Why do adult women develop hormonal acne?
Hormonal acne has a specific cause: an imbalance between androgens, estrogens, and progesterone. When androgens dominate, they stimulate the sebaceous glands in the face. The result is an overproduction of sebum that clogs pores, promotes the growth of the bacterium Cutibacterium acnes, and triggers inflammation.
In adult women, this type of acne differs from teenage acne. The lesions are concentrated on the lower part of the face: the chin, jawline, and sometimes the neck. This is referred to as a “U-shaped” distribution. The pimples are often deep, inflamed, and painful. They recur cyclically, which is a strong indication of their hormonal origin.
There are many causes of these hormonal fluctuations:
- The menstrual cycle: 60 to 70% of women experience a flare-up of acne 7 to 10 days before their period, when progesterone levels rise and estrogen levels fall.
- Menopause and perimenopause: The drop in estrogen levels allows residual androgens to take over, causing lesions to develop in women who had never had them before.
- Polycystic ovary syndrome (PCOS): This condition leads to excessive androgen production and is one of the common causes of persistent acne.
- Stopping or changing birth control: Some pills containing androgenic progestins can worsen acne, as can stopping an anti-androgen pill.
Genetic predisposition also plays a role: it is found in about 50% of cases.
Stress, diet, and lifestyle: underestimated contributing factors
Chronic stress is a major trigger for hormonal acne. Cortisol, the stress hormone, directly stimulates the sebaceous glands and exacerbates skin inflammation. City life, the juggling of work and family responsibilities, and lack of sleep are all factors that fuel this vicious cycle.
Diet also plays a role. Clinical studies have highlighted the impact of high-glycemic-index foods on acne flare-ups. Refined sugars, dairy products, and ultra-processed foods promote inflammation and can worsen hormonal acne. Conversely, a diet rich in omega-3s, zinc, and antioxidants helps regulate sebum production.
A few simple habits can also make a difference: avoid touching your face, clean your phone regularly (that screen pressed against your cheek…), and steer clear of comedogenic cosmetics that clog your pores.
How to tell if your acne is hormonal
There are several signs that should raise a red flag. Hormonal acne in adult women can be recognized by:
- A characteristic location: the chin, jaw, neck, and sometimes the cheeks.
- Episodes that occur in cycles, often in sync with the menstrual cycle or periods of intense stress.
- Deep inflammatory lesions: papules, pustules, and microcysts rather than simple blackheads.
- Resistance to conventional treatments that had been effective during adolescence.
Only a doctor or dermatologist can make a definitive diagnosis. A physical examination, medical history, and possibly hormone testing can confirm the hormonal cause and rule out other conditions, such as rosacea, fungal acne, or acne caused by medication. Blood tests are not routinely performed, except when PCOS or hyperandrogenism is suspected.
Medical treatments for hormonal acne
The dermatologist tailors the treatment based on the patient’s age, the severity of the lesions, medical history, and any plans for pregnancy. It takes at least 3 months to assess the effectiveness of a treatment.
Topical treatments are the first-line of treatment: benzoyl peroxide, topical retinoids (adapalene, tretinoin), sometimes combined with a topical antibiotic. These topical treatments are covered by Medicare when prescribed by a doctor.
For moderate to severe acne, a doctor may prescribe oral antibiotics from the cycline class, with treatment limited to three months to prevent bacterial resistance. Isotretinoin (formerly Roaccutane) is reserved for severe cases, with strict monitoring required by the ANSM and mandatory contraception.
Hormone therapy is a key treatment option. A birth control pill with antiandrogenic properties can regulate the hormones responsible for acne. Spironolactone, a diuretic with antiandrogenic effects, has proven particularly effective for lesions in the jawline area, although its use for this indication is not yet approved.
Natural approaches: omega-7, zinc, and sebum regulation with sea buckthorn
For women looking for natural alternatives to the birth control pill or spironolactone, there are several options worth considering. Among them, sea buckthorn stands out.
Omega-7 (palmitoleic acid) has been shown to have anti-inflammatory and sebum-regulating properties. Palmitoleic acid is one of the natural components of human sebum: it is therefore fully recognized and integrated by the skin. Only four fruits in the world contain significant amounts of omega-7, and sea buckthorn berries offer a concentration at least 20 times higher than other sources.
That’s where La Rayonnante from Maison de l’Argousier comes in—a nutricosmetic made with organic sea buckthorn berry oil, enriched with coenzyme Q10, lutein, and vitamin E. Just 4 ingredients, 100% natural. Naturopath Myriam Lepetit-Brière confirms: “In naturopathy, we know that about 75% of skin quality is determined internally: at the level of cell membranes, inflammatory balance, and hormonal balance.” Acting from the inside out—that’s the principle.
