or becoming more noticeable in the days before a period.
What causes hormonal acne?
Hormonal acne doesn't have one single cause. Instead, several factors can influence how your skin responds to hormonal changes.
Androgens and sebum
Androgens are one of the key hormones involved in acne.
They can stimulate the sebaceous glands, increasing sebum production. When there is more oil on the skin, there is a greater opportunity for pores to become congested.
Your skin can also be particularly sensitive to hormonal changes, meaning that even relatively subtle fluctuations may affect how much sebum it produces.
Your menstrual cycle
For many women, hormonal acne follows the menstrual cycle.
Hormone levels naturally fluctuate throughout the month, and some people notice that their skin becomes oilier or more congested in the days leading up to their period.
If you notice the same type of breakout appearing at roughly the same point in every cycle, keeping a simple record of your skin can help identify a pattern.
Perimenopause and menopause
Hormonal acne doesn't necessarily disappear with age.
During perimenopause and menopause, fluctuations and changes in oestrogen and androgen activity can affect the skin. Some women experience new or persistent breakouts alongside other changes such as dryness, sensitivity and loss of firmness.
In fact, the American Academy of Dermatology notes that adult-onset acne can occur into the 30s, 40s and 50s and is particularly common among women going through menopause.
This can make skincare particularly challenging because the skin may be both dry and breakout-prone at the same time.
Stress
Stress isn't necessarily the sole cause of hormonal acne, but it can contribute to flare-ups.
During periods of stress, hormonal changes can influence oil production and inflammation. Stress can also affect sleep, lifestyle and skincare habits, all of which may influence the appearance of your skin.
Genetics
Your genetics can influence how your skin responds to hormones and how much sebum your sebaceous glands produce.
If acne runs in your family, you may be more predisposed to developing persistent adult acne.
How can you tell if your acne is hormonal?
There isn't one definitive sign that proves your acne is hormonal. Instead, look for recurring patterns.
Your acne may have a hormonal component if you notice that:
- Breakouts repeatedly appear around your chin or jawline
- Spots are deep, sore or tender
- Your skin flares at a similar point in your menstrual cycle
- The same areas repeatedly break out
- Acne developed or changed during perimenopause or menopause
- Your breakouts became more noticeable after starting or stopping hormonal contraception
- Your skin tends to flare during periods of stress
These signs can be useful clues, but they aren't a diagnosis. Acne has multiple potential causes, and persistent or severe breakouts should be assessed by an appropriate healthcare professional.
What skincare ingredients can help hormonal acne?
The best ingredients for hormonal acne will depend on your skin, the severity of your breakouts and what else you're using.
Some of the most established topical ingredients include:
Salicylic acid
Salicylic acid is a beta hydroxy acid (BHA) that helps exfoliate the skin and unclog pores.
It can be particularly useful when congestion and excess oil are concerns. If your skin is sensitive or dry, start gradually rather than using it too frequently.
Azelaic acid
Azelaic acid is a versatile option for skin experiencing breakouts, redness and post-inflammatory pigmentation.
It can help unclog pores, reduce bacteria associated with acne and improve the appearance of dark marks left behind after blemishes.
This combination of benefits makes it particularly interesting for adult skin, where acne may not be the only concern.
Retinoids
Topical retinoids help prevent pores from becoming blocked and can reduce inflammation, making them an established treatment option for acne.
Because they can initially cause dryness and irritation, they should be introduced carefully, particularly if your skin is already sensitive.
If you're pregnant or trying to conceive, speak to your doctor before using retinoid products.
Benzoyl peroxide
Benzoyl peroxide can reduce acne-causing bacteria and is an established treatment for acne. It can be particularly useful for inflammatory breakouts.
It can be drying for some people, so using an appropriate moisturiser and introducing it gradually can help your skin adjust.
Understanding the relationship between hormones, sebum, congestion and inflammation can help you take a more informed approach. The most effective routine isn't necessarily the strongest one, it's the one that's appropriate for your skin, consistent enough to maintain and targeted towards your individual concerns.
At Skin Pharmacy, we believe there is no one-size-fits-all approach to skincare.
If you're experiencing recurring breakouts and aren't sure which ingredients or products are right for you, the Skin Pharmacy Concierge team can provide personalised skincare advice based on your skin type, concerns and goals.
Whether you're dealing with hormonal breakouts, congestion, redness, post-acne pigmentation or a combination of concerns, our Skin Experts can help you understand your skin and build a more considered routine.
