Acne


Acne is not just a teenage skin issue—it is often a hormone-driven condition, especially in adult women and men with androgenic imbalances. Hormonal acne tends to be persistent, inflammatory, and resistant to over-the-counter treatments unless the underlying hormonal triggers are addressed.


 What Causes Hormonal Acne?

Elevated androgens Increase sebum (oil) production, clogging pores

Increased DHT sensitivity : skin cells are more reactive to normal testosterone levels

Polycystic Ovary Syndrome (PCOS)

Menstrual cycle fluctuations: estrogen/progesterone drops trigger breakouts before periods

Stress and cortisol can increase androgen production and worsen acne


  Who Is Affected by Hormonal Acne?

 Females:

  • Jawline, chin, and lower cheeks most affected
  • Worsens before periods
  • Often associated with irregular cycles, hirsutism, or PCOS
  • May persist into 30s and 40s

 Males:

  • Often due to high testosterone or anabolic steroid use
  • Can appear on face, chest, shoulders, and back
  • Persistent in those with androgenic alopecia or excess DHT activity


Oral Contraceptives (for women)

Certain combined birth control pills can reduce androgen levels and acne:

  • FDA-approved: Yaz, Ortho Tri-Cyclen, Estrostep
  • Best for women with irregular cycles or PCOS


  Topical Treatments

Retinoids (tretinoin, adapalene) Promote cell turnover, prevent clogged pores

Benzoyl peroxide Kills acne-causing bacteria

Azelaic acidAnti-inflammatory, anti-comedogenic

ClindamycinTopical antibiotic (often combined with BP)


Oral Antibiotics (short-term use only)

Used for moderate to severe inflammatory acne, usually limited to 3–6 months.

 Isotretinoin (Accutane)

  • Reserved for severe, cystic, or treatment-resistant acne
  • Reduces sebum, shrinks oil glands, and alters follicle lining
  • Requires monthly labs and strict contraception for women of childbearing age


 Vitamins and Supplements for Acne

Zinc - reduces inflammation, antibacterial & DHT blocker

Vitamin A Retinoid precursor, supports skin turnover

Vitamin D Anti-inflammatory and immune modulator

DIM Supports estrogen metabolism, sometimes useful in PCOSO

mega-3s Reduces inflammation and androgen effects

Probiotics Gut-skin axis support


Hormonal acne—especially in adult women or men with high androgens—requires a root-cause approach. Treatment often involves balancing hormones, short-term antibiotic support, and long-term topical regimens, with diet and nutrient optimization playing a critical role in prevention.