Ever experienced a breakout and you have no idea why? Acne might seem a little mysterious, but the reality is that it can be triggered by many different intersecting factors, including hormones. But exactly what causes hormonal acne and what specific hormones can affect your skin? Let’s dive right in.

What is hormonal acne?

Hormonal acne is triggered by changes in the body’s hormone levels. Some hormones can stimulate the production of sebum, the skin’s natural oil, and when mixed with dead skin cells, excess sebum can clog pores and lead to breakouts. Hormonal acne can occur not just during adolescence but also throughout one’s lifetime. While puberty is a very common time when adolescents experience hormonal acne, it can also be common during or around one’s menstrual cycles, and during other times of hormonal changes.¹

How do different hormones affect the skin?

There’s no single answer to what hormone causes acne in females and males. Different hormones can affect your skin in a variety of ways.²

• Estrogen. Estrogen can potentially reduce acne. In high doses, the hormone causes sebaceous glands to reduce in size. This can reduce sebum production, a contributing factor to acne. Lower doses of estrogen typically found in birth control pills don’t directly decrease sebum production but have been found to help with acne in other ways.  

• Progesterone. Progesterone can cause more sebum production. Sebum is one of the contributing factors to acne because excess oil can clog pores and give bacteria the perfect environment to thrive in.³

• Testosterone. Testosterone is another hormone that can affect your skin. It’s one of several androgens, a group of sex hormones, and it stimulates sebum production in both men and women. Testosterone is one of the main factors that contribute to hormonal acne during times such as puberty.  

What is the role of progesterone in the body?

Now that we’ve discussed hormonal acne and how different types of hormones can affect the skin, let’s turn our attention to progesterone, which performs several functions in the body. In women, it helps the uterus prepare for the implantation of a fertilized egg and helps maintain a pregnancy.⁴ It also regulates blood pressure and is connected to sleep and mood.⁵,⁶ While fluctuating levels of progesterone can contribute to acne breakouts, it’s important to remember that it doesn’t directly cause acne.

Does progesterone cause cystic acne?

Remember, progesterone isn’t a direct cause of acne. Instead, think of it as a potential contributing factor. Hormonal acne treatments may be recommended in addition to other forms of acne treatments to help combat hormonal acne,⁷ but that doesn’t mean hormones like progesterone are the only factor contributing to your pimples. It’s likely just one factor of several.

Can low progesterone cause acne?

Hormones are like a balancing act and a hormonal imbalance can trigger factors that can contribute to acne. For example, when estrogen and progesterone levels fall after ovulation, testosterone levels become higher in comparison. This can trigger more sebum production, potentially leading to worsening acne during menstruation.

Does progesterone cause acne in early pregnancy?

Progesterone levels are elevated during pregnancy. Progesterone can sebum production, which may lead to more clogged pores and pimples popping up. 

How do estrogen levels affect acne?

High estrogen levels may help reduce excess sebum production by shrinking the size of sebaceous glands. Sebum, when mixed with dead skin cells, can clog pores and cause acne. So, in theory, reducing the amount of sebum the body produces may help reduce acne lesions.

What are the symptoms of hormonal acne? 

The symptoms of hormonal acne may be the same as any other type of acne. The term “hormonal acne” simply describes what could contribute to blemishes forming—hormones. Or, more specifically, fluctuations in the body’s hormone levels, which can cause increased sebum production. 

Hormonal acne can follow what’s known as a “hormonal pattern,” meaning that it concentrates around the jawline and chin in particular.⁸ That said, hormonal acne isn’t restricted to the lower third of the face; it’s possible to also experience hormonal acne elsewhere.

What are some products that can help with hormonal acne? 

Hormonal acne can be treated using the same topical treatments as you would with any other type of acne breakout. If breakouts persist despite topical treatments, you may want to talk to your medical provider about potentially addressing the hormonal component more directly.

That said, below are some of our recommendations to help keep hormonal acne at bay.

• Benzoyl peroxide: Benzoyl peroxide is a topical acne treatment that’s available over the counter, either in the form of facial cleansers or spot treatments. Benzoyl peroxide helps to target the bacteria that contribute to acne.⁹

• Tretinoin: Tretinoin is a topical retinoid that can help treat acne lesions. Retinoids like tretinoin are vitamin A derivatives and are a mainstay in dermatology for treating acne. Because of all the stellar research backing tretinoin, we like to think of it as one of the superstar ingredients in our personal prescription formulas.

