Hormonal Acne
Understanding Hormonal Acne
Hormonal acne describes acne that follows recurring patterns which may be associated with hormonal changes. It often appears around the jawline and chin, and may flare at particular times, such as before a menstrual period.
Hormonal acne is described by its pattern rather than by a single type of lesion. Other contributing factors may also need to be considered, and clinical assessment can help clarify how the condition is presenting before management options are discussed.
What is Hormonal Acne?
Hormones, particularly androgens, may influence how much oil the skin produces. When hormone levels change, or when the skin responds more strongly to them, some people may experience breakouts that follow a recurring pattern.
Unlike comedonal, inflammatory or cystic acne, which describe how lesions look, hormonal acne describes a pattern. It may involve blocked pores, inflamed spots, deeper lesions or a mix of these.
Does Hormonal Acne Mean My Hormones Are Abnormal?
Not necessarily. Many people with hormonal acne have hormone levels within the normal range, but their skin may respond more strongly to normal hormonal changes. In some cases, other features may suggest that further evaluation is appropriate.
How Hormonal Acne can present?
01
Breakouts That Follow a Cycle
Some people notice breakouts that appear or worsen at similar times each month, often in the days before a menstrual period.
02
Jawline, Chin and Neck
Hormonal acne commonly appears on the lower face, including the jawline, chin and upper neck, although it can also affect other areas.
03
Different Types of Lesions
Hormonal acne may involve blackheads and whiteheads, red or tender spots, or deeper lesions beneath the skin. The mix can change over time.
04
Acne Beyond the Teenage Years
Hormonal acne may continue beyond adolescence or begin for the first time in adulthood.
Because hormonal acne can involve any lesion type, it often overlaps with other acne presentations.
WHAT IT CAN LOOK LIKE
What can look like Hormonal Acne?
Not every breakout on the chin or jawline is hormonal. Several conditions and factors can cause similar looking bumps in the same areas.
If you are unsure what you are seeing, clinical assessment can help distinguish between these concerns.
Perioral Dermatitis
Perioral dermatitis may cause small red bumps around the mouth, chin and nose, and is sometimes mistaken for acne.
Rosacea
Rosacea may cause facial redness with acne like bumps and pustules, usually without blackheads or whiteheads.
Folliculitis From Shaving
Inflammation of the hair follicles in shaved areas, such as the beard line, may cause red bumps that resemble acne.
Friction and Product Related Breakouts
Frequent touching, resting the chin on the hand, face masks or certain products may contribute to breakouts in the lower face.
WHAT IT CONTRIBUTES
What can contribute to Hormonal Acne?
Hormonal acne is usually associated with a combination of factors rather than a single cause.
The Menstrual Cycle
Hormonal changes during the menstrual cycle may be associated with breakouts that appear or worsen before a period.
Life Stages
Puberty, pregnancy, the period after pregnancy and perimenopause involve hormonal changes that may be associated with changes in acne.
Starting or Stopping Hormonal Medication
Some people notice changes in their skin after starting, stopping or switching hormonal contraception or other hormonal medication.
Underlying Conditions
In some cases, acne may occur alongside other features such as irregular periods or excess hair growth. These may be considered during assessment, as they can be relevant to conditions such as polycystic ovary syndrome.
Clinical Insight from Dr Ramita
What do patients often assume about hormonal acne that is not quite right?
A common misconception is that hormonal acne necessarily means a person has abnormal hormone levels. In reality, acne can occur even when hormone levels are within the normal range, as the skin's oil glands may be particularly responsive to normal hormonal fluctuations. Breakouts that appear around menstruation can suggest a hormonal influence, but the timing and location of acne alone do not establish the underlying cause.
For example, acne along the jawline is often described as hormonal, although other factors may also contribute. It is helpful to consider the overall pattern of breakouts alongside symptoms such as irregular menstrual cycles or increased facial hair, which may warrant further investigation. Hormones are one part of acne development, rather than necessarily being the only explanation.
HOW IT IS ASSESSSED
How Hormonal Acne is Assessed?
01
Current Presentation
Assessment considers the types of lesions present, the areas affected, the apparent severity and whether marks or scarring have developed.
02
Pattern and History
The consultation may consider when the acne began, whether it follows a recurring pattern, menstrual history where relevant, hormonal medication, other symptoms and previous treatments.
03
Management Discussion
Following assessment, appropriate management options can be discussed according to the patient's clinical needs, including whether further evaluation may be helpful.
Common Questions about Hormonal Acne
Why does my acne flare before my period?
Hormone levels change during the menstrual cycle, and in the days before a period these changes may influence oil production and inflammation in the skin. This is why some people notice breakouts that appear or worsen at a similar time each month, often around the jawline and chin.
Can men get hormonal acne?
Yes. Hormones influence oil production in everyone, and men may also experience acne associated with hormonal changes, particularly during puberty. Recurring or persistent acne in men is assessed in the same way, by considering the presentation, pattern and other relevant factors.
Do I need a hormone test for hormonal acne?
Not always. Many people with hormonal acne do not need hormone testing. Whether further evaluation is appropriate depends on the overall clinical picture, including the acne pattern, menstrual history and any other symptoms, and is discussed during assessment.
Can hormonal acne start in adulthood?
Yes. Some people experience acne for the first time in their twenties, thirties or later, while others find that acne continues beyond their teenage years. Adult acne often appears on the lower face and may be associated with hormonal changes.
When should hormonal acne be assessed?
Assessment may be helpful if acne is recurring or persistent, if it is painful or leaving marks, if it began in adulthood, or if it occurs alongside other symptoms such as irregular periods.
Hormonal Acne Patient Guides
Learn More About Hormonal Acne Patterns
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Dr. Ramita Kaur Shahi
Dr Ramita Kaur Shahi leads acne consultations at The Acne Clinic. She assesses the skin and relevant history before discussing management options and follow up.
Clinical Assessment Can Help Clarify What You Are Seeing
Hormonal patterns, other acne presentations and conditions that resemble acne can look similar, and more than one factor may be involved at the same time. Clinical assessment can help clarify the current presentation and support a discussion about appropriate management options.