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Hormonal Acne

Hormonal acne, also known as adult acne, is a skin condition that primarily affects teens and adults and is most common in women. Adult acne presents as cysts, pus-filled pimples, blackheads and whiteheads.

Last Modified: September 5, 2023
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Hormonal Acne Symptoms

Primary symptoms of hormonal acne depend on the location of the skin breakout, and the gender, age and lifestyle circumstances of the person who has them.

Adult acne varies by individual but has common symptoms, including:
  • Whiteheads: Known as closed comedones, whiteheads are closed underneath your skin surface. Whiteheads can be soft or hard with a white top, often on the back, chest or face.
  • Blackheads: These are open comedones and form around clogged pores. “Open” refers to the fact that skin doesn’t cover the blackhead. The openness causes the comedones to turn dark. You can get them on your shoulders, face, chest or back.
  • Papules: These are solid, inflamed bumps, usually conical. They’re small and can be of the same color as the skin. With time, papules can progress into pustules.
  • Pustules: Unlike papules, pustules have a yellow or white pus-filled tip.
  • Cysts: These are inflammatory acne with pus-filled, painful pimples that form deep under the skin. It’s the most severe and painful acne, likely to cause scarring.

These outbreaks in adults show up in the T-zone and on lower cheeks and jawlines. Sometimes acne develops on the back, aptly called back acne. In pubescent women, symptoms of hormonal acne include hair loss and irregular periods that come along with skin breakout.

In teens, hormonal acne usually appears in their T-zone, which spans from eye to eye above the eyebrow and down the bridge of the nose, forming a “T.” It can also appear on the chin.

Hormonal acne can develop on your forehead, upper back and face — areas that have the most sebaceous glands. It is sometimes confused with fungal acne, a good reason to consult your dermatologist for a definitive diagnosis. With early diagnosis, you can have early treatment to prevent acne scars.

What Causes Hormonal Acne?

Hormonal acne stems from oil on your skin that increases because of changing hormone levels, particularly in women who are pregnant and have irregular periods. Although doctors often use birth control pills to treat acne, IUDs can cause it.

Medical studies show that consuming certain foods such as bread, chips and bagels can worsen acne. Acne and testosterone are connected. During puberty, testosterone production increases, often prompting teen acne. Other hormones, such as insulin-like growth factor-1, also play a role in teen acne.

Finally, acne can also be genetic, citing that if your family has a history of acne, you’re also likely to develop adult acne.

Hormonal acne can be worsened by:
  • Environmental conditions
  • Picking, popping or squeezing pimples
  • Stress
  • Excessive scrubbing

In fact, scrubbing your face too hard or using harsh chemicals can worsen the acne condition.

To bust some acne myths, eating greasy food and chocolate has little or no effect on acne. Likewise, dirty skin cannot cause acne.

Hormonal Acne and Pregnancy

Pregnant women often experience hormonal acne during their pregnancy because of the amount of hormone changes their bodies go through. During the first trimester, women experience a production surge of progesterone. The hormone usually increases the volume of sebum the body creates, triggering the start of an acne outbreak. Breakouts often continue until the baby arrives.

Acne doesn’t automatically develop during a pregnancy, but splotchy skin and pimples are more likely to crop up.

Because genetics often play a role in acne breakouts, newborns can arrive with, or quickly develop, a mild skin condition known as baby acne. This form of acne clears up on its own. It does not require medical addition and it does not lead to any scarring of the skin.

How to Treat Hormonal Acne

Because hormonal acne usually takes the form of cystic bumps, which form deep beneath your skin, most topical medications show little to no effectiveness. Oral contraceptives are suitable for acne treatment because they work from the inside out. These contraceptives may contain ingredients such as:

  • Norgestimate
  • Norethindrone
  • Drospirenone

These ingredients target hormones that trigger acne. Oral contraceptives are among the hormonal therapies that can work. A dermatologist may also prescribe Spironolactone, which can treat deep-seated acne on the neck, lower face or jawline. Doctors advise pregnant women to avoid this medication.

Over-the-counter topical treatments can minimize mild adult acne in women. But as with teenager acne, doctors recommend treating hormonal acne based on the severity of the outbreak and skin type. Retinol, benzoyl peroxide and salicylic acid are among the best topical OTC acne treatments.

Retinoids are especially effective for individuals with mild adult acne. The combination of niacinamide and retinol can also clear your skin and help with fine wrinkles.

When to See a Doctor for Hormonal Acne

While acne can clear within a few weeks, it’s essential to seek medical help as early as possible.

Cystic acne occurs deep below the skin, and the treatment itself can cause problems. At times, over-the-counter treatments and laser therapy might not yield results. It’s important to see a doctor before acne scarring develops.

Your dermatologist will consider family history, hormone levels and stress, among other factors, to give an effective treatment procedure.

Can Hormonal Acne Be Prevented?

Hormonal acne, especially in teens and pregnant women, is often unavoidable, but you can minimize the risk of more breakouts. Consider treatments that work well for your skin and acne type.

One recent study showed the combined use of plant preparations, lactic acid and ultrasound treatments with green-tea gel helped with excess sebum levels and reduced skin eruptions.

Ensure you make a lifestyle change by eating healthily, getting enough sleep and reducing stress. When it comes to skin care products, choose items that won’t clog your pores. Chemical products and treatments can also worsen your acne.

Adult acne can be painful, and it can negatively impact your confidence. But don’t give up working with a dermatologist to find a solution.

Please seek the advice of a medical professional before making health care decisions.