Hormonal acne: why it happens and what can help

Why hormones affect your skin

Acne starts when pores become blocked with oil and dead skin cells, and bacteria then cause inflammation. The glands that make oil are sensitive to hormones. So when hormone levels shift, oil production can rise and pores block more easily.

That's why breakouts often follow your menstrual cycle, and why they can appear or change during pregnancy, perimenopause and menopause. Some medicines can trigger or worsen acne too, so tell your practitioner about anything you take. Stress and poor sleep don't cause acne on their own, but many people notice flares during difficult weeks.

What hormonal breakouts tend to look like

You can't diagnose hormonal acne in the mirror, but there are common patterns:

• Spots around the jawline, chin, neck and lower cheeks.
• Deeper, tender spots that sit under the skin and take a long time to settle.
• Flares in the week or so before a period.
• Breakouts that started or changed in adulthood, or alongside other changes in your body.

When to see your GP

Some acne needs medical treatment, and treating it early can help reduce the chance of lasting marks. Please see your GP if:

• Your spots are deep, painful or leaving scars.
• Acne has appeared suddenly, or suddenly got much worse, particularly as an adult.
• You've followed a good routine for a few months and it isn't improving.
• You also have irregular or missed periods, extra facial or body hair, hair loss, or weight gain and difficulty losing weight. These can be signs of a hormonal condition such as polyendocrine metabolic ovarian syndrome (PMOS), previously called polycystic ovary syndrome (PCOS).
• Your skin is affecting your mood or confidence.

A calm routine for hormonal skin

Hormonal skin usually does best with consistency, not intensity:

• Cleanse twice a day with a gentle cleanser, and always take make-up off before bed.
• Choose moisturiser, SPF and make-up labelled non-comedogenic, which means they're made not to block pores.
• Introduce salicylic acid, an exfoliating acid that works inside the pore, a few evenings a week.
• Don't scrub, and try not to pick or squeeze spots. Both can worsen inflammation and lead to marks and scarring.
• Change pillowcases often and wipe your phone screen regularly.
• Give a new routine around 12 weeks before you judge it, and change one thing at a time.

Clinic treatments that can help

I'd start with an Advanced In-Depth Skin Analysis or a free consultation, so your practitioner can see what's driving your breakouts and plan around your skin and routine. From there, the options include:

• The Anti-Bacterial Facial: steam, careful extractions, high frequency and an enzyme peel for congested, breakout-prone skin, often booked with a chemical peel. Inflamed spots are never squeezed. Available at Chichester, Petersfield and Bognor Regis.
• Chemical peels: salicylic acid peels are often chosen for breakouts. Our 12 Week Acne Bootcamp pairs an Anti-Bacterial Facial and peel with five further peels, one every two weeks, at Chichester, Petersfield and Bognor Regis.
• LED light therapy: blue light is used for congested skin, with no downtime, at all four of our clinics.
• Laser acne treatment: best for red, inflamed spots, usually as a course of four to eight sessions one to two weeks apart, at our Chichester clinic. It can reduce breakouts, but it isn't a cure.

Who should wait

Please tell us if you're pregnant or breastfeeding, as many acne treatments and skincare ingredients aren't suitable, and your practitioner can advise on what is. Peels and laser aren't used over broken or infected skin or a cold sore. LED isn't suitable if you have epilepsy or take medicines that make your skin sensitive to light. If you take or have recently taken prescription acne or skin medication, tell us at your consultation, because some treatments need to wait. For more on your options, see our page on acne and breakouts.