Hormonal Acne Causes, Symptoms and How to Treat It - Dr. Axe

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Adult Acne: How to Get Rid of Hormonal Acne Naturally


Hormonal acne - Dr. Axe

If you’re someone who suffers from hormonal acne, chances are you’ve tried numerous home remedies for acne but may not be getting the results you hoped for. That’s likely because this type of acne can be complicated to treat, considering it occurs for reasons beyond having clogged pores, which is often the case with other forms of acne.

How can you stop hormonal acne? One of the first steps is working on balancing your hormones, such as by eating a nourishing diet, managing stress and getting enough sleep.

The next layer in your treatment plan is using the right types of cleansers and topical products. That means those that help clean and soothe your irritated skin without worsening symptoms.

The good news? You’re not alone if you’ve developed adult-onset acne, since this affects most people at one point in their lives or another based on a variety of factors.

What Is Hormonal Acne?

One definition of hormonal acne (which is sometimes referred to as adult acne) is “acne caused by genetic and hormonal factors that cause breakouts well past puberty and the teenage years,” or basically after someone’s early 20s.

The specific hormones that contribute to this type of acne include reproductive hormones like estrogen, progesterone and testosterone. While adult acne can affect both women and men, according to the American Academy of Dermatology Association, it’s more common among women, in part because it’s commonly tied to menstrual cycle changes along with menopause and pregnancy.

Related: How to Get Rid of Nodular Acne


How do I know if my acne is hormonal? Here are some telltale signs:

  • Developing painful cysts that feel like deep bumps under the skin’s surface, which cannot be “popped” easily or extracted.
  • Zits and sometimes painful cysts that develop around the lower face, especially the chin and jawline and sometimes the neck, shoulders and back.
  • Increased oiliness and shininess of the skin.
  • Pimples that tend to show up at the same time each month, often coinciding with a woman’s menstrual cycle.
  • Zits that develop in the same places over and over, which happens because certain pores become enlarged and prone to becoming infected and inflamed.

How do these symptoms differ from those of cystic acne or other types of acne?

Cystic acne and hormonal/adult acne have many things in common, such as they both cause painful, tender pimples below the skin.

These breakouts are different than surface-level blackheads and small white dots on the skin, which are mostly caused by bacteria stuck in your pores. The main difference is that cystic and hormonal acne cause painful cysts that are due to an inflammatory reaction, rather than just poor hygiene.


As the name implies, hormonal acne is caused by an imbalance of hormones, including estrogen, progesterone, testosterone and “stress hormones,” such as cortisol.

Women are more susceptible to developing this type of acne than men, especially in their 20s and 30s, when they are in their “peak reproductive years” and are producing the most hormones.

What triggers hormonal acne? The most common causes include:

  • Changes in hormones due to a woman’s menstrual cycle. Breakouts are most likely to happen prior to a woman getting her period or sometimes during ovulation, both times at which hormone levels increase.
  • Hormonal fluctuations that lead to increased oil production in the pores, which can “clog” pores and cause pimples. Excess hormones can stimulate the oil glands, leading to generally oilier skin.
  • Affects on hormone levels due to pregnancy, childbirth and lactation (breastfeeding).
  • Menopause, which lowers production of estrogen and progesterone.
  • Genetics, as most types of acne tend to run in families.
  • Stress, which can impact hormone production.
  • Hormonal birth control treatments, especially when you first begin taking them.
  • Rapid changes in weight or a big change in one’s exercise routine, since both affect hormone production.
  • Use of certain medications that may alter cortisol levels or other hormones.

Treatment and Prevention

Since you’re here reading about hormonal acne treatments, you’re probably wondering: How do you get rid of hormonal acne fast?

According to experts, here’s how to get rid of hormonal acne:

1. Cleanse Your Skin Regularly but Gently

Even though adult acne tends to be due to hormonal factors and stress more so than unclean skin, it’s still important to cleanse your face twice daily and to remove all makeup at night.

Many dermatologists recommend trying cleansers that contain salicylic or glycolic acids, which help exfoliate the surface of the skin, remove bacteria and dead skin cells (such as P. acnes bacteria that commonly causes breakouts), and prevent pores from becoming clogged.

Another recommended option is using a cleanser containing probiotics, which can help remove harmful bacteria from the skin and support a healthy “skin microbiome.” Probiotic cleansers are also helpful for normalizing the skin’s pH and reducing inflammation.

Because skin that is prone to adult acne tends to be sensitive overall, avoid products that contain fragrances, dies, refined oils and lots of synthetic chemicals, which can make irritation and dryness worse. Resist the temptation to over-wash or over-exfoliate your face, and moisturize regularly to keep your skin’s oil level balanced.

It’s also a good idea to wear sunscreen when you’re in the sun for long periods, since overly dried skin can cause more oil to be procured, which may trigger breakouts. (However, a little sun exposure can be helpful because this normalizes your vitamin D levels, which supports immune function and skin health.)

2. Try Retinoids

There are many different topical retinoid products available both over-the-counter and as prescriptions. Retinoids tend to be helpful for mild to moderate acne because they help remove dead skin cells and unclog pores, while also improving the overall texture and tone of skin. They might also help to fade dark spots, keloids and acne scars.

Because retinoids can sometimes be irritating to sensitive skin, especially if you apply a lot or use these products too often, start slowly by applying a small amount every other night. Work your way up to once daily application if your skin seems to respond well.

