What causes hormonal Acne?

Hormonal acne is triggered by your body producing either too much or too little of your reproductive hormones – Oestrogen, progesterone, testosterone or dehydroepiandrosterone (DHEA).

These triggers cause the pores in your skin to become larger and secrete oil (sebum), which clogs the pores and creates pimples.

Common hormonal imbalances:

  • High Androgens: Androgens are male and female sex hormones. The most common is DHEA and Androstenedione. When women produce too much this can cause terrible consequences for the skin. Common causes: contraceptive pill, genetics and increased production of insulin.
  • Low Progesterone: Progesterone reduces pore size and sebum (oil) production. The synthetic progesterone in the pill can clear up acne, and because of this, once you stop taking the pill, your oil production can go crazy.
  • Low Oestrogen: Oestrogen heals the skin and improves texture. The synthetic Oestrogen in the pill clears up acne and stops the male hormones exerting a strong oil production. Again, once this is taken away, a rebound effect can occur.

Contraceptive pill

A fun fact that I have recently learnt is the effects of coming off the contraceptive pill. I was originally prescribed Yasmin to help my skin, and in combination of other lifestyle and dietary choices – this worked. However, there will be a time to come off the pill and I can say that all of the original problems came back with a vengeance. My skin began to severely break out again and I had the added bonus of hair loss. These are common symptoms from coming off the contraceptive pill, and are due to removing the ‘treatment’. The symptoms can occur 3-4 months down the track.

Whilst taking the pill the synthetic hormones can suppress androgens, but then when you stop, you get a rebound in androgen production and your levels shoot up triggering excess oil production.

The pill can also make your cells insulin resistant causing your body to produce excessive amounts of insulin. Excess insulin causes your ovaries to overproduce testosterone and this can also cause excess oil.

The pill treats acne by reducing the effects of testosterone on the skin at the skin receptor level, along with other actions, resulting in clear skin. Testosterone can cause congestion as it is pro-acne which has the opposite effect of oestrogen. Once you stop taking the pill your hormones may appear a little ‘crazy’ and have effects on your skin, however this is the result of hyper-sensitive skin receptors for testosterone, which have been blocked by the pill.

Because you have changed your hormonal profile, it may take time to find a hormonal balance.

While the contraceptive pill is a very common treatment option for acne, it does not solve any hormonal imbalances, it only masks symptoms. As soon as you stop taking the pill your hormonal imbalances will still be there and often worse than before.

What to do before ceasing the pill

  • Be prepared. Start mentally preparing yourself.
  • See a naturopath/GP in advance to request any support to transition
  • Monthly facials can help to address issues on a regular basis and can be a useful preventative tool
  • Address stress. Incorporating an Adaptogen or sleep tonic into your daily regime can help balance your nervous system.
  • Probiotic. Encouraging healthy micro-flora.

Foods that cause hormonal acne

Certain foods cause inflammation and make the androgen (male sex hormone) receptors on your skin cells super sensitive to androgens. This results in excessive oil and can cause white heads and/or cystic acne.

If you remove potential inflammatory foods (gluten, dairy, highly processed, high sugar) and this does not clear your acne, then your acne is not a result to your diet.

How to balance hormones for acne

  1. Discover what hormones are out of balance via testing.
    1. Salivary testing for Testosterone, DHEA, Progesterone, Oestrogen and cortisol
    1. Qualified Naturopath, GP, and Dermatologist – research local practitioners that conduct hormonal testing.
  2. Blood test
    1. Iron, zinc and Vitamin D levels

Best herbs for hormonal acne

Fresh herbs in first aid kit
  • Vitex/Chaste Tree: This herb works by indirectly raising your progesterone levels. Less progesterone means more oil and more acne, therefor Vitex prevents this happening.
  • Liquorice & Paeony: Suppress androgen (testosterone) production in women
  • Saw Palmetto: Stops testosterone exerting strong effects on your cells. Weaker testosterone = less oil production
  • Blue flag: Helps decongest skin


  • Zinc: Ideal for ovary function and a potent anti-androgen, making cells less sensitive to androgens.
  •  Iron: ideal for optimal ovary function.
  • Magnesium: Great for insulin problems, and reduced insulin prevents ovaries from overproducing testosterone. 


  • Vitamin A: helps control and minimise oil production.
  • Vitamin D: useful for optimal ovary function, to make optimum amounts of oestrogen and progesterone.

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