Causes and Natural Solutions for Hormonal Acne

December 12, 2018

Causes and Solutions for Hormonal Acne

Hormonal acne is an ugly, sometimes painful skin condition which many of us know far too well.

But why do these flare-ups happen? It seems that for some, the presence of adult acne even exceeds what they experienced during their teen years, so what has changed?

In this post, we will explore the answers to these questions, along with some suggestions for natural acne treatment.

By helping you overcome the condition known of as acne vulgaris caused by hormonal fluctuation, you can better avoid the scarring and possible psychological damage which the condition can cause.

What is Hormonal Acne?     

When your hormones are out of balance, many things happen, most of which are not good for your health. This includes your skin’s health, which is important considering that your skin is your body’s largest organ. (1)

However, your skin is also sensitive to excessive production of androgens, AKA your body’s male hormones, and testosterone, in particular. While both men and women produce testosterone, women don’t produce as much of it as men, which is why women typically don’t display male features such as deep voice or body hair.

Likewise, men also produce female hormones such as estrogen, though in much smaller amounts than women.

However, androgenic steroids such as testosterone increase the skin’s secretion of an oil called sebum, which is responsible, amongst other things, for cleansing pores of dead skin cells. Unfortunately, in excessive amounts it causes skin cells to become sticky and clog skin pores, which then become inflamed and infected as bacteria collects along with excess oil and skin cells.

Altogether, this combination becomes what is known of as an outbreak of cystic acne.

When is Hormonal Acne Most Likely to Occur?

Hormonal outbreaks are most commonly associated with teenagers who often experience this condition as they go through puberty. This is because extra androgens are necessary for the growth and development of male organs and traits in boys, as well as he  development of muscle and bone strength in girls.

However, women of menstrual age or who are experiencing menopause are also commonly afflicted with hormonal acne. In fact, studies document that of acne sufferers over age 20, 50% of them are women between the ages of 20-29, along with over 25% of women between the ages of 40-49. (2)

This includes monthly outbreaks due to hormone fluctuations caused by menstruation, as well as the reduction in female hormones caused by menopause which then leaves an imbalance of male hormones. Usually when this occurs, androgen levels stay the same despite a decrease in the production of female hormones, thus causing a higher ratio of androgens in the system.

Other causes of hormone imbalance can include stress, endocrine disruptors such as soy, phthalates, or other chemicals commonly found in modern plastics, paper and foods; as well as an underproducing thyroid gland, which can be caused by a diet containing too little iodine.

It should also be noted that at any age, those who abuse anabolic steroids are often afflicted with hormonal acne as a result. These can include athletes seeking a competitive advantage, as well as men looking for increased youth or sex drive.

Which Hormones Affect Acne

While androgens have the most notable and direct effect on breakouts, other hormones also play roles in the presence of adult breakouts:

  • Estrogen—Large doses of estrogen can reduce sebum production by negatively influencing the gonadal axis, which then increases the production of sex hormone-binding globulin (SHBG) in the liver. This results in reduced sebum formation due to a decrease in free serum testosterone, along with a reduction in the sebaceous gland size. However, too much estrogen can also be harmful for skin quality, since it acts as a balancer for testosterone levels.
  • Progesterone—Progesterone inhibits the production of 5α-reductase, which is an enzyme responsible for the conversion of testosterone to the more potent DHT. While progesterone does not cause increased oil production in the skin, it does block estrogen activity in the skin. Since estrogen commonly works to heal the skin, high doses of progesterone reduces the effect of estrogen so that skin becomes more susceptible to acne.
  • Corticotrophin-releasing hormone—Another hormone with a strong connection to acne is corticotrophin-releasing hormone, which regulates the cortisol production cycle. It also increases oil production by targeting the sebaceous glands and enhancing androgen production, along with stimulating the conversion of DHEA to testosterone.
  • Insulin—Insulin may be the hormone which explains the connection between a diet of high-glycemic foods and outbreaks of acne. This is because consumption of foods high on the glycemic index cause an insulin response, which then increases androgen and subsequently sebum production. This is because it inhibits SHBG production along with stimulating adrenal and ovarian production of androgens. (3)

While there are other associations with hormone imbalance and cystic outbreaks, these are some of the main hormonal causes and influencers.

Natural Acne Treatment

When it comes to relieving the occurrence of your outbreaks, there are some natural acne treatments you can use:

  • Use of bioidentical hormone therapy—Bioidentical hormones can be used in reducing cystic outbreaks, since they are identical to your body’s own natural hormones.
  • Diet—Since there is a connection between foods high on the glycemic index and hormonal acne, it only makes sense that reducing the consumption of processed sugars, white flour, and other foods high in processed simple carbohydrates can help to reduce the occurrence of outbreaks. By increasing the amount of proteins, complex carbohydrates and healthy fats in your diet, you can avoid the flood of insulin which can lead to an increase in your skin’s oil production and acne occurrences, since doing so slows your digestion. As an added bonus, increasing your consumption of natural whole foods while eliminating foods high on the glycemic index can help you more easily manage your weight, which not only helps control your acne, but helps you lead a healthier life, as well.
  • Probiotics—Probiotics—AKA good bacteria—have been shown to directly inhibit the occurrence of outbreaks through the increased production of antibacterial proteins. They also play a key role in immune health and can help reduce sebum production by calming the skin and reducing inflammation, as well as other aspects which can improve both your skin’s health, along with your overall health and well-being. (4)
  • Reducing the effects of stress—Stress is common for most of us in our modern world, although it can also be responsible for hormone imbalances that can lead to cystic outbreaks. However, there are ways to manage your stress and reduce the occurrence of stress hormones like insulin, epinephrine and cortisol. These include using meditation, nature, music or other means of relaxing, along with exercise, which has other added benefits to relieving hormonal acne breakouts. By doing your best to stay positive, reducing your daily screen time, meditating, practicing yoga or other stress-reducing exercises, you can better control your body’s fight or flight hormone response to stress, along with the increased production of skin oils it causes. (5)
  • Exercise—Among the many benefits of regular daily exercise is its use as a natural acne treatment. This is because exercise works to decrease stress, increase circulation, balance hormones and flush away free radicals, bacteria and other impurities from pores and skin cells. However, the importance of showering directly after exercise and not lingering in sweaty workout clothes is also essential in acne treatment, since doing so can increase the instance of bacteria and oils trapped in skin pores. Likewise, it is recommended that overly tight workout clothes, or any clothing which causes chafing is avoided, as both can also contribute to poor skin health. (76)


Outbreaks of hormonal acne are never fun, although there are measures you can take to improve your skin’s health while reducing their occurrence.

By maintaining a healthy diet which includes probiotics, de-stressing, getting regular exercise, and restoring your hormones with bioidentical hormone therapy, you can better enjoy healthy, glowing acne-free skin.

And, while you’re at it, many of the above natural acne treatments can also improve your heart health, immune health, BMI management and many other aspects of your health and well-being.

So, what are you waiting for? Getting rid of your outbreaks will leave a healthier, more confident you, which is something you can’t put a price on.

Be well!




Written By: Steven F. Hotze, M.D.

Steven F. Hotze, M.D., is the founder and CEO of the Hotze Health & Wellness Center, Hotze Vitamins and Physicians Preference Pharmacy International, LLC.


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