Breakouts that keep appearing along the jawline and chin, often flaring before a period, are commonly called hormonal acne. They are especially common in adult women, but hormones influence acne at every age. Here is why it happens and which treatments work.
Why hormones affect acne
Androgens, a group of hormones present in everyone, stimulate the oil glands to produce more sebum. More oil means a higher chance of blocked pores and inflammation. Fluctuations around the menstrual cycle, pregnancy, starting or stopping hormonal contraception, and perimenopause can all trigger flares. Stress raises cortisol, which can also make breakouts worse.
Signs your acne may be hormonal
- Spots concentrated on the lower face, jawline, chin and neck
- Deeper, tender bumps rather than mainly blackheads
- Flares at the same time each month, often in the week before a period
- Acne that started or returned in your twenties, thirties or forties
When hormones may point to an underlying condition
Acne together with irregular periods, excess facial or body hair, scalp hair thinning or difficulty losing weight can be a sign of polycystic ovary syndrome (PCOS). If you notice these symptoms, see a doctor, who may suggest blood tests.
Treatments that help
Topical treatments
Retinoids (such as adapalene), benzoyl peroxide and azelaic acid are good foundations and help prevent new spots. Azelaic acid is also an option during pregnancy when used under medical advice.
Prescription options
- Combined oral contraceptives: certain types are approved for acne and reduce androgen effects.
- Spironolactone: a medication that blocks androgens at the oil gland, widely used for adult female acne.
- Clascoterone cream: a topical anti-androgen available in some countries.
- Isotretinoin: for severe or scarring acne that does not respond to other treatments.
These treatments need a prescription and medical supervision, as they are not suitable for everyone.
Helpful habits
- Keep a simple routine and apply treatment to the whole lower face, not just existing spots.
- Manage stress where you can, and prioritize sleep.
- Avoid picking deep jawline spots, as they scar easily.
- Note your cycle and breakouts for a few months to share with your doctor.
This article is for general information only and is not a substitute for advice from a doctor or dermatologist.