Acne affects us at all ages and is caused by a variety of factors. Some of the most common causes of acne include clogged pores, genetics and hormonal acne. Hormonal acne is a type of acne that forms from fluctuations in the levels of hormones your body produces. It can affect both men and women from puberty to adulthood. We dive into the details behind hormonal pimples and their causes and treatments so you can learn how to best manage and treat it for clearer skin.

What is hormonal acne?

At its core, all acne can be described as hormonal. That’s because breakouts and blemishes happen when your body overproduces certain hormones that increase the production of sebum, an oily substance that your body needs to keep your skin and hair moist. 

Regular sebum production is key to healthy, smooth skin, but when hormones cause your sebaceous glands to produce more than normal, the excess sebum can clog pores and hair follicles and lead to acne. 

Androgens and hormonal acne

Androgens are a group of hormones that are present in both men and women. The primary androgens are testosterone and androstenedione. Androgens are key contributors to your strength, energy levels and fitness, as well as sebum production. 

Regardless of gender, testosterone is the most common reason why hormonal acne develops. Women have small amounts of male hormones like testosterone in their bodies, and it’s when your body produces more androgens than it needs that hormonal acne occurs. It’s quite common for this increase in androgens to happen around menstrual cycles for women. 

While hormonal acne is exceptionally common in puberty with hormones changing in adolescents, it’s also quite common in adults. One study found that 64% of people in their 20s and 43% of people in their 30s have acne, demonstrating that adult acne is something many people deal with. 

Hormonal acne causes and symptoms

As the name suggests, hormonal acne is caused by changes in hormones. In women, this frequently happens before the start of your period due to an increase in androgen production. These higher testosterone levels lead your body to create more sebum which, in turn, leads to hormonal acne on your chin and face. 

With this increase in sebum production comes the potential for clogged pores and hair follicles, also known as whiteheads or blackheads. Whiteheads are comedones that are completely blocked while blackheads are comedones that are only partially blocked and exposed to air, causing the material inside to oxidise and darken.

Many people might only experience whiteheads and blackheads as the extent of their hormonal pimples while others could experience bacterial infections that lead to painful, inflamed blemishes. Severe cases of hormonal acne can lead to nodules and pus-filled cystic acne. 

Because your sebaceous glands occur in the greatest number on your face and scalp, hormonal acne breakouts tend to happen in the T-zone (forehead, nose and chin) and generally around your chin, cheeks and around your mouth. 


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PCOS and acne

Polycystic ovary syndrome (PCOS) is a fairly common condition, affecting up to 21% of Australian women. It’s a hormonal disorder in women of childbearing age that can affect hormone levels and fertility. One of the key features of PCOS is high levels of androgens in a woman’s body that can often be linked to hormonal acne. Some women with PCOS do not have hormonal abnormalities or acne problems and do not have problems with fertility. 

Menopause and acne

For women, menopause is a natural part of life and comes with a reduction in your body’s production of estrogen and other female reproductive hormones. For some women, these fluctuations can lead to an increase in hormonal acne breakouts. That’s because your balance of androgens to estrogenic hormones has changed.

Hormonal acne treatment 

There are several lifestyle changes and over-the-counter remedies that you can try as a first line option of treating mild cases of hormonal acne. These involve improving overall hygiene and skincare. 

Lifestyle changes and first line treatments

Making a few modifications to your routine could be very effective in controlling mild hormonal acne. 

  • Avoid harsh face washes and skincare products with chemicals and rough exfoliants to keep from irritating your skin
  • Avoid scratching or picking at your pimples and blemishes
  • Avoid makeup if possible; if you want to use makeup try to use makeup that is water-based
  • Shower right after working out or sweating
  • Try over-the-counter washes and masks that include salicylic acid or benzoyl peroxide, two proven acne-fighting ingredients

Prescription acne treatments

If over-the-counter washes and treatments aren’t working for you, there are several clinically proven hormonal acne treatment options that are commonly prescribed by doctors and dermatologists. 

  • Retinoids and other topical acne treatments that help improve skin cell turnover and reduce the chances of pores getting blocked
  • Oral antibiotics to fight the bacteria that causes red, inflamed, painful pimples and blemishes
  • Hormonal medication like the birth control pill to help balance out your hormone production

As always, the best way to explore prescription acne medications is by talking to a doctor. Rosemary connects you to online doctors in Australia who can help prescribe a personalised acne treatment plan with clinically proven ingredients. Fill out an online assessment, upload photos of the affected area and receive prescription-strength medication with free delivery. Start your online assessment today.


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