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We often think that acne will go away for good in our teen years but, unfortunately, many of us suffer from different forms of adult acne. Hormonal acne is a common form of adult acne that can occur in both men and women. However, Hormonal acne is most commonly found in women between the ages of 20-40, who see unpleasant pimples along the jawline and lower face in a cyclical breakout pattern. These hormonal breakouts can be incited by a variety of changes, such as a change of birth control, but they can often appear as if out of the blue after years of clear skin. Though hormones play a role in most forms of adult acne, the direct relationship between hormones and acne is still not entirely understood, but tends to be stimulated when our bodies produce more androgens. Androgens are a type of hormone regularly linked to male traits and reproductive activity (such as testosterone), and have also been connected to hair growth.

Hormonal acne can also occur when women experience menopause, due to additional fluctuations and hormone shifts that are triggered by a decrease in estrogen and progesterone being produced in the body, as well as an increase in more tradtitionally male hormones (particularly androgens). Hormonal acne, whether due to hormonal fluctuations caused by a change in birth control, menstruation, pregnancy, menopause, or an imbalance in hormone levels, can lead to severe acne. Hormonal acne can not only be painful to the touch, but also make a person feel self-conscious. While this type of acne flare-up is frustrating for many, it can be successfully treated with a variety of treatment options, including birth control pills, spironolactone, severe acne medication, chemical peels, topical treatments, and hydrafacials, among others.

If you’re frustrated by unexpected breakouts, board-certified dermatologist Dr. Michele Green is here to help. Dr. Green has over 25 years experience in cosmetic dermatology, including acne treatment and skincare. Dr. Green will help to both diagnose and treat your acne, whether it be genetic, situational, or hormonal acne. In the world of dermatology, Dr. Green is an internationally respected voice, as well as a favorite skincare advisor amongst beauty editors, both in the New York City and abroad. She has even developed her own skincare line, MGSKINLABS, in order to treat a variety of different skin conditions, from acne-fighting to anti-aging. Dr. Green has a thorough understanding of all forms of teenage and adult acne, and helps to curate acne treatment plans that will help you to both look and feel like your best self.

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Before and After photo: 25-34 year old woman treated with acne scar treatment

Why Hormonal Acne Occurs

Hormonal Acne is just like it sounds: acne that is incited by hormonal shifts. We typically associate hormonal acne with the experience of puberty in one’s teen years, but hormonal acne breakouts can develop at any age. Hormonal acne occurs in adults who are dealing with clogged hair follicles, excess oil production, unwanted bacteria, and fluctuating hormonal changes. Hormonal acne is more commonly experienced by women than by men due to a number of factors, including that of menstrual cycles, pregnancy, menopause, increased androgen levels, or polycystic ovary syndrome (PCOS).

During menopause, many women experience hormonal acne due to a shift in hormone levels. Menopause is typically marked by a decrease in estrogen and an increase in androgen hormones like testosterone, which can lead to more blemishes. Additionally, hormone replacement therapies to ease menopause symptoms often use progestin to replace lost estrogen and progesterone levels in the body, which can lead to additional acne flare-ups.

Do I Have Hormonal Acne Breakouts?

Hormonal acne breakouts can be identified through a few key characteristics. If you are experiencing acne breakouts and you are no longer in your teen years, you may be experiencing hormonal adult acne. Additionally, f you experience fluctuations in acne breakouts in a cyclical pattern, you may well be dealing with hormonal acne. Oftentimes, patients with hormonal acne will experience breakouts more intensely once a month. An increase in stress can also have a huge impact on hormonal acne breakouts. Hormonal acne blemishes appear most commonly in the t-zone during puberty, but typically appear on along the jawline and lower face in cases of adult hormonal acne.

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Vbeam, 2 months before and after

How Can You Tell Apart Hormonal Acne From Regular Pimples?

Hormonal acne tends to develop differently form ordinary zits. Although hormonal acne can appear as a blackhead, which is caused by clogged hair follicles, or as a whitehead that’s caused by dead skin cells and excess sebum production (oil), hormonal acne often appears as a painful cyst. Cystic acne is a variety of severe acne that form deep under the skin’s surface, and cannot be extracted by ordinary means. Cysts caused by hormonal shifts also can reappear in the same location over and over.

Is Hormonal Acne the Same As Adult Acne?

Hormonal acne is a variety of adult acne, but adult acne can be caused by a variety of issues, including naturally oily skin, clogged hair follicles, poor diet, stress, the development of bacteria on the skin, or irritants such as make-up or fabric. A common example of non-hormonal acne is mask acne or “maskne”, which has become a huge problem for many individuals during the Covid-19 pandemic. Learn more about how to treat maskne.

