What does hormonal mean in acne?

What are hormones doing to the skin?

Androgens are a group of hormones that includes testosterone. They stimulate sebum, the skin's natural oil, and contribute to acne in both sexes from puberty onwards. Although androgens are often called male hormones, their role in acne is not limited to men. The word hormonal describes a contributing cause, not a special class of pore awaiting its own product launch.1

Acne develops when excess oil and dead skin cells block hair follicles, the openings where hairs grow. Bacteria can then grow inside the blocked follicles and cause inflammation and pus. Hormones are part of that process, rather than an alternative to blocked pores or inflammation. Hormone changes during puberty, periods, pregnancy and menopause can contribute to breakouts.2

What does hormonal acne look like?

Breakouts around the chin and jawline, flares before a period, and persistent adult acne are common patterns. Adult acne can also affect the neck, chest, back or other parts of the face. It can include inflamed spots or whiteheads, so hormonal does not simply mean deep, painful lumps. Adult acne can continue from teenage years or begin after age 25.3

Do I need hormone tests?

Hormone testing is not automatically needed for brief breakouts or acne that responds well to standard treatment. A clinician can consider testing when acne resists treatment or appears alongside signs of excess androgen activity. Mention new excess facial or body hair, scalp hair thinning, or a deepening voice. These details help decide whether the acne needs more than a skin treatment.14

Some ovarian hormone conditions can cause persistent acne alongside hair changes, but acne alone cannot diagnose a hormone condition. Even people with an underlying condition can have mild acne or none at all. A clinician may need hormone tests or an ultrasound rather than relying on where the spots appear.4

Does hormonal acne need different treatment?

Ordinary topical acne treatments can still help hormonal acne, so the word hormonal does not require an entirely new bathroom inventory. Benzoyl peroxide and salicylic acid are options for mild to moderate acne. A pharmacist can help you choose a treatment; persistent or more severe acne can need prescription medicines. Treatment choice depends on severity as well as the suspected cause.245

• Wash with a gentle cleanser twice daily and remove makeup at the end of the day.
• Choose skincare and makeup labelled noncomedogenic, meaning designed not to clog pores.
• Avoid scrubbing, which can irritate skin and worsen acne, and picking or squeezing, which can cause scars.

For women with persistent acne, certain combined contraceptive pills and spironolactone are hormonal treatment options. These treatments reduce androgen production or block androgen effects, helping reduce oil and clogged pores. They can be combined with topical treatments. Not every contraceptive pill treats acne, and hormonal medicines require an assessment of suitability rather than simply matching a jawline pattern.3467

Hormonal treatment is not an overnight fix. With suitable combined contraceptive pills, acne improvement can become apparent by the third cycle and continue over later months. Acne can worsen again within months of stopping. Topical treatment for persistent adult acne also often needs to continue to maintain its effects.37

When should I see a doctor?

See a doctor if self treatment is not helping, spots are deep or painful, scars are developing, or acne affects your mental health. Seek medical help for hot, swollen skin that suggests infection. Tell your prescriber if you are pregnant or planning pregnancy: spironolactone can harm a developing fetus, and combined contraceptive pills must not be taken during pregnancy. Combined pills also carry blood clot risks and are unsuitable for some people.247