POSTED: 11 Aug 2023

The Best Treatments for Hormonal Acne According to Doctors

Dealing with the ups and downs of hormonal acne? We get it. This particular type of acne, triggered by hormonal fluctuations, can be an unwelcome guest during certain phases of our lives. But don’t worry! There are effective solutions to target and treat hormonal acne at its root. In this post, we’ll guide you through the best over-the-counter products, prescription skincare and professional treatments for hormonal acne.

What is Hormonal Acne?

Hormonal acne is a specific type of acne breakout that occurs in response to fluctuations in the body’s hormones. Whilst acne is commonly associated with the hormonal changes of puberty, it’s not limited to teenagers. Many adults, particularly women, experience hormonal acne well into their 20s, 30s, 40s and even during menopause.

What Causes Hormonal Acne?

At its core, acne is caused by a combination of excess oil production, clogged pores, bacteria and inflammation. However, with hormonal acne, the trigger is fluctuating hormone levels. Here’s how hormones play a role:

  • Androgens: these are male hormones that both men and women produce. A spike in androgen levels, can cause the oil glands under the skin to produce more oil. This excess sebum can then clog the pores, leading to acne.
  • Menstrual Cycle: many women experience breakouts right before or during their menstrual cycle. This is due to the natural fluctuations in oestrogen and progesterone levels.
  • Polycystic Ovary Syndrome (PCOS): women with PCOS tend to produce more androgens, which can lead to hair growth, menstrual irregularities, and, yes, acne.
  • Other Factors: hormonal changes during pregnancy, menopause, certain types of contraceptives or when starting or stopping birth control pills can also trigger acne.

How To Know if Your Acne is Hormonal

Whilst acne can appear anywhere on the face or body, hormonal acne tends to localise around the lower face, particularly on the jawline, chin and neck. The breakouts might be more severe during certain periods, such as menstruation, and they often appear as deep, painful cysts beneath the skin’s surface. Due to the underlying cause, hormonal acne can sometimes be more resistant to treatments that typically work for other types of acne.

Over-the-Counter Skincare for Hormonal Acne

When facing a sudden breakout, it’s tempting to grab a quick solution from the skincare aisle. However, not all treatments are equal or work for everybody. These are some of the most effective over-the-counter products for hormonal acne:

  • Salicylic Acid: this beta hydroxy acid (BHA) exfoliates the skin, unclogs pores and reduces inflammation. It’s great for superficial acne lesions (the ones that have a head), blackheads and texture or scarring. The best way to use this is regularly as a toner after cleansing your skin. If your skin is very sensitive or you don’t have time for a toning step, then look for a cleanser that contains it as a compromise.
  • Benzoyl Peroxide: a well-established acne-fighting powerhouse, benzoyl peroxide kills acne-causing bacteria and reduces inflammation. For isolated breakouts, use this as a gel or cream for spot treating pimples. If you have a more extensive breakout, use it in a cleanser or lotion.
  • Niacinamide: not only does it tackle inflammation, but Niacinamide also regulates oil production and reduces the appearance of pores. This makes it a solid choice for those with oily skin prone and hormonal breakouts. Niacinamide is best used in a serum or moisturiser.
  • Retinol: this accelerates cell turnover and unclogs pores. Retinol reduces the appearance of acne and post-inflammatory hyperpigmentation. Look for night creams or serums that contain Retinol.
  • Azelaic Acid: this gentle acid has antibacterial, anti-inflammatory and exfoliating properties. Azelaic acid helps prevent pores from clogging. It can also reduce redness and inflammation associated with acne breakouts. use it in the form of gels, serums or creams.

Prescription Treatments for Hormonal Acne

For severe or more persistent breakouts, prescription skincare may be the best treatment for hormonal acne. You will need to see a doctor who can check which treatment is best for you, prescribe the treatment and monitor your progress. Whilst by no means exhaustive, these are the most effective and commonly used prescription treatments for hormonal acne:

  • Tretinoin: this retinoid increases cell turnover, unclogs pores and reduces inflammation. Tretinoin can not only treat hormonal acne but also improves scarring, texture and fades hyperpigmentation. It also has anti-ageing benefits and can improve the overall appearance of the skin. Tretinoin is most commonly prescribed as a cream but there are also gel options.
  • Clindamycin: This antibiotic tackles the bacteria that cause acne and reduces inflammation. It is usually prescribed either as a tablet or can be prescribed mixed with Tretinoin in a cream.
  • Spironolactone: although this is a blood pressure medication, Spironolactone can also block the effects of androgens (hormones that can trigger acne) on the skin. It is usually prescribed in tablet form alongside other acne treatments like Tretinoin.
  • Birth Control Pills: some birth control pills, like the combined oral contraceptive pill, are approved to treat acne. They can regulate hormones which can lead to clearer skin in some women.
  • Isotretinoin: this is an oral retinoid and is considered one of the most effective treatments for severe forms of acne that haven’t responded to other treatments. Isotretinoin works by dramatically reducing the size and secretion of the sebaceous glands which inhibits sebum production. It also reduces the proliferation of skin cells inside hair follicles which prevents clogging and has anti-inflammatory properties. Patients usually take it for a course of 4-6 months and may see long-lasting results.

Professional Skin Treatments for Hormonal Acne

For many people, over-the-counter products and prescription medications may not be enough alone or they might be looking for more rapid improvement. Professional skin treatments, often available at dermatology clinics or medical spas, can offer additional solutions to combat and manage hormonal acne. You will normally need to have a course of several treatments spaced 4-6 weeks apart. To get the most out of these treatments you should still optimise your skincare and treat any underlying causes of hormonal acne. You should also ensure that you see a trained and experienced practitioner to get the best and safest treatment for you. Here’s a breakdown of some of the most best skin treatments for hormonal acne:

  • Chemical Peels: certain types of chemical peels remove the outer layers of skin, unclog pores and promotes faster skin cell turnover. They are best for mild to moderate acne and can also help reduce post-acne scars and hyperpigmentation.
  • Laser Treatments: some lasers can reduce inflammation, oil production and kill acne-causing bacteria. They also resurface the skin and can address post-acne scarring and dark spots.
  • Extraction Facials: when done by a qualified aesthetician or dermatologist, these facials will manually clear out blackheads and clogged pores.
  • Microneedling: this is best for acne scarring and texture but won’t help with acne breakouts. Traditional microneedling and RF Microneedling promote collagen production to reduce the appearance of acne scars and improve skin quality.

The world of hormonal acne treatments can feel daunting. This is a huge industry and unfortunately not all treatments live up to the cause. However, with the right knowledge and guidance, clearer skin is possible. Remember to always consult with a dermatologist or skincare professional if you are experiencing severe acne or breakouts that aren’t responding to treatment. This will ensure that you get the best treatment for your skin and avoid any risks or side-effects. Equally important is to first understand whether there is an underlying cause to your acne as treating that may improve or even eliminate your breakouts. Your family doctor or GP should help you in finding this out.

At City Skin Clinic, we offer a variety of skincare treatments that can help treat hormonal acne. Check out our online skin clinic which offers prescription-strength skincare products like Tretinoin  and Obagi CLENZIderm MD system to treat skin concerns like acne and hyperpigmentationBook a virtual consultation with one of our doctors and take your first step towards better skin.


Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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