Is Cystic Acne a Part of Hormonal Acne?

Cystic acne is a common part of hormonal acne, presenting as painful cysts that are swollen, irritated, and tender to the touch. Initially, cystic acne will start when bacteria, oil, and dead skin cells clog the pore, but will become swollen as the bacteria increases and gets trapped under the skin. It tends to occur in patients with overactive oil glands, and is often a frustrating aspect of hormonal acne. Learn more about different kinds of adult acne.

Will Hormonal Acne Ever Go Away?

Many patients search for different methods to treat hormonal acne. Though a regiment of proper facial hygiene and over-the-counter products can be useful, most patients turn to Dr. Green to help with the reduction and prevention of hormonal acne. In general, patients experience fluctuations between clear skin and hormonal acne flare-ups, a cycle that can unfortunately last for years. In order to quell these unwelcome zits and acne breakouts, targeted skin care products, spot treatments, cosmetic procedures, and oral medications can make a huge difference.

When Will Hormonal Acne Stop?

A pimple caused by a hormonal acne flare-up will usually last about a week before it resolves, but for some, hormonal acne can lead to frequent breakouts on the skin. Hormonal acne is typically cyclical, though it can be exacerbated by certain life events such as pregnancy and menopause. Sometimes, hormonal acne will fade on its own, but for many, prescribed treatment of acne is essential to restore clear skin.

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Accutane before and after – 6 months

Is Hormonal Acne Curable?

Though hormonal acne is a common form of acne breakout among adults, the cause of hormone acne varies from patient-to-patient. At this point, the world of dermatology has not developed a finite cure for hormonal acne. However, hormonal acne is entirely treatable and, through an active skincare and treatment plan with Dr. Green, hormonal acne can become a thing of the past. Oral medications such as birth control pills or Spironolactone, can keep hormonal acne under control.

How a Dermatologist Can Help

Dr. Michele Green is an expert dermatologist that specializes in skincare for those who suffer with hormonal acne and other skin imperfections. When you work with Dr. Green, will take a comprehensive medical history and blood work to evaluate the cause of your acne breakouts. She will be able to assess the cause of your acne and determine if you’re suffering from hormonal acne. Based on her complete evaluation, she will discuss the best skincare routine and treatment options available to you.

What To Do If You Have Hormonal Acne

The best thing to do if you think you may have hormonal acne is to meet with Dr. Green to have the cause of your acne diagnosed. In some cases, what may look like hormonal acne may indicate a more severe issue, such as severe hormonal imbalance or a thyroid condition. If you are suffering from hormonal acne, Dr. Green will be able to curate a treatment plan that can help you to treat breakouts, lessening the risk of acne scars and helping you to restore your healthy, clear complexion. Dr. Green can prescribe specific spot treatments, skincare routines, cosmetic treatments (such as chemical peels) and/or oral medications that can all work to eliminate the appearance of hormonal acne.

Can Topical Treatments Help Hormonal Acne?

Topical treatments are a common way to reduce the appearance of hormonal acne. Typically, Dr. Green will recommend topical retinoids as a first step for acne treatment, particularly to reduce the effects of unwanted dead skin cells clogging a patient’s pores. Topical retinoids can help to prevent new acne breakouts with continued treatment, and have very limited side effects from long-term use. A popular topical retinoid like product, that is available over-the-counter, is Differin Gel (adapalene gel), though Dr. Green can prescribe stronger concentrations of retinoid creams or oral treatments for those patients who are experiencing more severe acne.

For those who have sensitive skin or who suffer from rosacea, topical retinoids may not be the best solution, as retinoid creams and gels can cause dryness, redness, and flaking skin when they are first introduced. Dr. Green may recommend your topical retinoid be applied only a few times a week at first in order to prevent irritation or other mild side effects. In these cases, other topical treatments such as salicylic acid, Cleocin T lotion, or Metrogel (metronidazole) may be more effective. Topical retinoids are contraindicated for those patients who are pregnant.

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Helpful Skincare Treatments for Hormonal Acne

A tailored skincare routine can make a vast difference when it comes to the treatment of hormonal acne. In particular, cleansers and targeted face washes can help to prevent hormonal acne from forming on the surface of the skin. Here are some key ingredients in skincare products that can help treat hormonal acne with consistent use.

