Dermatologist-Recommended Skin Care Routine for Hormonal Acne

Contrary to popular belief, hormonal acne isn’t just a skin ordeal for adolescents. “To some extent, hormones play a role in acne for everybody, but adult women can experience a type of acne primarily driven by their hormones caused by pregnancy, menstrual cycle, menopause and oral contraceptives,” explains Dr. Jeremy Fenton, a board-certified dermatologist at Schweiger Dermatology Group. While adolescents and women from 20 to 50 years of age are the primary targets, hormonal acne affects both genders. Doctors are even seeing an increase in pediatric acne cases due to children hitting puberty earlier than previous generations.

The following dermatologist-recommended tips can help you create the best skin care routine for hormonal acne, as well as understand how a dermatology specialist can help you find the right treatments to achieve clearer, healthier skin.

Understanding Hormonal Acne

“While it is more commonly discussed in the context of women, men also experience hormonal acne,” says Dr. Brian Zelickson a board-certified dermatologist at Schweiger Dermatology Group.

In men, hormonal acne is often linked to fluctuations in testosterone levels, which can increase sebum production and lead to clogged pores and breakouts, Zelickson says. For women, hormonal disturbances stimulate oil production within the skin, promoting the growth of acne-causing bacteria. Often driven by androgens — known as the male sex hormones — hormonal acne has other triggers like stress and dietary choices. It tends to appear across the jawline, chin and lower cheeks, but also pops up on the neck, chest, shoulders and back.

Determining if a patient has hormonal acne involves a combination of clinical examination and patient history. “For women, breakouts that coincide with their menstrual cycle are a strong indicator. Also, hormonal acne often manifests as deep, painful cysts and nodules, particularly around the jawline and chin,” says Dr. Zelickson. Blood tests or other imaging tests to check hormone levels or evidence of a condition in women called polycystic ovary syndrome can be useful, especially if an underlying hormonal imbalance is suspected, he adds.

Step-by-Step Dermatologist-Recommended Hormonal Acne Skin Routine

Establishing a skin care routine for hormonal acne will help you reach your goal of resolving your hormonal breakouts. The general rule is to stick with more gentle treatments. “Women with adult female hormonal acne can cause their acne to flare up if they’re too aggressive with the topicals,” says Dr. Fenton. Refrain from harsh scrubbing and avoid picking or popping pimples.

The first step towards an acne-free complexion is to create a skin routine for hormonal acne that includes the following steps:

  • Cleansing

    Start with an over-the-counter acne wash or topical gel that contains salicylic acid or glycolic acid to help remove the dead skin cells and clear out pores, says Dr. Zelickson. Wash your face twice a day and rinse with warm water. If your skin can tolerate it, try an over-the-counter benzoyl peroxide gel or wash for its antibacterial properties.

  • Exfoliation

    Gentle exfoliation can help unclog pores, but avoid over-scrubbing, says Dr. Michele Farber, a board-certified dermatologist at Schweiger Dermatology Group. If your acne is inflamed, gently wash with your hands or pat with a washcloth to avoid irritating acne or causing deeper inflammation.

  • Prescription Treatments

    “If over-the-counter products don’t improve the acne after several weeks or if the acne is severe and causing significant distress or scarring, a dermatology provider can offer advanced treatments,” says Dr. Zelickson. Oral medications include antibiotics, hormonal treatments like birth control pills or anti-androgens, as well as topical prescription treatments like stronger retinoids, combination therapies and even oral retinoids. “Some prescription topical medications such as Winlevi and Aczone tend to work well with hormonal acne. You can also try the over-the-counter adapalene gel nightly,” he advises.

    While oral contraceptives can be effective in treating adult acne in female patients, not all dermatologists prescribe them to address hormonal breakouts. There are some conditions — including tobacco use or clotting disorders — that make birth control a riskier option. If you’d like to explore this option, inquire whether your provider uses birth control pills as a hormonal acne treatment before making your appointment.

  • Moisturizing

    For the best skin routine for hormonal acne, you must hydrate your skin. “Daily moisturizing helps maintain the skin barrier, preventing it from becoming dry and irritated, which can exacerbate acne,” says Dr. Zelickson. If you have oily skin, use oil-free or gel products with humectants like glycerin and hyaluronic acid. And stick with non-comedogenic moisturizers, which are less likely to clog your pores.

  • Sun Protection

    Every hormonal acne skin routine must include sun protection. Dr. Fenton recommends daily sunscreen usage as a crucial step because many acne treatments can make the skin more sensitive to UV rays, increasing the risk of sunburn and hyperpigmentation. “Consistent use of sunscreen helps protect the skin and prevent acne scars from worsening,” he says. Apply a non-comedogenic broad spectrum sunscreen daily, every day of the year. Reapply every two hours when outdoors and make sure it has a SPF 50+.

Morning vs. Night Skin Care Routine for Hormonal Acne

Leaving makeup on overnight and allowing oil accumulation can contribute to clogged pores. Washing your skin daily, especially after sweating, is imperative for a clear complexion, according to Dr. Farber. A dermatologist recommended skin care routine will be different from morning to night.

To start the day, Dr. Zelickson advises using a topical antibiotic treatment that contains benzoyl peroxide, which is available over the counter or as a prescription antibiotic. He also stresses the importance of using a broad-spectrum sunscreen with at least SPF 30.

At night he suggests washing the skin to remove makeup, dirt and oil accumulated during the day with a mild cleanser. “Follow that with a topical retinoid to help prevent clogged pores and promote cell turnover,” he says. Then a non-comedogenic moisturizer to hydrate the skin can be applied, if needed.

How Can a Dermatologist Help with Hormonal Acne?

Your provider will determine the best skincare routine and treatments to clear up your skin and assess whether over-the-counter products will work or if prescription-strength medications are needed. Chemical peels, laser and light therapy and drainage of large cysts may be recommended in certain cases. And medical acne facial treatments may be suggested as a great option for treating acne and preventing future outbreaks.

A dermatologist will also assess lifestyle issues like diet and stress with the goal of reducing inflammation. If dietary and/or lifestyle triggers are suspected, Dr. Fenton recommends the following tips to reduce hormonal acne:

  • Reduce dairy Intake, particularly fat-free dairy, which has been shown to affect both testosterone and estrogen levels.
  • Cut back on high glycemic foods, such as refined flour, sweets and processed carbohydrates, which can lead to an insulin spike that causes a hormonal cascade.
  • Manage stress as it can release a variety of hormones that can cause an inflammatory response in the body, a major cause of acne.

Get Started with an Acne Dermatologist at Schweiger Dermatology Group

If you think hormone fluctuations might be the cause of your acne, and you’re not seeing results with at-home measures, consult a dermatology provider at Schweiger Dermatology Group. Our providers can pinpoint the cause of your breakouts and help clear your complexion and prevent future outbreaks. They can also provide treatments for acne complications, such as scarring.

To make an appointment, call or text (844) DERM-DOC / (844) 337-6362 or book your appointment online.

About Schweiger Dermatology Group

Founded by Dr. Eric Schweiger in 2010, Schweiger Dermatology Group began as a single office in Midtown Manhattan with a mission to deliver high-quality dermatologic care without long waits. As demand grew, so did the practice. Today we have over 120 locations across 8 states with more than 400 of the nation's leading providers and were ranked as the number one practice nationally in cosmetic and reconstructive care by Castle Connolly. In 2023, we broadened our expertise by integrating allergy care into our services. We remain committed to offering exceptional medical, cosmetic, and surgical dermatology as well as comprehensive allergy services, ensuring patients receive expert care in a modern, state-of-the art environment.

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