Top 10 Signs Your Acne Might be Hormonal According to Dermatologists

If you’re tired of breakouts that seem to come and go without any real reason, you might be dealing with hormonal acne. This type of acne is a common, yet often misunderstood skin issue that’s particularly stubborn and usually requires more than just your average skincare routine or over-the-counter products to get under control. To help you better understand what’s going on with your skin, we’ve gathered insights from dermatologists about the top signs your acne could be hormonal—and what you can do about it.

What is Hormonal Acne?

Hormonal acne happens when fluctuations in your hormones cause your pores to get clogged and your skin to become inflamed. Androgens, like testosterone, are usually the main culprits—they can boost oil production, and more oil means more chances for pimples, cysts, and blackheads to appear. While most people think of acne as a teenage problem, hormonal acne can affect both teens and adults, especially during times of hormonal changes like puberty, your period, pregnancy or menopause.

Unlike typical acne caused primarily by bacteria or external irritants, hormonal acne is caused by factors inside your body, which can make it a bit trickier to manage. For many women, hormonal acne tends to get worse in the days leading up to their period when estrogen levels drop and androgens increase. This hormonal imbalance triggers the skin’s oil glands to go into overdrive, which is why breakouts often seem to follow a cycle.

Cleansing and exfoliating can help, but for hormonal acne, they’re often not enough to keep breakouts under control long term.

How Do I Know if My Acne is Caused by Hormones, or Something Else?

Telling hormonal acne apart from other types can be challenging, but there are a few clues dermatologists often look for. One of the biggest hints is timing. If your breakouts flare up around your period—usually about a week to 10 days before it starts and then calm down afterward—that’s a strong indicator that hormones could be involved, since acne caused by bacteria or external factors tends to be more random.

Location is another clue. Hormonal acne often shows up in areas rich in hormone-sensitive oil glands, like the lower face and neck. Persistent breakouts in these spots can point toward hormonal causes, because acne from clogged pores or bacteria usually appears more randomly across the face.

The appearance of the pimples matters too. Hormonal acne tends to be deeper, with cysts or nodules developing under the skin, which are sometimes painful. These breakouts can also hang around longer than the surface-level whiteheads or blackheads you might see with other types of acne.

Adult acne is another red flag. If you’re noticing breakouts for the first time in your 20s, 30s, or later, hormones are often a bigger factor compared to teen acne, which usually has a different pattern.

Remember, hormonal acne also doesn’t always respond to over-the-counter treatments, so if you’ve tried multiple products and your breakouts keep coming back, you may be experiencing hormonal acne.

Finally, pay attention to other symptoms, like irregular periods, excessive hair growth, or changes in weight, which can all signal a hormonal imbalance that’s contributing to your acne.

Where Does Hormonal Acne Usually Show Up?

If you’re wondering whether your breakouts are hormone-driven, where they appear can give you a big clue. Hormonal acne usually pops up in areas packed with hormone-sensitive oil glands—think lower cheeks, jawline, chin, and neck. These spots tend to flare during hormonal shifts because androgens rev up your oil glands, leading to clogged pores and stubborn pimples.

Sometimes, you might notice a breakout along your hairline, or even on your chest or upper back, but most of the time, it’s the face that’s the main troublemaker.

On the other hand, acne from bacteria or external factors behaves differently. It shows up more randomly on the forehead, nose or in scattered spots across the cheeks, and usually clears up a bit more easily with regular cleansers and topical treatments.

What Triggers Hormonal Acne to Flare?

Hormonal acne isn’t usually constant— it tends to come and go. One of the biggest triggers is your menstrual cycle, and many people notice breakouts about a week to 10 days before their period, when hormone levels naturally shift. Changes in hormonal birth control can also trigger acne, as starting or stopping these medications temporarily alters your hormone balance until your body adjusts. For some people, an underlying condition like polycystic ovary syndrome (PCOS) can also cause ongoing hormonal imbalances that lead to persistent acne.

Even stress can play a role, since higher cortisol levels can influence androgen hormones and increase oil production, which may lead to those stubborn pimples. Diet may also be a factor, since some people notice that eating lots of sugary snacks or certain dairy products seems to make breakouts worse, though everyone’s skin responds a little differently.

The good news? Paying attention to your triggers can make a big difference. Once you know what causes your acne, you can start to take steps to prevent flare-ups and manage them more effectively.

Can A Good Skincare Routine Alone Treat Hormonal Acne?

While a consistent skincare routine is essential, when it comes to hormonal acne, it usually isn’t enough on its own. That’s because these breakouts are driven by internal changes, so even though cleansers, exfoliants, and spot treatments can help soothe the skin and reduce surface-level symptoms, they don’t address the underlying hormone fluctuations that are causing the acne.

Dermatologists usually suggest looking at hormonal acne from several angles rather than relying on skincare alone. This often means using treatments that help unclog pores and calm inflammation, such as topical retinoids, along with acne medications that target bacteria and reduce irritation. For many people, addressing the hormone side of things is an important part of the plan, which can include options like oral contraceptives or medications such as spironolactone to help reduce oil production. Beyond medications, simple lifestyle changes like managing stress, getting enough sleep and paying attention to diet can also play a key role in keeping hormones balanced and supporting overall skin health.

Most people find that combining these strategies gives the best results, especially if their hormonal acne is moderate to severe. Think of it as tackling the problem from multiple angles, rather than relying on skincare alone, so that you can see clearer, longer-lasting results.

When Should I See a Dermatologist for Hormonal Acne?

If your breakouts are deep, painful, and tend to leave scars, or if acne just won’t clear up no matter how many over-the-counter treatments you try, that’s usually a good sign you’re dealing with hormonal acne, and it’s time to see a dermatologist. It’s also worth seeking help if your acne started in adulthood or has suddenly gotten worse. You might notice that your breakouts follow a pattern, flaring up around the same time in your menstrual cycle, or you may suspect an underlying hormonal condition like polycystic ovary syndrome (PCOS). In these cases, a dermatologist can make a big difference by creating a treatment plan tailored to your hormones and your skin type, which often makes managing hormonal acne much more effective and helps improve long-term results.

Discover Treatments for Hormonal Acne at Schweiger Dermatology Group

While hormonal acne can sometimes feel frustrating and overwhelming, you don’t have to manage it on your own. At Schweiger Dermatology Group, our dermatologists specialize in understanding how hormones affect acne. They can help determine whether your breakouts are hormone-driven or caused by other factors, and will develop a treatment plan tailored specifically to you.

Booking an appointment is the first step toward getting the support you need toward hormonal acne treatment. During your consultation, you’ll receive care that addresses both the visible symptoms and the underlying hormonal causes to help you improve your skin and start your journey toward clearer, healthier skin. To schedule an appointment, book online or call 844-DERM-DOC.