Salicylic Acid Face Wash

Salicylic acid is designed to exfoliate the skin, reducing the amount of lingering dead skin cells on the epidermis. Salicylic acid can not only dissolve dead skin cells but also remove bacteria from the skin, helping to improve the overall health of the skin. It’s ideal for acne-prone or oily skin as it’s able to penetrate deep into pores, and it has an anti-inflammatory effect that can often reduce redness on the skin.

Glycolic Acid Face Wash

Glycolic acid is another excellent exfoliant when incorporated into a skincare routine. Glycolic acid can help to reveal brighter layers of skin underneath lingering dead skin cells along the surface, and it can help to make the skin feel firmer. Glycolic acid not only helps to reduce clogged pores and zits, but also can reduce the appearance of fine lines and wrinkles. Glycolic acid and Salicylic acid are both favored by Dr. Green in her MGSKINLABS acne treatment, and glycolic acid can also be used as an active ingredient in chemical peels to reduce the appearance of acne and inflammation on the skin.

Benzoyl Peroxide Cleanser

Benzoyl Peroxide is an excellent ingredient used in face washes and spot treatments alike to reduce the amount of bacteria living on the surface of the skin. It can clear away pimples through the elimination of bacteria, as well as clearing out pores and reducing excess sebum. Benzoyl Peroxide essentially dries out acne zits, and helps to prevent further blemishes from developing.

Probiotic Cleanser

A topical probiotic treatment or cleanser can be an excellent way to keep the skin’s microbiome in check. Probiotics help to stabilize the pH balance of the skin, which can then allow prescription-strength acne treatments to better penetrate the skin’s pores and heal an acne breakout. According to the National Institutes of Health, topical probiotics can help to reduce inflammation, improve the skin’s natural protective measures, and inhibit acne-causing bacteria.

Retinol cream

Retinols can be an excellent mild solution to treating adult acne breakouts. Retinol is the key ingredient in topical retinoids, and is a vitamin-A derivative that can help to stimulate cell turnover and in turn create firm, healthy skin. A good retinol serum can help to not only help to treat acne, but also reduce the appearance of wrinkles and fine lines on the surface of the skin.

MGSKINLAB’s at-home Acne Treatment

Dr. Green’s innovative skincare products have become an essential part of her patients’ skincare routines. Her three step at-home acne treatment includes a cleanser, exfoliant, and spot treatment to eliminate acne. Step one is a pore-minimizing cleanser, designed to clear out acne spots and blemishes. Step two is retexturing pads, which are filled with glycolic acid and salicylic acid to reduce dead skin cells and boost cell turnover. Step three is an acne spot treatment that uses benzoyl peroxide to eliminate unwanted acne on the surface of the skin.

MGSKINLAB’s Ultimately Sheer Hydrating Lotion

As many of Dr. Green’s patients suffer from acne, she has developed a lightweight moisturizer custom designed for acne-prone and sensitive skin. It uses a combination of aloe and rosewater to best hydrate the skin without causing any excess sebum production or inflammation. It’s a unique formulation that many of Dr. Green’s patients swear by as a part of their daily routine.

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Before and after – 8 months after hormonal acne treatment

What Oral Medications can help with Hormonal Acne?

There are a variety of oral medications that can work to reduce and prevent hormonal acne. These oral medications vary in terms of composition, but all excel in controlling acne breakouts and preventing further hormonal acne from developing.

Birth Control Pills

One of the most common approaches for women is the use of birth control. Oral contraceptives are often used to put a lid on hormonal acne breakouts, and select brands-including Ortho Tri-Cyclen and YAZ-are FDA approved to treat hormonal acne. Oral contraceptives are unique in treating hormonal acne as their composition alters hormone levels that would otherwise trigger an acne breakout. If you’re not already taking birth control pills, Dr. Green may recommend it as a method to treat hormonal acne.

Anti-Androgen Medications

Anti-androgen oral therapy is helpful in reducing the amount of androgens (or commonly male hormones) that can lead to hormonal acne. Anti-androgen medication is able to block androgen receptors in the body, which in turn can limit the effects of androgen hormones like testosterone. A common anti-androgen that can help is Spironolactone, which is typically used to control blood pressure, but can also help lower androgens, specifically testosterone, reduce oil production and dead skin cell build-up that often clogs pores.

Isotretinoin

Isotretinoin, commonly referred to as the popular brand name Accutane, is a variety of oral medication that relies on Vitamin A to limit the amount of oil production in the skin, thereby allowing for greater cell turnover. It’s commonly used to treat severe acne, after patients have attempted other acne treatments or antibiotics  without success. Though it can have potential side effects, it is an important treatment option for those who have not found relief from topical treatments, cosmetic procedures, or other oral medications. Isotretinoin is contraindicated for those who are pregnant or are actively trying to conceive, as it can increase risk for birth defects. However, it does not affect a patient’s child-bearing ability down the line.

