What's Really Happening Under Your Skin
If you feel like you’ve tried everything for your acne—harsh cleansers, prescription creams, even antibiotics—only for the breakouts to keep coming back, there’s a good chance your hormones are at play.
Hormonal acne isn’t just a teenage problem (though it can start in your teens). It affects women in their 20s, 30s, and even 40s, often showing up as deep, cystic breakouts along the jawline, chin, cheeks, and even the neck. If your acne worsens around your period, during pregnancy, after stopping birth control, or when you’re stressed, it’s likely hormone-driven.
So, what’s actually happening beneath the surface? And more importantly—how do you fix it for good?
In this article, I’ll break down:
✅ Which hormones cause different types of acne
✅ Why your breakouts may be a sign of an underlying imbalance
✅ Natural ways to clear hormonal acne (that actually work!)
What's in this article?
Your skin is basically a mirror for what’s happening inside your body—especially when it comes to hormones.
Here’s how different hormones can lead to breakouts:
1. Androgens (Testosterone, DHEA, & Other “Male” Hormones)
What it does: Stimulates oil (sebum) production. Too much can clog pores and trigger cystic acne.
How It Shows Up on Your Skin:
Deep, painful cysts (especially on the jawline, chin, and neck)
Oily skin and large pores
Acne flares before or during your period
👩⚕️ Case Study: Rachel, 28
Rachel had painful jawline cysts that would show up like clockwork a week before her period. Her testosterone was slightly elevated due to stress and under-eating. With blood sugar balance, stress support, and targeted supplements, her skin improved within 3 months.
2. Estrogen & Progesterone (Your Menstrual Cycle MVPs)
What they do: Keep skin hydrated, control oil, and balance inflammation. But when they’re off? Breakouts happen.
How It Shows Up on Your Skin:
Breakouts that get worse right before your period
Dry, sensitive skin between breakouts
Hormonal “flares” after stopping birth control
👩⚕️ Case Study: Jessica, 34
Jessica’s acne worsened after stopping the pill. Her skin was dry but still breaking out. We supported her estrogen metabolism and progesterone with DIM, magnesium, and hormone-balancing foods. Her skin calmed down in 4 months.
3. Cortisol (The Stress Hormone)
What it does: Increases oil production and triggers inflammation.
How It Shows Up on Your Skin:
Random breakouts during stressful weeks
Acne that’s resistant to all topical treatments
Red, inflamed skin that won’t calm down
4. Insulin & Blood Sugar Imbalance
What it does: High insulin levels spike oil production and inflammation—leading to breakouts.
How It Shows Up on Your Skin:
Small, inflamed pimples on the forehead and temples
Acne plus weight gain or sugar cravings
Worsens with high-sugar foods
How to Treat Hormonal Acne Naturally (What Actually Works)
If your acne is hormonal, treating it only with spot treatments or medicated creams won’t be enough. You need to support your hormones from the inside out for long-term, clear skin.
Let’s break down the four most effective ways to tackle hormonal acne naturally:
1. Eat to Balance Hormones
Food is one of the biggest influences on hormone health—and by extension, your skin. What you eat (or don’t eat) affects testosterone, estrogen, insulin, and cortisol, all of which play a role in acne.
Here’s what to focus on:
✅ Add Hormone-Balancing Foods
Fiber-rich foods (flaxseeds, chia seeds, leafy greens, lentils) → Helps remove excess estrogen and supports gut health
Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) → Contains DIM, a natural compound that helps balance estrogen
Healthy fats (avocados, wild-caught salmon, extra virgin olive oil) → Supports hormone production and keeps skin hydrated
Protein-rich foods (organic chicken, grass-fed beef, pasture-raised eggs) → Helps stabilize blood sugar, which reduces androgen spikes
Fermented foods (sauerkraut, kimchi, yogurt, kefir) → Supports gut health and estrogen metabolism
❌ Avoid High-Inflammatory & Acne-Triggering Foods
Dairy products (milk, cheese, ice cream) → Increases insulin-like growth factor (IGF-1), which spikes oil production and worsens breakouts
Refined sugars & processed carbs (pastries, white bread, soda) → Causes insulin spikes, which increase testosterone and trigger acne
Vegetable oils (canola, soybean, corn oil) → Highly inflammatory and can worsen cystic acne
Excess caffeine & alcohol → Disrupts cortisol and estrogen balance
2. Support Your Liver & Gut
Your liver and gut are your body’s detox powerhouses. They help process and eliminate excess hormones—but if they’re sluggish, acne-prone hormones like estrogen and testosterone can build up.
How to Support Your Liver:
Drink warm lemon water in the morning to support liver detox
Take DIM supplements or eat cruciferous veggies to metabolize estrogen
Support liver function with milk thistle, dandelion root, and turmeric
Avoid excess alcohol, medications, and processed foods, which slow down detox pathways
How to Support Your Gut:
Eat fermented foods and take a probiotic to balance gut bacteria
Get enough fiber (at least 25g/day) to help remove excess estrogen
Avoid chronic constipation—if you’re not pooping daily, estrogen can get reabsorbed into your system and worsen breakouts
3. Manage Stress (Seriously, It Matters)
Stress isn’t just “in your head”—it’s a major player in hormonal acne. When you’re stressed, your body pumps out cortisol, which:
✅ Increases oil production (leading to clogged pores)
✅ Triggers inflammation, making acne worse
✅ Throws off progesterone, which can lead to breakouts
How to Reduce Stress for Clearer Skin:
Prioritize sleep (7–9 hours) → Your skin heals the most overnight
Try adaptogenic herbs (ashwagandha, rhodiola, holy basil) → Helps balance cortisol
Daily movement (walking, yoga, weightlifting) → Reduces cortisol naturally
Deep breathing & meditation → Lowers stress hormones in minutes
Cut back on caffeine → Too much coffee increases cortisol and can worsen hormonal imbalances
4. Consider Lab Testing
If you’ve tried everything and your acne still isn’t improving, getting hormone testing can help you pinpoint exactly what’s out of balance.
A functional hormone panel (like the DUTCH test or blood hormone testing) can reveal if you have:
High androgens (testosterone, DHEA) → Common in PCOS-related acne
Low progesterone & estrogen imbalance → Can cause breakouts around your cycle
High cortisol & stress-related acne → Often linked to chronic inflammation
Insulin resistance & blood sugar issues → Triggers forehead and jawline acne
With testing, we can create a personalized hormone-balancing plan to clear your skin naturally.
Healing Hormonal Acne Naturally
Hormonal acne isn’t just about skincare—it’s a whole-body issue that requires balancing your hormones from the inside out.
By adjusting your diet, supporting your liver and gut, managing stress, and getting the right tests, you can clear your skin naturally and keep it that way long-term.
Need help balancing your hormones for clear skin?
Book a 1:1 consultation today and get a personalized plan tailored to your acne and hormone health!ok a consultation with me, and let’s get your gut and hormones back on track!
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*Dr. Francesca works only with patients physically located in California.*
*Disclaimer: Although I am a doctor, I may not be your doctor. The information contained within the pages of this site is for educational purposes only and should not be used to treat conditions. Please consult with your doctor before implementing any of the treatments, diets, supplements, etc. mentioned in this blog.*