Zinc is another well-known ally. Its anti-inflammatory, antibacterial, and healing properties make it a supplement frequently recommended by dermatologists for adult women with acne.
Other options being explored include chaste tree (Vitex), DIM (diindolylmethane), and inositol, particularly for PCOS. However, these approaches require medical supervision to adjust dosages.
Skincare routine for acne-prone skin
When hormonal acne appears on the face, it’s tempting to scrub the skin. That’s a classic mistake. Adult acne-prone skin needs gentle care, sebum regulation, and hydration.
Here are the steps for an effective routine:
- Gentle cleansing: a mild, soap-free cleanser for morning and night.
- Purify and soothe: Maison de l’Argousier’s Secret d’Éclat is formulated with native sea buckthorn berry water, rich in malic acid and vitamin C. This acid cleanses pores, helps eliminate bacteria, and reduces inflammation. Clinical tests on 22 volunteers over 21 days: 100% of participants reported smoother, soothed, and purified skin.
- Hydrate and regulate sebum: Lissant Actif, a sebum-regulating and antioxidant cream, hydrates without leaving a greasy film. This is a rare find for acne-prone skin types who tend to avoid rich textures. The synergy between native water (vitamin C) and sea buckthorn berry oil restores the berry’s natural balance for comprehensive action.
Avoid products containing essential oils or irritating ingredients. And of course, never squeeze a pimple: you risk developing dark spots, which are much harder to get rid of than the pimple itself.
Hormonal Acne and Menopause: A Special Case
The appearance of breakouts during menopause often comes as a surprise. However, the sudden drop in estrogen creates a hormonal imbalance that favors androgens. The sebaceous glands, stimulated by these hormonal changes, produce more sebum. Paradoxically, mature skin is often drier overall, yet it can still have oily areas and breakouts.
This duality calls for skincare products that nourish without clogging pores. The omega-7 fatty acids in sea buckthorn address this issue precisely: they deeply hydrate the mucous membranes and skin, while also regulating sebum production in both directions (balancing both excess and deficiency).
When to see a dermatologist
If your acne persists for more than 3 months despite following a proper skincare routine, if the lesions are deep or painful, or if they leave scars, see a doctor. A dermatologist can assess the severity, prescribe appropriate treatment, and refer you for hormone testing if necessary.
Hormonal acne in adult women is not a matter of “poor hygiene.” It is a biological reality that warrants serious treatment, combining medical care with complementary natural approaches. By addressing the issue both internally (diet, stress management, targeted supplements) and externally (sebum-regulating and anti-inflammatory skincare), you give your skin the best chance to restore its balance.
The information provided is for informational purposes only and does not constitute medical advice. Consult your doctor or pharmacist.
Sources and references
- French National Health Insurance (Ameli.fr), “Acne: What Is It?”, 2023 — ameli.fr
- Internal data from La Maison de l’Argousier: Secret d’Éclat clinical trials (dermatologist scoring, 21-day protocol, 22 volunteers, accredited organization)
- “Omega-7 fatty acids are particularly beneficial for treating certain skin conditions, especially acne” (The Sea Buckthorn Bible)
Frequently Asked Questions
How can you get rid of adult hormonal acne?
Hormonal acne in adult women requires a multi-pronged approach. A dermatologist may prescribe topical treatments (benzoyl peroxide, retinoids) or hormonal treatments (anti-androgen pills, spironolactone). In addition, a sebum-regulating skincare routine, a low-glycemic-index diet, stress management, and supplements such as zinc or sea buckthorn omega-7 can help reduce breakouts. Expect to see the first results after at least 3 months.
How can you tell if it's hormonal acne?
Several signs distinguish hormonal acne from other types of acne. Breakouts tend to occur on the chin, jawline, and lower face. They are often deep and inflammatory (papules, microcysts). Breakouts are cyclical, linked to the menstrual cycle or periods of stress. If you didn’t have acne as a teenager and it appears after age 25, a hormonal cause is likely. A doctor will confirm the diagnosis.
What is the connection between hormonal acne and the menstrual cycle?
Hormonal fluctuations during the menstrual cycle directly affect sebum production. During the premenstrual phase (7 to 10 days before menstruation), progesterone levels rise while estrogen levels drop. This imbalance stimulates the sebaceous glands, which can lead to clogged pores and the development of pimples. According to data from the French National Health Insurance, 60 to 70% of women experience a worsening of their acne during this phase.
Which IUD should you choose if you have hormonal acne?
If you have hormonal acne, you should discuss your IUD options with your doctor. The hormonal IUD containing levonorgestrel can, in some women, worsen acne due to its progestin activity. The copper IUD, which contains no hormones, has no direct effect on acne. Your dermatologist and gynecologist can advise you on the type of contraception best suited to your hormonal profile.
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