Got Adult Acne? 4 Signs Your Hormones Are To Blame

One thing that still surprises me in my herbal practice is how many women come to me because they’re suffering from acne and can’t seem to find any relief. Of all of the symptoms that wreak havoc in women’s lives when they’re struggling with hormonal woes, it seems like acne is at the top of the list when it comes to symptoms that are frustrating, demoralizing, and deeply connected to a woman’s ability to feel like herself.

If you’re struggling with acne as an adult, I want you to know that you’re not alone. Your concerns are real and valid. Wanting clear skin isn’t something to be dismissed as a matter of vanity, and it doesn’t make you shallow if you feel your acne chiseling away at your self-confidence. You deserve the same compassion that anyone with a chronic health issue deserves.

And you deserve support that really works to help you get better. The first step is to learn as much as you can about your symptoms so you and your health care team can get to the underlying issue.

I want to give you some clues to help you figure out whether or not your acne is related to fluctuations in your hormones. Then, I’ll give you a few tips for how to get started with a hormone-balancing regimen. Please do remember that this article is just a starting point and that you’ll get the best results by working one-on-one with a practitioner who understands these issues.

There are a few clues that tell us if acne is related to your hormones:

  • the timing of your breakouts
  • the location of your acne
  • the shape, size, sensation, and appearance of your acne
  • the treatments your acne responds to (or doesn’t respond to)

As you read on, ask yourself if any of these clues apply to you. The more you feel yourself nodding “yes,” the more likely it is that your acne has a hormonal component.


Acne that has a hormonal component will often flare up at predictable times due to the cyclical nature of hormones during the phases of the menstrual cycle. For many women, the week before the menstrual cycle is the time when symptoms peak. Some women experience characteristic breakouts during menses, or even during ovulation.


Acne located beneath the cheekbones and along the jawline is often more likely to be related to hormonal issues than acne across the forehead or the bridge of the nose. Pimples around the mouth are said in some traditions of facial reading to be connected to the reproductive system, and I’ve had many clients with PCOS who get tiny pimples just below their lower lip at the time of ovulation.

Shape, Size, Sensation and Appearance

Hormonal acne tends to be deep, cystic, and sensitive to touch. You may feel a sensation of pain or pressure where you have a pimple even when you’re not touching it, or it might feel painful with even gentle pressure as you wash your face. This kind of acne is likely to leave a scar, especially if you try to relieve the pain by “popping” your pimple. It may not respond at all to topical creams or over-the-counter acne products and can even show signs of being dry or flaky even though you can feel a pimple underneath the surface of the skin.

Treatment Response

If your acne gets better or worse with hormonal birth control methods, that’s a good clue that hormones are behind the problem. Similarly, if topical treatments don’t seem to work, there’s a good chance that it’s because the problem isn’t coming from the surface of your skin but from hormonal changes that affect your whole body — including your skin.

What next?

If you think you might have hormonally based acne, the best thing to do is to discuss it with your health care provider. Your OB-GYN might be as helpful (or more helpful) than your dermatologist. Check your birth control method to make sure it’s working for you and get any necessary testing done to check your hormonal balance.

If (like many of my clients) you get all of the tests done and nothing seems to be wrong, or if you don’t want to take hormonal birth control as a treatment for your skin, this is a good time to consult with an herbalist who can work alongside you and your doctor to support your body’s natural systems of detoxification and elimination. For most of my clients just a few tweaks to their lifestyle and some customized herbs to help support their livers and digestion are enough to create serious change.

In the meantime, eating lots of veggies (especially ones in the Brassica family like broccoli and cabbage), drinking plenty of water, and being very gentle with your skin will help to get you on the right track.

No matter how hard it seems, don’t give up on your skin and don’t give up on yourself. Hormonal acne is a great warning sign that’s showing you that your body needs some support and attention, but it’s not a curse. With the right tender care, your skin and hormones can find their way back to balance.

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