Hormonal Acne: Causes & Treatment

Written By: Dr Robert Ong (MBBS, GDFP (Dermatology), Member - American Academy of Aesthetic Medicine)
Last updated: Mar 9, 2026

When breakouts keep showing up along your jawline and chin, follow a predictable cycle, and resist everything you throw at them, it is worth asking whether hormones might be behind them.

Hormonal acne behaves differently from other types of acne, and understanding the difference can save you months of trying treatments that do not address the real trigger.

Hormonal acne is a common reason adults experience breakouts well beyond their teenage years, affecting both women and men across different life stages. It often looks like regular acne on the surface, which leads many people to treat the symptoms without addressing what is actually driving them.

Once you understand whether hormones may be involved, you can move towards treatments that target the root cause, not just what shows up on your skin.

Hormonal acne is caused by fluctuations in hormone levels rather than external factors such as poor hygiene or surface bacteria alone.

Unlike typical teenage acne, which often resolves on its own, hormonal acne can persist into adulthood and tends to follow a cyclical pattern linked to hormonal changes.

It most commonly appears as deep, inflamed bumps along the jawline, chin, and lower face, and can range from mild papules to severe cystic or nodular lesions that sit beneath the skin.

Hormonal acne develops when fluctuations in hormones, particularly androgens such as testosterone and dihydrotestosterone (DHT), stimulate the sebaceous glands to produce excess oil, which combines with dead skin cells to clog pores and create conditions where acne-causing bacteria trigger inflammation.

Several factors can contribute to these hormonal fluctuations.

Menstrual Cycle

Hormone levels shift throughout the menstrual cycle, influencing oil production in the skin. In the week before menstruation, progesterone and oestrogen levels fall, creating a relative increase in androgen activity that stimulates sebum production and makes breakouts more likely.

This is why many women notice acne flaring in the same pattern each month.

Polycystic Ovary Syndrome (PCOS)

PCOS is associated with chronically elevated androgen levels, which stimulate excess oil production and contribute to persistent breakouts. If your acne occurs alongside irregular periods, weight changes, or thinning hair, PCOS may be a contributing factor worth discussing with your doctor.

Pregnancy

Pregnancy causes rapid hormonal shifts, particularly in the first trimester, as progesterone levels rise to support pregnancy. These changes can increase oil production, making breakouts more likely and sometimes more inflamed or persistent due to heightened skin sensitivity during this period.

Perimenopause and Menopause

During perimenopause and menopause, declining oestrogen levels create a relative increase in androgen influence. This hormonal shift can stimulate oil production and lead to breakouts, even in women who have not experienced acne for many years.

Testosterone Fluctuations

In men, hormonal acne is primarily driven by testosterone and DHT, which directly stimulate the sebaceous glands. Levels surge during puberty and may fluctuate in adulthood due to factors such as ageing and testosterone replacement therapy (TRT). Because these changes do not follow a predictable monthly pattern, hormonal acne in men can be harder to recognise.

Stress

Chronic stress raises cortisol levels, which can increase androgen activity and stimulate oil production. Breakouts often worsen during periods of sustained pressure, poor sleep, or emotional strain.

Medications

Certain medications can trigger or worsen hormonal acne by altering hormone levels or increasing androgen activity. These include corticosteroids, some hormonal contraceptives, and anabolic steroids.

Genetics

A family history of acne increases your likelihood of developing hormonal acne. Genetic factors influence how sensitive your sebaceous glands are to androgens and how your skin responds to hormonal fluctuations.

Hormonal acne has distinct patterns that set it apart from other forms of acne, making it possible to recognise the condition based on its presentation.

• Location – Breakouts typically appear along the jawline, chin, and lower cheeks, where sebaceous glands are more sensitive to androgens. Acne concentrated on the forehead or upper face is more often linked to other causes.
• Timing – Flares that occur in a predictable monthly pattern or during hormonal shifts such as pregnancy or perimenopause suggest a hormonal trigger.
• Appearance – Lesions are often deep, tender bumps beneath the skin rather than surface-level whiteheads or blackheads, and they may heal more slowly with a higher risk of scarring.
• Response to standard products – If your acne does not improve with over-the-counter treatments such as benzoyl peroxide or salicylic acid, a hormonal component may be involved.

Hormonal Acne vs Other Types of Acne

Hormonal acne differs from bacterial and fungal acne in its underlying cause, typical location, pattern of flare-ups, and appearance.

Treating hormonal acne typically involves addressing hormonal causes while reducing inflammation and preventing pore blockage.

The most suitable approach depends on acne severity, medical history, and associated conditions such as PCOS.

While medical treatment addresses hormonal drivers, certain skincare, lifestyle, and dietary habits can support improvement and reduce flare-ups:

• Skincare — Use a gentle, non-comedogenic cleanser and moisturiser to avoid irritation and pore blockage. Apply broad-spectrum sunscreen when out in the sun for prolonged periods of time. Avoid heavy oil-based make up that may worsen clogging.
• Lifestyle — Manage stress through regular physical activity, adequate sleep, and relaxation techniques, as elevated cortisol can increase androgen activity and oil production.
• Diet — Limit high-glycaemic foods and excessive dairy intake, which may worsen breakouts in some individuals. Include omega-3 and zinc-rich foods as part of a balanced diet to support overall skin health.

These measures can support medical treatment but are not sufficient on their own for moderate to severe hormonal acne.

At Medical Aesthetics, we offer treatment for hormonal acne and other forms of acne. Our consultation and treatment fees are as follows:

*Prices are NETT and inclusive of GST.
All patients are required to undergo a consultation with our doctor to assess his or her suitability for the relevant treatment(s).

"Hormonal acne is common among adult patients, especially women in their 20s to 40s. Once we identify the hormonal drivers, we can treat the root cause, not just the surface symptoms. Most patients see improvement within a few months of a tailored treatment plan."
— Dr Robert Ong

"Hormonal acne is common among adult patients, especially women in their 20s to 40s. Once we identify the hormonal drivers, we can treat the root cause, not just the surface symptoms. Most patients see improvement within a few months of a tailored treatment plan."

— Dr Robert Ong