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    Hormonal Acne: Why It Happens and How to Manage It

    • 4 min read

    Written by Dr. Olivia Rose, ND

    Watch Video: Hormonal Acne

    What is Hormonal Acne?

    Hormonal acne is exactly what it sounds like - acne that is due to the changes and fluctuations in your hormones. Although acne is often thought of as an adolescent phase, one third of total acne office visits are made by women over 25 years old.1 Acne in adult years is more common in females, with twice the number of women seeking help for their acne than men.1

    Hormonal acne usually forms on the bottom part of the face around the jaw line and on the lower part of the cheeks. During menstruation, pregnancy and menopause, acne may flare up due to changes in estrogen levels.2 During puberty, and in conditions such as polycystic ovarian syndrome (PCOS) testosterone levels rise, which can also increase sebum production, the oily substance produced by your sebaceous glands.2 Sebum is needed to keep the skin healthy and hydrated, however, too much sebum production can lead to acne.2

    Your naturopathic doctor may order blood work on top of conducting a detailed history and physical exam to diagnose your acne in order to measure the levels of your hormones. 

    How is Hormonal Acne Managed?

    Before treating your hormonal acne, any underlying conditions should be addressed. Seemingly unassociated health issues such as food intolerances and sensitivities may be causing your skin to break out due to excess inflammation.3 The proper elimination of your bowels is also important. If you are suffering from functional constipation and if you don’t have a daily bowel movement, it may show up on your skin. This may in part due to the reabsorption of estrogen from your stool, if your stool is sitting in the large intestine for an extended period of time.4 Therefore, ensuring proper digestion is important when dealing with skin health, especially hormonal acne.4

    Supplement with GLA

    Gamma-linolenic acid (GLA) is an omega-6 fatty acid, which, unlike other types of omega-6 fatty acids, is anti-inflammatory. GLA is found in high amounts in borage oil and it can be taken as a supplement in the form of a liquid or capsule. In a study in which women were given 400mg of GLA to take orally for 10 weeks, participants saw a reduction in the average number and severity of acne lesions when compared to the baseline values and when compared to the control group.5 The participant’s subjective assessment of their own acne in the treatment group also improved when compared to the control groups.5

    The Role of Zinc

    Zinc is another reliable hormonal acne treatment. Acne is generally associated with a lower blood level of zinc in the body and when taken orally, zinc may decrease excessive sebum production.6 However, a high dose of zinc can cause side effects such as copper deficiency, nausea and vomiting, therefore only take the recommended amount by your doctor.6

    In a 2020 review, authors found subjects with acne had significantly lower serum zinc levels when compared to controls.6 Additionally, patients who were treated with zinc had a significant improvement in inflammatory lesions compared to those who were not treated with zinc. No side effects were found in either group.6

    Facial Masks

    Topical treatments such as bentonite clay can also be helpful in targeting oily skin and treating acne. The clay pulls excess sebum from the skin and may also help reduce inflammation at the skin level.7 You can easily make your own clay mask at home by mixing bentonite clay powder with water to make a thick paste. Apply a thin layer of the paste to your face and leave it on for about 20 mins. Once it has dried, use a washcloth to remove the mask completely and follow up with a moisturizer.

    When dealing with hormonal acne, it is important to not only target the skin, but to look beyond the surface to see the role that underlying health conditions may have on your breakouts. Often, the skin can act as a window to what is going on in the body whether it is to do with digestive issues or hormonal imbalances.



    1. Alanazi MS, Hammad SM, Mohamed AE. Prevalence and psychological impact of Acne vulgaris among female secondary school students in Arar city, Saudi Arabia, in 2018. Electronic physician. 2018 Aug;10(8):7224.
    2. Ju Q, Tao T, Hu T, Karadağ AS, Al-Khuzaei S, Chen W. Sex hormones and acne. Clinics in dermatology. 2017 Mar 1;35(2):130-7.
    3. Life Labs Testing. Allergy and Intolerance Testing. Accessed on Feb. 8, 2021.,common%20symptom%20of%20food%20intolerance.
    4. Jung JY, Kwon HH, Hong JS, Yoon JY, Park MS, Jang MY, Suh DH. Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial. Acta dermato-venereologica. 2014 Sep 1;94(5):521-6
    5. Ju Q, Tao T, Hu T, Karadağ AS, Al-Khuzaei S, Chen W. Sex hormones and acne. Clinics in dermatology. 2017 Mar 1;35(2):130-7.
    6. Yee BE, Richards P, Sui JY, Marsch AF. Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta‐analysis. Dermatologic Therapy. 2020 Nov;33(6):e14252.
    7. Fox L, Csongradi C, Aucamp M, Du Plessis J, Gerber M. Treatment modalities for acne. Molecules. 2016 Aug;21(8):1063.