Advertisement

Understanding Hormonal Acne

How changes in hormone levels contribute to acne outbreaks in adolescents and adults.

Acne caused by changes in hormone levels affects people of all ages, including many adults.

Acne is often associated with adolescence and for good reason—roughly 85 percent of people experience some degree of acne between the ages of 12 and 24. One reason acne is so common among this age group is the increasing levels of hormones that occurs during adolescence.

However, acne is not limited to adolescents. Acne caused by changes in hormone levels affects people of all ages, including many adults. Here, we look at how changes in hormone levels contribute to acne and the role that hormones play in the treatment of acne.

How hormones contribute to acne

Acne is a skin condition that causes pimples. To understand how hormones cause acne, it helps to understand the basics of how pimples form.

  • Pimples begin when hair follicles become clogged with clumps of dead skin cells and a substance called sebum.
  • Sebum is a waxy, oily substance that helps the skin hold onto moisture and also helps protect the skin. Sebum is produced by glands in the skin called sebaceous glands.
  • When more sebum is present in the skin, it can lead to an overgrowth of acne-causing bacteria. These bacteria can get trapped inside clogged hair follicles, which causes the clogged follicles to become inflamed.

During puberty, the body begins to produce more androgen hormones, particularly testosterone. Androgen hormones drive growth and sexual maturation, and act on many different parts of the body, including the skin. Increased levels of androgens cause the sebaceous glands to grow larger and increase sebum production—creating a better environment for pimples to form.

Changes in hormone levels can cause acne in adults as well. Examples include the hormonal fluctuations that occur during a menstrual cycle, during pregnancy, and during menopause—all are associated with acne breakouts.

Hormonal therapy for acne

Some acne treatments work by acting on hormone levels. Hormonal contraceptives (such as birth control pills) are a well-known example, and certain types of hormonal birth control can be used to treat acne. Not all hormonal contraceptives help clear up acne—some can make acne worse for some people.

A drug called spironolactone is another hormonal therapy option for acne. Because this drug lowers testosterone levels, it is typically only prescribed as an acne treatment in adult females.

Topical hormonal therapy

There is also a topical medication that contains a drug called clascoterone. This drug is an androgen receptor inhibitor, which works by reducing hormone activity in hair follicles. This appears to reduce sebum production and inflammation, which in turn helps reduce acne-causing bacteria and pimples. Topical medication containing clascoterone cannot be used by a person who is pregnant.

If you have acne—and especially if you have severe acne—talk to a healthcare provider. There are many treatment options available, which can help clear up the skin, prevent future breakouts, and prevent scarring and damage to the skin.

Always ask about potential side effects when starting any medication and tell your healthcare provider about all medications you are taking.

Article sources open article sources

American Academy of Dermatology Association. Skin Conditions by the Numbers.
American Academy of Dermatology Association. Acne: Who Gets and Causes.
Usma Iftikhar and Nakhshab Choudhry. Serum levels of androgens in acne & their role in acne severity. Pakistan Journal of Medical Sciences, 2019. Vol. 35, No. 1.
Cleveland Clinic. Hormonal Acne.
UpToDate. Patient education: Acne (Beyond the Basics).
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Acne.
Cleveland Clinic. Androgens.
American Academy of Dermatology Association. Adult Acne.
American Academy of Dermatology Association. Stubborn Acne? Hormonal Therapy May Help.
John S. Barbieri, Nandita Mitra, et al. Influence of Contraception Class on Incidence and Severity of Acne Vulgaris. Obstetrics & Gynecology, 2021. Vol. 135, No. 6.
Mary Scoviak. Clascoterone Cream First Topical to Target Androgen Receptors. Dermatology Times. December 28, 2021.
Adelaide Hebert, Diane Thiboutot, et al. Efficacy and Safety of Topical Clascoterone Cream, 1%, for Treatment in Patients With Facial Acne. JAMA Dermatology, 2020. Vol. 156, No. 8.
Julie Kalabalik-Hoganson, Kathleen M. Frey, et al. Clascoterone: A Novel Topical Androgen Receptor Inhibitor for the Treatment of Acne. Annals of Pharmacotherapy, 2021. Vol. 55, No. 10.
Saikrishna Patibandl, Joseph Heaton, and Htoo Kyaw. Spironolactone. StatPearls. July 4, 2022.

Featured Content

article

5 Ways to Avoid Adult Acne

Five ways to keep your skin from breaking out.
article

How Acne Can Affect Your Mental Health

Having acne as an adolescent or adult can have a long-lasting impact on mental health, self-esteem, and quality of life.
article

A Quick Guide to Different Acne Medications

Learn how topical medications and oral medications work to treat acne.
article

Understanding Types of Acne and Acne Severity

Why different types of pimples are important when determining the severity of acne.
article

How Acne Affects Darker Skin Tones

For people with darker skin tones, treating acne often comes with additional considerations and challenges.