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Acne in adulthood doesn’t have to be your normal. Here’s how to treat hormonal acne naturally and figure out the root cause.

The big red bumps start on your jawline. They spread all around your mouth and on the lower half of your face. Then they start appearing on your forehead, cheeks, and sometimes your back.
It’s embarrassing, it’s painful, and long after the bumps are gone, the scars and redness stick around for what seems like forever.
Research shows adult acne has a different root cause from teenage breakouts. Adult onset acne is often caused by both genetic and hormonal issues, and can persist for decades. While it actually affects both men and women, the American Academy of Dermatology has found women deal with it more often than men because of hormonal shifts that occur during the menstrual cycle, pregnancy, and menopause. For women, acne often flares a week before menstruation.
So, how can treat hormonal acne naturally? The first step is to balance hormones by taking care of your gut and liver, reducing stress, and avoiding topical triggers. A few simple shifts in how you eat, move, and take care of your skin can make a big difference in treating the root cause.
Jump to:
Symptoms
Everyone has occasional acne and blemishes. Breaking out when you’re going through stress—or even a few zits around your menstrual cycle—can all be 100% normal. But, hormonal acne is different. Here are a few symptoms:
- Acne around the chin and jawline
- Painful, chronic cystic acne that can’t be extracted or “popped”
- Acne that spreads to the neck, shoulders, and back
- Zits and pimples that flare in the week leading up to your menstrual cycle
Treating Hormonal Acne Without Birth Control
Most conventional doctors recommend treating adult onset acne with hormone based therapies like the birth control pill. This is because the birth control pill works by shutting down ovulation, which suppresses your body’s own production of estrogen and progesterone through a negative feedback loop.
But, what most people don’t tell you? Treating hormonal acne with the birth control pill doesn’t actually solve the problem. The root cause of your hormonal acne will still be there when you come off the pill because it is simply replacing your body’s own hormone production with synthetic hormones.
There is a way to treat hormonal acne without the pill. Once you know what is REALLY behind your hormonal acne, you can take steps toward healing it.
Hormone Imbalances
Hormonal acne is different from other kinds of acne because it’s tied to hormone imbalances. It can be the result of too much or too little of any of your main sex hormones, specifically estrogen, progesterone, and testosterone. It can also be tied to stress hormones, including DHEA and cortisol.
It’s normal for hormone levels to rise and fall throughout the day and month. For instance, cortisol should be highest in the morning and drop throughout the day. Levels of estrogen and progesterone rise and fall with the menstrual cycle.
When the normal ebbs and flows of hormone levels get disrupted, it can lead to acne, among other issues. This is why treating hormonal acne naturally must involve supporting your body’s ability to balance hormones.

