Acne: How it’s Related to Your Hormones

Acne vulgaris, commonly known for short as acne, impacts around 85% of people between 12 and 18 years old. Although acne is commonly understood to be a ‘teenage problem’, Yale Medicine dermatologist Christopher Bunick, MD, PhD claims that the most common reason women aged 20-40 years old come to the dermatologist is because of acne. As a matter of fact, acne affects 50% of women in their 20s, 33% of women in their 30s, and 25% of women in their 40s (YaleMedicine, 2023). A 2015 study indicated that acne doesn’t just affect the skin, it has a drastic impact on emotions, daily activities, studies, work, and relationships. 88% of women in this study reported that their acne caused low self-esteem and a decrease in self-confidence. The embarrassment brought on by the acne led 69% of these women to avoid social contact (Hazarika, 2015). This is significant information because it demonstrates that acne psychologically affects women. So, with all of that to say, what causes acne and how can it be improved naturally?

“88% of women in this study reported that their acne caused low self-esteem and a decrease in self-confidence. The embarrassment brought on by the acne led 69% of these women to avoid social contact.”

Acne is most commonly caused by fluctuations in hormone levels, particularly testosterone and progesterone. Testosterone is a predominant male sex hormone. For men, testosterone plays an important role in male physical characteristics, muscle & bone mass, fat distribution, mood & energy levels and cognitive function among other things. Testosterone is needed in women as well, but at much lower levels. The normal range for testosterone in men is 300-1000ng/dl whereas the normal range for women is 15-70ng/dl (MountSinai, 2025). When testosterone is elevated in women it can present with symptoms such as increased body and/or facial hair, acne & oily skin, irregular periods, absent periods, thinning hair and/or balding, etc. Women who suffer from PCOS (polycystic ovarian syndrome) typically experience these symptoms. PCOS is a syndrome that affects 6-13% of women, although it is thought to be under-diagnosed due to the lack of education women receive about their menstrual cycles and the prescription of birth control for hormonal imbalances. Statistics suggest that up to 70% of women remain undiagnosed (WHO, 2025). There are many different causes of PCOS, but the main contributing factor related to acne is elevated androgens, mainly testosterone. DHEA (dehydroepiandrosterone) is a hormone produced by the adrenal glands that is necessary to produce testosterone. If a doctor suspects that a woman has PCOS, they will evaluate her DHEA level. DHEA is converted in the body’s tissues into estrogen and testosterone. Both of these hormones, when elevated, can be menstrual cycle disruptors and, as already discussed, testosterone can be a contributor to acne. One common cause for elevated DHEA is chronic stress (psychological or physiological). When the body is under stress, cortisol and DHEA are released. It is important to find ways to decrease stressors on the body through improving your diet and implementing self-care practices. View this article to find out ways to decrease psychological and physiological stress.

“It is important to find ways to decrease stressors on the body through improving your diet and implementing self-care practices. View this article to find out ways to decrease psychological and physiological stress.”

Another important hormone is Progesterone, a crucial female hormone that has a myriad of health benefits when it is at normal levels throughout the female ovulation cycle. After ovulation, progesterone rises to the highest point it will ever be in your cycle. This is because of the integral role progesterone plays in maintaining the lining of the uterus (endometrium) and preparing it for a baby if conception occurs (read this article to learn more about the health benefits of progesterone!). Testosterone and progesterone don’t have many similarities, but one thing they have in common is oil. Both of these hormones stimulate sebaceous glands (glands on your skin that produce oil). Oil can contribute to acne because, when it mixes with dead skin cells and bacteria, it clogs pores. If you notice more acne prior to your period, progesterone could be part of the reason. If testosterone is the main contributing factor for acne, the primary goal for treatment should be to heal the menstrual/ovulation cycle first. If testosterone levels are high, the woman is likely not ovulating and, therefore, not in an optimal state of health. Typically, once the woman’s hormones are regulated she will no longer experience acne in the same way she did prior to the treatment of her cycle. If you’d like to discover how you can identify if you have PCOS and find ways to heal, contact me! I’d love to talk with you through it all.

“If testosterone is the main contributing factor for acne, the primary goal for treatment should be to heal the menstrual/ovulation cycle first.”

There’s a few factors other than just testosterone and progesterone that could be contributing to acne. Cortisol is a hormone that’s released in response to stress (physiological and psychological) and it raises glucose levels in the body. High cortisol and glucose levels can cause and exacerbate inflammation, leading to inflammatory skin conditions, such as acne. Some food allergies can also cause inflammatory skin conditions. For example, a sign of celiac disease could be excess acne with an unexplained origin. In addition, thyroid hormone, when at high levels, can cause increased oil production, contributing to acne.

“High cortisol and glucose levels can cause and exacerbate inflammation, leading to inflammatory skin conditions, such as acne.”

I recommend understanding the menstrual cycle first, evaluating hormone levels, incorporating more anti-inflammatory foods into the diet, and getting regular exercise to improve acne. Take a look at this article for more information on anti-inflammatory foods and ways to decrease inflammation in the body.

Here’s the most important thing to remember: you’re not alone in your struggle for wellness. There are ways to heal that won’t compromise your morals, your health, or your fertility goals. You’re meant to live in harmony with your body. Work with a fertility awareness educator who can tailor a care plan for you!

References:

Yale Medicine. (2023, September 22). Acne (acne vulgaris). Yale Medicine. https://www.yalemedicine.org/conditions/acne

Hazarika, N., & Archana, M. (2016). The Psychosocial Impact of Acne Vulgaris. Indian journal of dermatology, 61(5), 515–520. https://doi.org/10.4103/0019-5154.190102

Testosterone. Mount Sinai Health System. (n.d.). https://www.mountsinai.org/health-library/tests/testosterone#:~:text=Normal%20Results%20*%20Male:%20300%20to%201%2C000,70%20ng/dL%20or%200.5%20to%202.4%20nmol/L.

World Health Organization. (n.d.). Polycystic ovary syndrome. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

Chavez, M. (2023, July 17). Hormones and how they affect your skin. Bend Dermatology Clinic. https://bendderm.com/hormones-and-how-they-affect-your-skin/