top of page
  • Cari Verde, MS, CNS

Why Hormonal Acne Occurs and What You Can Do About It

Updated: Nov 5, 2023

Often times we associate hormonal acne with the adolescent years, affecting 79% to 95% of teenagers (1). However, it’s no surprise that 40% to 54% of women above age 25, still have some degree of facial acne (1). Aside from poor hygiene, less than stellar diets, food allergies/sensitivities, genetics, stress, and environmental causes, female acne outbreaks are often the result of monthly hormonal fluctuations.

Why do hormonal fluctuations cause acne?

The typical female menstrual cycle is approximately 28 days. During the first 14 days, estrogen continuously rises as the primary hormone. From day 14 to 28, progesterone begins to rise taking over as the main hormone. An imbalanced level of progesterone could stimulate sebum production (2). Sebum is an oily substance made in the skin’s sebaceous glands. Excess oil can cause clogged pores, provide a breeding ground for bacteria, cause sticky skin, and ultimately result in acne breakouts.

Although an excess of progesterone could lead to breakouts, it’s important to note that progesterone is not the "bad guy". Healthy levels of progesterone inhibit an enzyme which transforms the androgen, testosterone, into a very potent form called dihydrotestosterone (DHT). DHT is known to greatly increase sebum production and trigger inflammation (2). Proper levels of estrogen help to lower androgens. On the other hand, an excess of estrogen could lead to a relative progesterone deficiency, which is also a cause for hormonal acne. Hormonal balance is the key!

How to tell if it’s hormonal acne:

  • The majority of acne occurs on your lower face, chin, and jawline.

  • Breakouts flare approximately 7 to 10 days before your period; although hormonal fluctuations can affect your skin all month long.

  • Sometimes hormonal acne is more cystic in nature.

What can I do about hormonal acne?

  • Avoid foods which are known to induce inflammation (i.e. sugar, dairy products, refined carbohydrates). High glycemic foods increase insulin and insulin-like growth factor (IGF-1), which increase androgens and sebum production (3).

  • Consume wild-caught fatty fish 2-3 times per week or supplement with 1-3 grams of omega- 3-fatty acids daily, which have been shown to decrease inflammation (3).

  • Consider supplementing with maca, which provides adaptogenic support to balance hormone levels and reduce hormone-related symptoms, such as acne (4). But not just any maca...Femmenessence is the only choice at Ross Nutrition Team as it is the only maca proven in human clinical trials to support hormone balance! To learn more, check out Dr. Ross published case studies on this topic.

  • Make sure you are getting enough zinc and vitamin A. Dietary zinc can be found in grass-fed red meat, poultry, beans, nuts, and whole grains. Vitamin A, a fat-soluble vitamin, can be consumed in retinoid form from liver, kidney, eggs, and dairy. It is also found in carotenoid form from dark or yellow vegetables, carrots and tree nuts. If supplementation is warranted, safe dosages range from 5,000-10,000 IU of vitamin A and up to 30 mg of zinc daily (3). Discuss this with your practitioner.

  • Vitamin B6 at 50 mg, taken 1 week prior to menstruation and continued throughout menstruation, has been shown to decrease premenstrual acne flares (5).

  • Drink at least 2-3 cups of green tea per day, which contains high levels of polyphenol antioxidants. The main antioxidant epigallocatechin-3-gallate (EGCG) has anti-inflammatory, anti-cancer, and anti-androgen properties which help to decrease sebum production, inflammation and skin bacterial growth (3).

  • Topical application of tea tree oil has been shown to improve acne due to its anti-microbial and anti-inflammatory properties. Use a 5%-15% topical tea tree oil applied 1 to 2 times per day (3). In a double-blind clinical trial, 5% tea tree oil was found to be more effective with few side effects, compared to 5% benzoyl peroxide.(3)

  • If inflammatory lesions have formed, consider the use of a topical mixture consisting of turmeric powder with milk or coconut oil, place on the lesions daily. Turmeric may also be ingested in supplemental form at 500 mg 2 to 4 times per day (3).

  • Gently wash your face twice a day, but keep in mind that excessive scrubbing or washing may increase sebum production and further aggravate acne.

To learn more about hormonal balance, get a free download,

"5 Tips for Happy Hormones"

when you sign up for our monthly e-newsletter.

About the Author: Cari Verde , CNS earned her Master’s degree in Applied Clinical Nutrition from New York Chiropractic College in August 2018. She is passionate about optimizing nutrition and wellness, as well as helping to identify and correct nutritionally related root causes of dysfunction within the body. She is an Army veteran as well as a military wife.

Last review and update: October 8, 2023


1. Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne Vulgaris: A Disease of Western Civilization. Arch Dermatol. 2002;138(12):1584–1590. doi:10.1001/archderm.138.12.1584

2. Elsaie ML. Hormonal treatment of acne vulgaris: an update. Clin Cosmet Investig Dermatol. 2016;9:241–248. Published 2016 Sep 2. doi:10.2147/CCID.S114830

3. Rakel, D. Integrative Therapeutics. 4th ed. Philadelphia: Elsevier, Inc. 2018

4. Meissner HO, Reich-Bilinska H, Mscisz A, Kedzia B. Therapeutic Effects of Pre-Gelatinized Maca (Lepidium Peruvianum Chacon) used as a Non-Hormonal Alternative to HRT in Perimenopausal Women - Clinical Pilot Study. Int J Biomed Sci. 2006;2(2):143–159.

5. Gaby, A. Nutritional Medicine. 2nd ed. Concord, NH: Fritz Perlberg Publishing. 2017

Image Credit: Kjerstin Michaela Haraldsen from Pixabay


Recent Posts

See All
bottom of page