5 Root Causes of Hormonal Acne
Since it’s pretty obvious that hormones are what cause hormonal acne, the solution is finding what’s messing with your hormones and which are imbalanced.
1. Gut and Liver Issues
While we often think of them as two difference systems, your gut directly influences your hormone levels. Your gut microbiome is home to trillions of bacteria. These microbes not only play an important role in breaking down food, they also help your body detoxify hormones, specifically estrogens.
When you have an overgrowth of too many bad bacteria, estrogen is recirculated in the body instead of eliminated. These recirculating estrogens can bind to estrogen receptors and cause high estrogen. Because of this, a healthy gut and diverse microbiome are the main players when comes to treating hormonal acne naturally.
Hormones also control some of the functions of the gut, specifically the constriction and relaxation of the gut that carries food through the digestive system. This is why some women experience diarrhea and constipation just before the menstrual cycle begins.
Additionally, your liver is responsible for metabolizing hormones. If your liver is sluggish because of a poor diet, alcohol use, or exposure to endocrine disruptors, it can lead to hormone imbalances.
Healthy gut bacteria also enhance GABA activity, which can help to balance mood and stress. GABA is a naturally occurring amino acid that works as a neurotransmitter in your brain and supports progesterone production.
2. Excess Androgens
Any kind of hormone imbalance can potentially cause hormonal acne to flare up, but by far the most common imbalance that causes hormonal acne is excess androgens. In fact, excess androgens are the most common hormonal dysfunction in women of reproductive age.
Androgens are hormones that produce “male traits” and include testosterone and DHEA. Healthy women should have androgens in their body, but excess levels can cause acne, unwanted hair growth, and thinning hair on the head.
Excess androgens are almost always present in Polycystic Ovarian Syndrome (PCOS), but there are other causes, including excessive high-intensity exercise, prolonged stress, undereating, and estrogen dominance.
3. PCOS
Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder that occurs in women. Most people assume the tell-tale sign of PCOS is cysts on the ovaries, but there are actually 3 criteria for diagnosis:
- Confirmed androgen excess on labs or androgen excess symptoms, which is what causes acne and other PCOS symptoms like insulin resistance.
- Ovulatory dysfunction
- Multiple cysts on ovaries
There’s also a strong link between the gut and PCOS. Women with PCOS have less diversity in their microbiome than women without it. Studies also show a common root cause of PCOS is insulin resistance, which occurs when your body stops responding to insulin. Insulin is a hormone that helps your body take sugar out of the blood stream, and deposit it into cells. When you become insulin resistant, the body needs more insulin and cortisol to manage blood sugar, which can contribute to high cortisol levels and inflammation.
4. Elevated Cortisol
When your body is chronically stressed, cortisol remains elevated. Chronic cortisol production can have a profound effect on your entire physiology, including your endocrine system. Stress elevates your heart rate, blood sugar, and suppresses both immune and sex hormone production. Overtime, this can lead to hormone imbalances.
Studies show chronic stress is positively correlated with acne because it can increase oil production. Stress disrupts the hypothalamic-pituitary-adrenal (HPA) axis, causing it to produce higher quantities of the androgens DHEA and DHEA-S, which are then converted to testosterone. This can cause unwanted acne, specifically hormonal acne around the chin and jawline.
Common sources of chronic cortisol output include lack of sleep, over-exercising and undereating, anxiety and worry, gut infections, blood sugar imbalances, mental and emotional stress, insulin resistance, and chronic inflammation from a poor diet.
5. Food Sensitivities
A food sensitivity occurs when someone has difficulty digesting or processing a specific type of food. Most of the time, reactions are delayed and can include anything from digestive issues to breakouts.
One of the most common foods that can trigger acne is dairy. Dairy is rich in hormones, and one of them—called insulin-like growth factor-1 (IGF-1)—can be particularly problematic for people with acne. IGF-1 mimics insulin and increases oil production and inflammation in the skin.
Research also suggests increased consumption of processed sugar like soda is positively associated with acne.
How to Treat Hormonal Acne Naturally
There are quite a few things you can do to help your body balance hormones naturally.
- Eat probiotic foods: Probiotic foods can help balance gut bacteria. Incorporate fermented foods regularly such as yogurt, kombucha, sauerkraut, and kimchi.
- Eat gut healing foods: Foods that are rich in omega-3s and fat-soluble vitamins, such as cold water fish, grass fed meats, and pasture-raised eggs, all play an important role in supporting proper gut function since Omega-3s help to reduce inflammation, and low Vitamin D has been associated with decreased immune function.
- Remove potentially problematic foods: Remove foods that are irritating your gut or triggering inflammation. Common culprits include gluten, dairy, and refined sugar.
- Get serious about reducing stress: For hormones to be in balance, you must prioritize eliminating sources of chronic stress in your life, improving mental and emotional health, and getting 7-9 hours of sleep each night.
- Support your liver: Your liver is responsible for metabolizing hormones. If your liver is sluggish, it can lead to hormone imbalances. Support liver detoxification by eating cruciferous vegetables like leafy greens daily, sulfur-rich foods like eggs and onions, and limit or avoid alcohol.
- Avoid topical triggers: One of the biggest aggravators for acne is UV radiation from the sun. Make sure to use a mineral based sunscreen, and avoid oxybenzone as it’s a known endocrine disruptor.
- Increase your protein intake: One of the most effective ways to balance blood sugar is to eat a protein-rich diet. Start your day with a solid breakfast with at least 20-30 grams of protein. This will help to stabilize blood sugar, sharpen insulin sensitivity, and improve satiety.
- Walk and lift weights: Regular physical activity, including both aerobic exercise and strength training, can help regulate hormone levels, improve insulin sensitivity, and reduce inflammation, all of which contribute to overall hormonal health.
- Reduce endocrine disruptors: An endocrine disruptor is a chemical or substance that can alter hormone function. They are found in cosmetics, cleaners, pesticides, plastics, and even food. Make swaps to safer skin care and cleaning products, and do not cook with or store food in plastic.