You can also use other soothing ingredients on your face during the day or with retinoid products, such as colloidal oatmeal, aloe or calendula. Tea tree and lavender essential oils are also safe for direct application to your skin in tiny amounts, and they can be combined with a carrier oil, such as jojoba or coconut oil if you have sensitive or dry skin.

3. Eat an Anti-Inflammatory Diet

Your diet can have a big impact on your body’s overall hormonal balance, such as by impacting the microbial balance within your gut. To beat acne, the goal should be to consume plenty of antioxidants and anti-inflammatory foods that help support hormone balance, immune function and overall healthy skin, such as:

  • Probiotic foods: The healthier your gut is, the better your balance of good versus bad bacteria. When you consume probiotic-rich foods like yogurt, kefir and cultured vegetables, the probiotics line your gut and create a healthy, sealed barrier that prevents inflammation that can trigger acne.
  • High-zinc foods: Zinc supports wound healing and enzyme reactions that play a role in immune function. People with acne tend to be low in zinc, but you can boost your intake by consuming things like grass-fed beef, chickpeas, pumpkin seeds and cashews.
  • Vitamin A and C-rich foods: Foods high in vitamin A and vitamin C — like berries, greens like kale and spinach, sweet potatoes, carrots, peppers, and citrus fruits — fight infection, defend against oxidative stress and speed up healing.
  • Fiber-rich foods: Consuming high-fiber foods like vegetables, fruits, nuts, seeds, legumes and 100% whole grains encourages colon cleansing as well as the growth of good bacteria in the gut.
  • High-quality protein foods: Grass-fed beef, organic chicken, wild-caught fish and free-range eggs are high in protein and nutrients and help balance blood sugar, a key component in the fight against hormonal fluctuations.
  • Liver-supportive foods: Since hormones are processed in the liver, eating liver-supportive foods can help clear up acne. Eat more cruciferous vegetables, like broccoli and cauliflower, as well as leafy greens and high-fiber fruits, such as berries, pears and apples.

Some people react badly to eating highly-processed foods or certain food allergens, so pay attention to your unique reaction to different foods and how your diet affects your skin. It may potentially help to avoid certain foods, such as:

  • dairy
  • chocolate
  • refined grains
  • added sugar
  • alcohol
  • processed meats
  • foods with trans fats

4. Manage Stress and Get Enough Sleep

Your adrenal glands release more cortisol when you’re stressed and sleep-deprived, which affects how much oil your skin produces. Increased oil production can cause development of inflamed cysts below your skin, leading to painful zits that are hard to treat.

Try natural stress relievers to help improve your skin, such as:

  • exercise
  • meditation
  • yoga
  • reading
  • journaling
  • spending time in nature

Exercising regularly to improve detoxification and immune function and getting enough sleep — about seven to nine hours per night for most adults — can also help improve your overall health, including by balancing hormone levels and decreasing the inflammation associated with adult acne.

5. Take a Probiotic and Other Helpful Supplements

The supplements below can be helpful for balancing hormones and keeping proliferation of unhealthy bacteria at bay:

  • Probiotics (10,000 international units (IU) to 50,000 IU daily, typically two to three capsules twice daily). Taking probiotics can boost immunity internally, while probiotic skin care products provide a protective external shield.
  • Zinc (25–30 milligrams twice daily). Research suggests that people with acne have lower blood and skin levels of zinc. Taking zinc by mouth can often help treat and reduce adult acne.
  • Omega-3 fatty acids (1,000 milligrams of fish oil/cod liver oil daily or 3,000 milligrams of flaxseed or chia seed oil). Omega-3 helps reduce inflammation and support hormone balance. You can also consider gamma-linolenic acid (GLA) found in evening primrose and borage oil for help with hormonal balance.
  • Vitex (160 milligrams of vitex/chasteberry). This herbal remedy is specifically recommended for women with hormonally induced acne.

Risks and Side Effects

While you can begin by tackling hormonal acne on your own at home, you may want to visit a dermatologist if your condition is reoccurring or worsening. Your doctor/dermatologist can help pinpoint any underlying conditions that might be contributing to our breakouts, such as PCOS, high testosterone or cortisol levels, a thyroid condition, or another hormone issue.

If the treatments above don’t seem to be doing enough to reduce your breakouts, speak with your dermatologist about other options — such as antiandrogen drugs, which block androgen receptors to decrease the actions and effects of testosterone, or stronger topical prescriptions to fight acne-causing bacteria.

When treating hormonal acne yourself, there’s potential to experience some side effects depending on the specific products and treatments you use. Some topical products might cause dry, red, flaky, painful skin at first, so make sure to follow directions, and remember that less may be more when it comes to improving your skin’s appearance.

If you have sensitive skin, such as eczema, dermatitis or rosacea, some products, such as retinoids and certain cleaners, may be too harsh. Certain products are also not safe when you’re pregnant, so get your doctor’s advice if this applies to you.


  • Hormonal acne is acne caused by genetic and hormonal factors that cause breakouts well past puberty and the teenage years.
  • It typically causes inflamed, deeply felt pimples, usually around the chin, jaw and neck.
  • Potential causes include changes in estrogen, progesterone, testosterone and cortisol levels due to things like stress, a woman’s menstrual cycle, a poor diet, pregnancy, menopause, or significant changes in one’s weight or exercise routine.
  • Here’s how to get rid of hormonal acne: Cleanse and nourish your skin, eat an anti-inflammatory diet, manage stress, get enough sleep, and take supplements, such as probiotics, zinc and possibly vitex.

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