Acne and Hormones, Explained
Hormones can play a major role in acne—especially acne that appears or worsens around puberty, menstrual cycles, pregnancy, or changes in hormonal medication.
How hormones cause acne
The main hormones involved are androgens (such as testosterone). They can:
- Increase oil production — sebaceous glands make more sebum.
- Promote clogged pores — excess oil mixes with dead skin cells.
- Encourage inflammation — clogged follicles can become inflamed and develop pimples.
- Affect skin-cell turnover — making it easier for pores to become blocked.
You don’t necessarily have “too much” testosterone. Some people simply have sebaceous glands that are more sensitive to normal androgen levels.
Signs acne may be hormone-related
Hormonal influence is more likely when acne:
- Concentrates around the chin, jawline, and lower face
- Flares predictably before or during a menstrual period
- Begins or significantly worsens in adulthood
- Comes with very oily skin
- Flares after starting or stopping certain hormonal medications
However, location alone cannot prove that acne is hormonal.
Hormones and periods
Before menstruation, shifts in estrogen and progesterone—and the relative effect of androgens—can increase oil production and inflammation. That’s why some people notice a recurring breakout in the week or two before their period.
What about PCOS?
Acne can occur with polycystic ovary syndrome (PCOS) because PCOS can involve increased androgen activity. Acne by itself, though, doesn’t mean you have PCOS.
PCOS becomes more worth discussing with a clinician when acne occurs alongside things such as irregular or absent periods, increased facial/body hair, or other signs of androgen excess.
Can hormonal acne be treated?
Yes. Depending on the person, treatment can include topical retinoids, benzoyl peroxide, other topical medications, or—when appropriate—hormonal treatments such as certain combined oral contraceptives or spironolactone. Treatment should be individualized, particularly if pregnancy is possible.
Bottom line: Hormones don’t cause every case of acne, but they strongly influence how much oil your skin produces and how prone your pores are to inflammation and blockage.