Does Laser Treatment Help Hormonal Acne?

According to the American Academy of Dermatology, laser treatments are a promising innovation in the world of acne treatments, and can be an effective part of an acne treatment plan. Dr. Green often utilizes the V-Beam laser as a part of acne treatment in order to reduce acne, as well as to treat redness and irritation caused by acne. V-Beam laser treatment is also an excellent option for those who suffer from rosacea or broken blood vessels. After a standard five-session V-Beam treatment for acne, acne lesions are typically reduced by 85%, and non-inflammatory acne lesions are generally reduced by 70%.  It’s a gentle laser that can even be used on patients with sensitive skin, and it can even help to reduce acne scars.

Another helpful light treatment is that of Blue and Red Light Therapy, which can kill acne-causing bacteria and shrink the glads that are responsible for oil production. Additionally, Blu-U Photodynamic Therapy can similarly be used to kill bacteria on the surface of the skin, as well as reduce inflammation caused by an acne flare-up.

If you suffer from acne scars, the Fraxel, eMatrix, and V-Beam lasers can all help to permanently remove acne scars and reveal healthy, glowing skin. The Fraxel laser resurfacing treatment is a non-ablative tool that reduces the appearance of acne scars over a series of 5-6 sessions. The Fraxel laser is unique in its innovative fractional resurfacing technology, which helps to pinpoint the laser’s light to a specific portion of the skin. In this way, it’s able to preserve healthy skin while reducing the appearance of acne scars or discoloration, which helps to expedite the healing process post-treatment. The entire procedure takes around 15 minutes and can be used to treat a variety of atrophic scars.

The eMatrix laser is a radiofrequency laser that is able to treat acne scars on a wide variety of skin types and skin tones. Its radiofrequency technology helps to boost collagen and elastin production in the skin, which in turn creates healthy skin cells and a smoother, firmer appearance. Each of these laser treatments can be provided in Dr. Green’s New York office and require little to no downtime.

What Other Cosmetic Procedures Help Treat Hormonal Acne?

Dr. Green offers a range of acne-fighting cosmetic treatments, including laser treatments, facials, and chemical peels. One of the most popular acne-fighting treatments in our office is that of the Hydrafacial. The Hydrafacial uses a three-step process of cleansing, exfoliating, and infusion of intensive serums in order to fully clear out clogged pores while simultaneously reducing redness and preventing further outbreaks. When it comes to active acne breakouts, the Hydrafacial can be combined with blue light therapy to wonderful effect.

Another popular non-invasive cosmetic procedure is that of an acne-fighting chemical peel, which uses glycolic or trichloroacetic acids to deeply exfoliate the skin. This removes dead skin cells from the surface of the skin and helps to reveal a healthy layer of skin. It also encourages the generation of new skin cells which can help to rejuvenate the skin, in turn reducing the appearance of scars, fine lines, and sun damage. With a chemical peel, Dr. Green is able to customize the formulation, thus creating a chemical peel tailored to meet your needs.

Additionally, many patients find that Microneedling with Platelet-Rich Plasma (PRP) can help to revitalize skin and reduce the likelihood that further acne breakouts will occur.  It uses the blood’s own growth factor’s to decrease pore size, as well as to improve the even tone and texture along the surface of the skin. Learn more about PRP Microneedling.

What is the Best Hormonal Acne Treatment?

The best hormonal acne treatment is one that factors in your medical history, skin condition, and lifestyle in order to restore your healthy complexion. When you work with Dr. Green in her private boutique NYC dermatology office, she will discuss all the best treatment options available, and provide expert advice as to which acne treatment plan is best for your needs. Dr. Green is a trusted source for acne treatment and innovative skincare, and will create a custom treatment plan that combines the best treatments that dermatology has to offer.

If you’re frustrated by the appearance of hormonal acne, there are solutions that can help. Dr. Green has been at the forefront of cosmetic dermatology and skincare for over two decades, and strives to help her patients look and feel like the best version of themselves. Contact the office today to create your own custom hormonal acne treatment plan with Dr. Green.

Dr. Michele Green is a board-certified dermatologist based in New York City and an expert in a wide variety of cosmetic treatments including the treatment of hormonal acne. Find out more and contact us online or at 212 535 3088 to arrange an appointment.

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