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. The good news is that there are effective ways to target and treat hormonal acne at its root. In this post, we’ll guide you through the best over-the-counter, prescription 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. Although 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 is 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 period. This is because of the natural fluctuations in oestrogen and progesterone levels.
- Polycystic ovary syndrome (PCOS): women with PCOS tend to produce more androgens. This can lead to extra hair growth, menstrual irregularities and acne.
- Other factors: hormonal changes during pregnancy, menopause, certain contraceptives, or starting or stopping birth control pills can also trigger acne.
How to Know if Your Acne is Hormonal
Although acne can appear anywhere on the face or body, hormonal acne tends to localise around the lower face. You’ll often see it on the jawline, chin and neck. In fact, the breakouts might be more severe during certain periods, such as menstruation. They also often appear as deep, painful cysts beneath the skin’s surface. Because of the underlying cause, hormonal acne can be more resistant to treatments that 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 with a head), blackheads and texture or scarring. The best way to use it is regularly as a toner after cleansing. If your skin is very sensitive, or you don’t have time for a toning step, look for a cleanser that contains it instead.
- Benzoyl peroxide: a well-established acne-fighting powerhouse, benzoyl peroxide kills acne-causing bacteria and reduces inflammation. For isolated breakouts, use it as a gel or cream to spot-treat pimples. For 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 and hormonal breakouts. Niacinamide is best used in a serum or moisturiser.
- Retinol: this speeds up 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 stop pores from clogging. It can also reduce the redness and inflammation that come 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 option for hormonal acne. You will need to see a doctor who can check which treatment is right for you, prescribe it 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 treat hormonal acne and also improves scarring, texture and hyperpigmentation. It has anti-ageing benefits too and can improve the overall look of the skin. Tretinoin is most commonly prescribed as a cream, though gel options exist.
- Clindamycin: this antibiotic tackles the bacteria that cause acne and reduces inflammation. It is usually prescribed as a tablet, or mixed with tretinoin in a cream.
- Spironolactone: although this is a blood pressure medication, spironolactone can also block the effects of androgens (the hormones that can trigger acne). It is usually prescribed alongside other acne treatments like tretinoin. It comes as a tablet and, in some cases, a topical.
- Birth control pills: some birth control pills, like the combined oral contraceptive pill, are approved to treat acne. They regulate hormones, which can lead to clearer skin in some women.
- Isotretinoin: this oral retinoid is one of the most effective treatments for severe acne that hasn’t responded to other options. Isotretinoin dramatically reduces the size and output of the oil glands, which lowers sebum production. It also reduces skin-cell build-up inside hair follicles (which prevents clogging) and calms inflammation. Patients usually take it for a course of 4 to 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 on their own. However, others might be looking for more rapid improvement. Professional skin treatments, often available at dermatology clinics or medical spas, can offer extra solutions to manage hormonal acne. You will normally need a course of several treatments spaced 4 to 6 weeks apart. To get the most out of them, you should still optimise your skincare and treat any underlying causes. You should also see a trained and experienced practitioner for the safest, most effective results. Here is a breakdown of some of the best skin treatments for hormonal acne:
- Chemical peels: certain types of chemical peels remove the outer layers of skin, unclog pores and promote faster skin-cell turnover. They are best for mild to moderate acne and can also reduce post-acne scars and hyperpigmentation.
- Laser treatments: some lasers can reduce inflammation and 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 manually clear out blackheads and clogged pores.
- Microneedling: this is best for acne scarring and texture but won’t help with active breakouts. Traditional microneedling and RF microneedling boost collagen production to soften acne scars and improve skin quality.
The world of hormonal acne treatments can feel daunting. It’s a huge industry and, unfortunately, not every treatment lives up to the claims. However, with the right knowledge and guidance, clearer skin is possible. There are a number of effective treatments, and new ones are being found all the time. Remember to consult a dermatologist or skincare professional if your acne is severe or isn’t responding to treatment. This will help you get the best treatment for your skin and also avoid any risks or side effects. It is also important to first understand whether there is an underlying cause, as treating that may improve or even clear your breakouts. Your GP can help you find this out.
At City Skin Clinic, we are passionate about personalised skincare. Our doctors offer safe and effective custom treatments using ingredients like tretinoin, clindamycin, azelaic acid and spironolactone where appropriate, through our online clinic. Our doctors treat acne, hyperpigmentation, melasma, rosacea and skin ageing through bespoke compounded treatments designed around you. To start your personalised plan, book a virtual video consultation or use our online consultation form. The journey towards great skin starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any health concerns or questions you might have.
