Hormonal acne: understanding it to treat it better

Who has never experienced that moment of discouragement in front of the mirror, discovering a pimple in the worst place at the worst time?

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Acne affects millions of people and often appears without warning. Whether you are a teenager or an adult, woman or man, your skin has its own stories to tell. Hormonal fluctuation, stress, or even menstrual cycles, your skin reacts to it all. Sometimes, with a few imperfections thrown in. But fortunately, far from being a fate you must accept, acne can be treated and reduced with the right steps and a little patience.

Ready to get back to a more serene skin? Discover our tips to understand the link between hormones and acne, and take gentle care of your skin.

Although medically inaccurate, the term “hormonal acne” is commonly used to describe acne influenced by hormonal fluctuations. Both girls and boys usually experience acne during puberty, affecting 80% of adolescents, with varying degrees of severity. The cause: hormonal changes that lead the skin to produce more sebum. The result is that the skin becomes oilier, and imperfections appear on the face, back, shoulders, or chest area. When sebum accumulates, it mixes with dead skin cells and clogs the pores. This can lead to the formation of blackheads, whiteheads, pimples (comedones, papules, pustules, nodules), or microcysts.

In most cases, hormonal acne tends to reduce or disappear after adolescence when the hormonal “turmoil” stabilises. But this is not always the case. It may persist, reappear, or even develop in adulthood, particularly in women. Around 25% of adults are affected by acne.

What circumstances favour hormonal acne?

Hormonal imbalances or fluctuations directly influence sebum production and skin condition.

Puberty: Androgen hormones increase to support body development, but they also stimulate the sebaceous glands, leading to the appearance of acne.
Menstrual cycles: studies have shown that, for women, acne tends to be more severe in the premenstrual phase, just before menstruation.
Pregnancy: hormonal changes during pregnancy can exacerbate or, in some cases, improve acne, depending on the individual’s skin reaction.

→ Learn more about pregnancy acne

Menopause: changes in hormonal balance can trigger a resurgence of acne in some women. However, acne during perimenopause and menopause is often multifactorial (stress, poor sleep quality, dietary changes…).
Contraception: some forms of contraception may contribute to acne by influencing sebum production. The choice of contraception should therefore be discussed with the prescribing physician, taking into account the risk-benefit balance and any contraindication. A reminder: if contraception is not needed, there is no recommendation to prescribe the pill to treat acne.

The different forms of hormonal acne

There is not just one but several types of acne. They can appear in succession or in combination.

The first stage of teenage acne is hyperseborrhoea : hormonal changes stimulate overproduction of sebum by the skin. At this stage, the skin is simply oily.

Under the skin, a micro-comedo may start to form: excess sebum thickens and becomes a hardened plug that clogs the pore. First invisible, it later develops into a comedo. When exposed to air, the sebum oxidises and turns black forming an open comedo (or blackhead). When it is covered by skin cells, it is called a closed comedo (microcyst or whitehead). The presence of both open or closed comedone is known as retentional acne.

If left untreated, the next stage is inflammatory acne. It is the result of the infection of comedones due to the proliferation of Cutibacterum acnes bacteria. Blocked pores can become a favourable breeding ground for Cutibacterium acnes, a bacterium naturally present on the skin. As it multiplies, this bacterium triggers an inflammatory reaction, causing redness and painful acne pimples. The blemishes then take the form of papules (large, hard, red pimples), sometimes topped with pustules (that contain a purulent liquid).

Why does acne persist into adulthood?

Acne is often thought to be a teenage problem, but for some, it lingers well beyond adolescence. For some adults, acne persists, reappears, or even develops for the first time. But what causes this unexpected return?

Factors contributing to hormonal acne in adults

Hormonal fluctuations do not necessarily stop after puberty: pregnancy, unsuitable contraception, menopause…

One of the most common causes of excess androgen in women is Polycystic Ovary Syndrome (PCOS), which is frequently associated with acne.

However, other factors can disrupt hormonal balance and trigger breakouts:

Stress is one of the main aggravating factors for acne. When stressed, the body releases cortisol, a hormone that can stimulate the sebaceous gland, and increase sebum production.
Lifestyle choices also matter. An unbalanced diet, lack of sleep, or excessive pollution can all contribute to persistent acne.
Inappropriate skincare products can also worsen breakouts. Beware of comedogenic products! If your pimples appear where you apply makeup or skincare, your cosmetics may be clogging your pores. Additionally, harsh cleansers that strip the skin can actually stimulate sebum production even more. The same goes for excessive exfoliation, it can irritate and inflame your skin.

Who can be affected by hormonal acne?

Acne affects both teenage boys and girls during puberty.

Menstruation, pregnancy, menopause… for women, hormonal fluctuations do not stop after adolescence!

While they are not spared from acne during puberty, men generally see their skin problems diminish and then disappear into adulthood as their hormones stabilise. Beware, however, as acne can be triggered in men by taking anabolic steroids (a doping substance with a similar structure to the male sex hormone: testosterone) and/or whey protein (a protein found in lactoserum or whey, the by-product of cheese production, often used to increase muscle mass).