What to Avoid
Topical treatments can help treat hormonal acne naturally by balancing oil production, reducing redness and inflammation, and supporting healthy skin microbiome.
When using products, avoid treatments that are harsh and contain unsafe ingredients that strip the skin of both bad and good bacteria. As tempting as it is to try and get rid of excess oil with harsh cleansers, it’s actually better to use products that help to maintain the skin’s moisture so it doesn’t overproduce oil to compensate for the dryness.
You also what to avoid all acne products that contain known endocrine disruptors, harsh surfactants, benzoyl peroxide, and silicones.
Best Ingredients for Acne-Prone Skin
One of the best safe and effective ways to treat hormonal acne naturally is with plant-based salicylic acid. It’s been shown to help exfoliate dead skin cells and restore the imbalance of bacteria to a healthy level. It also has strong anti-inflammatory effects.
Charcoal is another great safe and effective ingredient that absorbs oil and impurities and clear out pores. And while it may seem counter productive, certain oils, like pumpkin seed oil, can be great for acne-prone skin since it has anti-inflammatory properties, and can help to balance oil production and has
Here is the basic topical treatment plan I recommend for people struggling with hormonal acne:
- Cleanse: Use a gentle pore cleanser with charcoal that removes oil and impurities
- Treat: Use a Charcoal Mask to help balance oil production and prevent brakouts, and a Spot Treatment that contains plant-based salicylic acid when breakouts occur
- Moisturize: Use a Facial Oil with pumpkin seed oil to help balance oil production and reduce redness.
- For scarring: Experiment with a stable Vitamin C Serum to help improve dark spots. This MUST be spot tested first to ensure it works with your skin.
- For body acne: Use a Charcoal Body Bar in the shower on your back, arms, and shoulders to help absorb oil and impurities, and balance the skin.

All of these suggestions must be done in tandem with the recommended changes above to be effective long-term.
Finding a Functional Doctor
While these recommendations might help you treat hormonal acne naturally, I recommend finding a Functional Medicine Practitioner who can order the right tests and come up with a personalized plan for balancing your hormones. A plan that offers long-term success involves gut and liver support, proper nutrition, and lifestyle shifts that prioritize sleep and sleep reduction.
Remember, hormonal acne isn’t just a cosmetic issue, it’s a sign of an underlying imbalance that could lead to serious issues down the road. You are worthy of having your concerns listened to and recognized.
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- HPA Axis Dysfunction: Symptoms, Causes, and Treatment
- 10 Ingredients to Avoid in Skincare and Makeup Products
- Estrogen Dominance: Symptoms, Treatment, & Supplements
- How to Start Cycle Syncing Your Skincare Routine




Tyron Ramthun says
It’s great to come across a blog every once in a while that isn’t the same out of date rehashed material. Fantastic read.
Carol says
Thank you for the skin treatment tips, I would try charcoal mask, seems very promising! It was really hard for me to sleep enough without calming supplements, so I may recommend GABA supplement that helped me to relax and sleep for 8 hours.