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Is my acne hormonal acne?

By: Rachel Day, M.D.


Acne, an inflammatory skin condition that affects the pilosebaceous unit (hair follicle and oil gland), is common in adolescence and for some, may continue into adulthood. It affects over a third of individuals between the ages 15 and 44 years.

The four well established causes of acne include:

  • Excess oil production
  • Inflammation around the hair follicle and oil gland triggered by bacteria
  • Delayed shedding of dead skin cells at the opening of the hair follicle
  • Hormones: both male, female and stress hormones

Oil gland hypersensitivity to circulating androgens (the male hormone) is believed to be the main factor in the development of hormonal acne. Clinically, hormone-related acne is characterized by pink papules and pustules along the jawline and chin, new-onset adult acne, pre-menstrual acne flares, cystic acne with/without menstrual irregularities and hirsutism (dark thick hair in women on their face, chest, and abdomen).

Cortisol, our main stress hormone, can also activate the oil gland resulting in increased frequency of break outs during periods of high stress.

Hormonally triggered acne can be very tender and uncomfortable.

Preventing breakouts is possible with a good skincare routine and systemic medication to help increase the threshold to developing these acne lesions. 

Some of Dr. Day’s favorite treatments include:

  • Gentle skin care! Hormonal break outs leave the skin barrier broken and sensitive. Using sensitive skin cleansers (minimize exfoliating cleansers) and moisturizers (no fragrance). Vanicream and Peet Rivko are two favorite brands to check out. 
  • Daily movement and nutritious foods! Exercise is a great for stress reduction (and your overall health). Recommend 30 minutes a day to purposefully attend to your body’s needs and build up a sweat. Supplementing daily exercise with a variety of colorful fresh foods and avoiding processed foods will help manage your internal inflammatory state and improve your skin’s health.
  • Get regular. Irregular periods can be a sign of an underlying condition called polycystic ovarian syndrome or PCOS. Unmanaged it can be an internal driver of hormonal acne. I recommend speaking to your primary care physician or OB/Gyn to address any menstrual irregularities. The oral birth control pill can be helpful at regulating periods and hormonally triggered break outs. But beware that progesterone only birth control forms can actually make hormonal break outs worse.
  • Spironolactone. This medication, which on label is a blood pressure medication, can be life changing for women with hormonal acne. It blocks the interaction between your hormones and the oil gland preventing that excess oil from accumulating in the hair follicle leading to painful papules. It is important to see a board-certified dermatologist, like me ??, that can educate you about the risks and benefits of spironolactone treatment.

Still have questions about hormonal acne, or ready for your acne to be evaluated by an acne expert in Chambersburg? We can’t want to welcome you to our Clear Skin by OneSkin club. To schedule your consultation give us a call at 717-504-8426 or text us at 717- 966-6142.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.