Is hormonal acne the same as acne vulgaris?

What is the difference between the names?

Acne involves blocked hair follicles and their oil glands, with inflammation contributing to the bumps. Oil, dead skin cells and bacteria are involved. The result can include blackheads, whiteheads, inflamed pimples and deeper lumps. "Acne vulgaris" names the condition, while "hormonal" describes a contributing factor, because apparently one name was not enough paperwork.23

Hormones are involved in acne generally, including teenage acne. Androgens, a group of hormones that includes testosterone, help drive the process. Sensitivity to these hormones also matters. Calling acne hormonal does not automatically mean you have a hormone disorder or need hormone testing.12

What suggests a hormonal pattern?

Breakouts around your period are one clue. Adult hormonal acne often appears around the chin, jawline and mouth, although it can affect other facial areas, the chest, shoulders and back. Location alone does not identify the cause.145

Pregnancy, menopause and stopping birth control can change acne patterns. Testosterone treatment can increase skin oil production, and other medicines can contribute to new adult breakouts. Tell your clinician about medicines you take or recently stopped. Acne can be treated while you continue testosterone therapy, without stopping it or changing the dose.46

Persistent acne alongside irregular periods or excess hair growth deserves an assessment for an underlying hormonal condition. Some hormonal disorders produce deep, inflamed lower face breakouts that resist standard treatments, but their appearance cannot diagnose or rule out the disorder. Acne usually needs only a skin examination; sudden, severe adult outbreaks or other unusual features can warrant additional tests.145

Does hormonal acne need different treatment?

Not necessarily. Benzoyl peroxide and salicylic acid can help mild to moderate acne, including acne associated with a hormonal disorder. An acne product does not need "hormonal" on the box to be relevant, even if the box would enjoy another adjective. Treatment depends on severity and response, rather than the name alone.15

Start with gentle cleansing once or twice daily, including after exercise, and avoid scrubbing or repeated washing. Remove makeup before bed and choose products labelled noncomedogenic, meaning formulated not to clog pores. Apply acne medicines sparingly and follow their directions. Redness, dryness and excessive peeling are possible; stronger products can be particularly drying on aging skin.34

A clinician can add prescription treatments if needed. Retinoids, medicines related to vitamin A, prevent clogged pores and are applied across the acne affected area rather than only to individual pimples. For suitable patients, spironolactone or certain combined birth control pills can address hormonal effects. These treatments can be combined with topical medicines. Combined pills require a safety review because they increase blood clot risk and are unsuitable for some people.17

Pregnancy changes the treatment choices. Do not take spironolactone or isotretinoin during pregnancy. Benzoyl peroxide and salicylic acid are generally considered safe during pregnancy; discuss your treatment choices with your pregnancy care clinician.35

How long should you wait before getting help?

Acne treatment often takes 6 to 8 weeks to show a response, and retinoids can take several months. Seek medical help if self care and pharmacy treatments have not helped after several months. Get help earlier for deep painful lumps, worsening acne, scarring or emotional distress. Avoid picking or squeezing pimples, which can slow healing and cause scars.13