Hormonal Acne: Causes, Treatments, and What Actually Works

When you get acne that shows up around your chin, jawline, or neck—especially before your period—you’re likely dealing with hormonal acne, a type of acne triggered by shifts in androgens like testosterone that increase oil production and clog pores. Also known as adult female acne, it’s not caused by dirt or poor hygiene—it’s biology. Unlike teenage acne that fades with age, hormonal acne can stick around for years, even into your 30s and 40s, and it doesn’t respond well to regular face washes or spot treatments.

This kind of acne often links to conditions like polycystic ovary syndrome (PCOS), a common hormonal disorder that causes higher androgen levels, irregular periods, and insulin resistance, or even stress-induced cortisol spikes. Birth control pills, thyroid issues, and menopause can also throw your hormones off balance and trigger breakouts. What makes it tricky is that the same treatments that work for regular acne—like benzoyl peroxide or salicylic acid—often barely touch hormonal acne. You need to target the root cause, not just the surface.

That’s where treatments like isotretinoin, a powerful oral medication used for severe, treatment-resistant acne that shrinks oil glands and resets skin cell turnover, come in. It’s not a first-line fix, but for people with stubborn hormonal acne that won’t quit, it’s often the only thing that delivers long-term clearance. Other options include anti-androgen medications like spironolactone, which blocks testosterone’s effects on the skin, or specific types of birth control that lower androgen activity. Topical retinoids can help too, but they work best when paired with internal hormone balancing.

What you won’t find in most acne ads is how much your lifestyle and medications interact with this condition. Things like high-glycemic foods, dairy, or even certain supplements can make hormonal acne worse. And if you’re taking other meds—for thyroid, depression, or autoimmune issues—they might be quietly making your breakouts worse too. That’s why a one-size-fits-all approach fails. What works for one person might do nothing for another, even if they both have "hormonal acne."

The posts below cover real-world insights on how hormonal acne connects to broader medication patterns, from how isotretinoin changes your body’s chemistry to how birth control affects skin over time. You’ll find practical advice on what treatments are backed by evidence, what to watch out for with side effects, and how to talk to your doctor about options that actually target the hormone issue—not just the pimples.