• Salicylic acid: Salicylic acid is a chemical exfoliant—specifically, a beta hydroxy acid, or BHA, that buffs away dead skin cells and also helps clear out clogged pores. It’s commonly found in face washes and other topical acne treatments.

Oral medications

Another option for treating hormonal acne is oral medications, which can be prescribed by your medical provider. These are often used along with topical treatments to help fight those difficult-to-combat acne lesions. 

• Isotretinoin: Research shows this oral medication can significantly reduce oil production, acne lesions, and acne scarring. Isotretinoin is often used to treat severe acne.

• Oral contraceptives: If you notice acne flare-ups around your menstrual cycle, it could be influenced by hormones. Certain hormonal birth control pills can be used to help treat acne that is influenced by hormones.

• Spironolactone: Another medication used to treat acne, spironolactone specifically works to block the effect of androgen hormones, which can cause the sebaceous glands to increase in size and produce excess oil.¹⁰

When to seek professional help

When it comes to taking care of skin concerns, seeking help from a healthcare provider is never a bad idea. If your acne is causing discomfort or stress, or you just want to get the best advice for you, a dermatology provider can help. Additionally, many treatments for acne are only available with a prescription, so if you want to try other options besides over-the-counter products, it’s best to reach out to a medical provider.

Four tips for treating hormonal acne 

• Wash your face regularly. Washing your face twice a day with a gentle cleanser helps keep your pores from clogging up with oil and dead skin cells.

• Use moisturizer. Another key step in taking care of your skin is to moisturize. Dry skin can be irritated and break out. In addition, if you are using acne treatments that could dry out your skin, moisturizer is key to help replenish your skin.

• Use non-comedogenic products. Even if your acne is triggered by fluctuating hormone levels, pore-clogging ingredients can only worsen the situation. Look for makeup, skincare, and hair care products labeled non-comedogenic to help keep your pores free of buildup that can lead to acne.

• Speak with a dermatology provider. Many treatments that combat hormones that could be contributing to acne require prescriptions, so if you find your breakouts to be too persistent for your favorite over-the-counter products, a medical provider may be able to offer alternative treatments.

Curology can help

Even if your breakouts are in a hormonal pattern, topical treatments such as Curology are still helpful to ensure you are treating the multiple factors that play a role in your breakouts. 

Curology was founded in 2014 by Dr. David Lorschter, MD, a board-certified dermatologist, to make skincare accessible and simple. We know it can seem overwhelming with all the options to take care of your skin, which is why we are here to create customized and simple skincare routines to meet your skin concerns. However, if topical treatments just don't seem to be enough, you may want to try additional options such as dietary changes or oral medication like birth control.

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When you sign up for Curology, you’ll be paired with one of our licensed dermatology providers who can prescribe you a personalized prescription formula with a mix of three ingredients for your unique skin. We’ll also include our cleanser and your choice of moisturizer for no extra cost. Sign up for a free 30-day trial of Curology* —just pay $4.95 (plus tax) to cover the cost of shipping and handling on your first month of customized skincare.

P.S. We did the research so you don’t have to:

1. Elsaie M. L.  Hormonal treatment of acne vulgaris: an update. Clinical, cosmetic and investigational dermatology. (2016, September 2).

2. Elsaie M. L.  Hormonal treatment of acne vulgaris: an update. Ibid.

3. Toyoda, M., & Morohashi, M. Pathogenesis of acne. Medical electron microscopy : official journal of the Clinical Electron Microscopy Society of Japan. (March 2001).

4. Cable, J. K., & Grider, M. H. Physiology, Progesterone. In StatPearls. StatPearls Publishing. (2022).

5. Mario Barbagallo, et al. Vascular Effects of Progesterone. (January 2001).

6. Andersen, M L et al. Effects of progesterone on sleep: a possible pharmacological treatment for sleep-breathing disorders?. Current medicinal chemistry. (2006, n.d.).

7. Zaenglein, A. L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016).

8. Elsaie M. L.  Hormonal treatment of acne vulgaris: an update. Ibid.

9. Andrea L. Zaenglein, et al. Guidelines of care for the management of acne vulgaris. Ibid.

10. Elsaie M. L.  Hormonal treatment of acne vulgaris: an update. Ibid.

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Written by

Curology Team

Medically reviewed by

Meredith Hartle, DO