Medical treatments: which option to choose?

Time to take action! A wide range of treatments is available for both teenagers and adults struggling with acne. Topical treatments with anti-inflammatory and antibacterial properties, oral antibiotics, vitamin A derivatives… Your dermatologist will be able to tell you how to effectively treat your acne and adopt an adequate daily skincare routine.

Contraceptive pills: a miracle solution?

A quick reminder: if you do not require contraception, dermatologists do not recommend taking the pill solely to treat acne (as per the French Society of Dermatology and the French National Authority for Health).

While some contraceptive pills may help reduce sebum production and improve acne, others can worsen breakouts.

→ Find out more about acne linked to the contraceptive pill

Talk to your gynaecologist to determine the better solution to your situation and needs.

Hormonal acne: our tips for an effective skincare routine

Some topical treatments prescribed for acne have a downside: they can strip the skin. That is why it is essential to use the right skincare products to restore balance. Look for labels such as “non-comedogenic” or “suitable for acne-prone skin” to guide your choice.

Step 1: start with a gentle cleansing and makeup removal with a soap-free product. Wash your face morning and evening with a gel or cream cleanser designed for acne-prone skin.

Intermediate step: exfoliate your skin once or twice a week to avoid irritating it. We recommend CLEANANCE Detox Masque, the ultimate mask for sensitive, blemish-prone skin.

Thanks to a unique blend of concentrated absorbent clays (19%) and exfoliating perlite, it purifies, mattifies, and tightens pores in five minutes*. The formula also soothes and nourishes the skin with hydrating agents and Avène Thermal Spring Water. Plus, it is biodegradable and vegan.

Step 2: Spray your face with thermal spring water with anti-irritant properties to calm redness and discomfort. This step helps remove any residue from tap water, leaving your skin ready to absorb a soothing cream that restores comfort.

Step 3: apply Cleanance Comedomed Anti-imperfections Concentrate morning and evening. Effective in 7 days.

💡 Hydrate your skin, even if it is oily. Oily blemished skin can be dehydrated, especially if it is undergoing anti-acne treatments

Step 4: wear sun protection daily, especially if you use sensitising treatments like retinoids or exfoliating acids. While the sun might seem to initially dry out blemishes, it can actually worsen acne in the long run. Choose a non-comedogenic sunscreen, designed for oily skin.

Step 5: apply an anti-blemish treatment only on pimples to limit irritation. Look out for formulas containing topical retinoids or benzoyl peroxide to treat acne locally.

💡 Be mindful of cycles: adjust your skincare a few days before your period to prepare your skin. Opt for gentle cleansers, purifying treatments and soothing creams to limit flare-ups.

The secret? Be gentle, always! That is how you will be able to create the perfect conditions to (finally) get rid of your acne, whether you are a teenager or an adult. Gentle products and techniques make all the difference. Avoid scrubbing too hard with cotton pads, and never pop your pimples, as it can worsen inflammation and leave scars.

Lifestyle and diet: how to manage them to soothe acne?

Your skin is like a mirror, it often reflects your lifestyle choices. A few simple adjustments can make a real difference in calming hormonal acne.

What you eat: the link between acne and diet, particularly dairy and fast sugars, remains a topic of debate. While completely eliminating these foods is not necessary, reducing your intake may help you see if your skin reacts positively. However, the latest advice and guidelines for acne management do not recommend dietary changes as a treatment.
How you sleep: a good night’s sleep (7 to 9 hours) gives your skin time to regenerate and restore balance.
How you manage stress: Stress does not directly cause acne, but it can worsen existing symptoms by stimulating the sebaceous glands to produce more oil. Less stress means fewer breakouts! Take time to unwind, whether it is with yoga, a walk, or simply a moment to take a break and breathe.

Our solutions for clearer skin

Your skin deserves the best. At Eau Thermal Avène, we have developed skincare products specifically designed for acne-prone skin, to soothe, purify, and rebalance with gentle care.

Because every skin has unique needs, our Cleanance range offers a simple yet effective routine to support skin prone to imperfections:

Cleanance Cleansing Gel: a gentle, soap-free cleanser that purifies the skin and removes excess oil without stripping it, creating the perfect base for your skincare routine.
Comedomed Concentrate: this anti-blemish treatment works directly at the source of pimples to prevent their appearance and smooth the skin texture. Proven effectiveness in 7 days*.
Comedomed Peeling: this intensive cream targets existing imperfections. Use it on a clean face for a localised or full treatment for 15 days. Enriched with Glycolic Acid and Retinoid Boosters, it exfoliates, renews the skin, and helps reduce marks and pimples.

* Using it twice a day on the face helps limit the reappearance of blemishes. Results demonstrated over 8 weeks, on 37 participants.

By integrating these products into your daily routine, you are giving your skin everything it needs to regain balance and comfort. As always, Eau Thermal Avène combines effectiveness and skin tolerance, ensuring your skin gets the care it truly deserves. Take care of your skin and it will be good to you.