As an adult, you might’ve assumed acne was behind you—something tied to your teenage years. But adult acne is very real, and it often pops up due to hormonal shifts.
Depending on how severe your hormonal acne is, treatment options range from lifestyle tweaks (like adjusting your diet or switching up skincare products) to in-office procedures such as laser treatments or corticosteroid injections.
1. Lifestyle Changes
A few adjustments to your daily routine might help keep breakouts in check:
- Use noncomedogenic products: Some hair and skincare items can clog pores, making acne worse. Stick to products labeled noncomedogenic, non-acnegenic, oil-free, or “won’t clog pores” to lower the risk.
- Change your diet: High-glycemic foods (like bread, rice, and potatoes, which spike blood sugar) can boost androgen levels and worsen acne.
- Manage stress: Stress raises androgen levels, which can trigger breakouts.
2. Over-the-Counter (OTC) Treatments
Some safe OTC options for acne include:
- Differin (adapalene): A vitamin A gel that helps with whiteheads, blackheads, and pimples.
- Azelex (azelaic acid): A topical treatment that fights acne and fades dark spots left behind.
- Clearasil (benzoyl peroxide): A cream or gel that tackles mild pimples but can dry out skin. Start with a 2.5% formula and gradually move up to 10% if needed.
- PanOxyl 2% (salicylic acid): Works best on whiteheads and blackheads by unclogging pores and exfoliating dead skin cells.
3. Complementary Therapies
These are extra options to use alongside (or sometimes instead of) traditional acne treatments. Always check with a doctor first to avoid interactions with other meds.
Some that might help:
- Topical tea tree oil & bee venom: Weak evidence suggests they could reduce acne, but they may irritate skin or cause allergies.
- Oral barberry extract: May help with moderate-to-severe acne.
- Oral zinc: Mixed evidence on whether it helps.
- Oral gugulipid: A gum guggul extract that’s been as effective as antibiotics for nodular acne when taken twice daily.
- Probiotics (topical/oral): Can help control acne-causing bacteria and inflammation.
4. Prescription Options
A dermatologist might prescribe:
- Birth control pills: FDA-approved for acne—they balance hormones (androgen-to-estrogen ratio).
- Spironolactone: A blood pressure med that also regulates hormones, especially helpful for women.
- Retinoids: Vitamin A derivatives that prevent clogged pores.
- Clascoterone: Specifically for hormonal acne—controls androgen production.
- Isotretinoin (Absorica, Claravis, Zenatane): For severe, scarring nodular acne. (Accutane, a type of isotretinoin, is no longer available.)
- Dapsone topical (Aczone): Slows bacterial growth and reduces inflammation.
Sometimes, doctors combine these for better results. Always follow their instructions to avoid side effects.
5. In-Office Treatments
For stubborn acne, a provider might suggest:
- Corticosteroid injections: Reduce swelling/pain in severe breakouts (used sparingly since they suppress immunity).
- Chemical peels: Remove dead skin and excess oil to prevent clogged pores.
- Laser light therapy: For mild-to-moderate acne—uses lasers/light to target breakouts.
- Acne surgery: Physically removes acne (should only be done by a trained dermatologist).
The Hormone-Acne Connection
Your skin needs sebum (oil from sebaceous glands) to stay hydrated. Androgens (male hormones) boost sebum production, while estrogen (female hormones) keeps androgens—and sebum—in check.
When hormones fluctuate (due to periods, menopause, pregnancy, or birth control), sebum can go into overdrive, clogging pores and causing acne.
Where Does Hormonal Acne Appear?
Older research suggested it mostly shows up on the lower face (chin, jawline, mouth). But newer studies note it can also appear on:
- Cheekbones
- Temples
- Forehead
- Lower jaw
Acne can also pop up near the eyes, neck, chest, back, or buttocks.
Types & Severity of Hormonal Acne
Different types include:
- Whiteheads: Closed, white bumps under the skin.
- Blackheads: Open pores where sebum darkens (not dirt).
- Papules: Small, tender pink bumps.
- Pustules (pimples): Papules with pus (red at the base).
- Nodules: Large, painful lumps deep in the skin.
- Cystic acne: Deep, pus-filled sacs (like nodules but worse).
Severity ranges:
- Mild: A few whiteheads/blackheads.
- Moderate: More breakouts, including pustules.
- Severe: Many breakouts with nodules/cysts.
Conditions That Mimic Acne
Some skin issues look like acne but aren’t:
- Hidradenitis suppurativa (HS): Deep, pus-filled abscesses.
- Folliculitis: Infected hair follicles (often from bacteria like Staphylococcus aureus).
When to See a Doctor
Mild-to-moderate acne can often be managed at home. Give treatments 4–8 weeks to work, with full clearing around 16 weeks. See a provider if:
- You see no improvement.
- Dark spots linger after acne heals.
- Your acne is moderate-to-severe (OTC meds may not be strong enough).
Summary
Hormonal (“adult”) acne stems from hormone imbalances. Too much androgen = excess sebum = clogged pores = breakouts.
- Mild/moderate cases: Try lifestyle changes, OTC meds, or complementary therapies.
- Severe cases: Prescription meds or in-office treatments may be needed.