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Hormonal Acne Help: St. Louis Dermatologists Explain What Works

  • feigen24
  • May 5
  • 3 min read

Updated: May 6


Profile of a person with hormonal acne touching their face.
A woman gently touches her jaw, highlighting her struggle with hormonal acne.

Struggling with breakouts in your late 20s, 30s, or 40s? You're not alone. Hormonal acne is increasingly common in adults—especially women—and it’s one of the top concerns we treat at Mid-County Dermatology in St. Louis.


As board-certified dermatologists, Dr. Feigenbaum and Dr. Gibstine help patients of all ages address stubborn, cystic acne caused by hormone fluctuations. In this post, we’ll break down what hormonal acne is, what causes it, and how to finally get clear skin again—with real, proven solutions.


What Is Hormonal Acne?

Hormonal acne is caused by shifts in hormone levels—particularly androgens like testosterone—which trigger excess oil production and clogged pores. It often appears in adults, especially women, and shows up as deep, painful pimples around the chin, jawline, and cheeks.


What triggers hormonal acne?

  • Menstrual cycles

  • Stopping or starting birth control

  • PCOS (polycystic ovarian syndrome)

  • Pregnancy or postpartum changes

  • Perimenopause


How to Know If Your Acne Is Hormonal

Wondering if your acne is hormone-related? Here are some signs to look for:

  • Breakouts that flare around your period

  • Painful cysts under the skin, often on the lower face

  • Persistent acne that doesn’t respond to typical treatments

  • Oily skin and clogged pores that don’t improve with OTC products


What are the best treatments for hormonal acne?

At Mid-County Dermatology, our board-certified dermatologists provide personalized, science-backed care for hormonal acne. These are the most effective treatments available today.


1. Topical Retinoids

Retinoids like tretinoin, adapalene, and tazarotene are essential for treating hormonal acne. They help unclog pores, reduce inflammation, and improve cell turnover. These prescription-strength creams are often the foundation of acne treatment.


2. Oral Spironolactone

This oral medication is a cornerstone of hormonal acne treatment for women. It blocks androgen receptors and reduces oil production. It’s especially effective for adult women with persistent acne along the jawline, chin, or neck—often triggered by menstrual cycles or hormonal shifts.


3. Topical Spironolactone (Winlevi®)

Winlevi (clascoterone 1%) is the first FDA-approved topical anti-androgen for acne. Applied directly to the skin, it works locally to block androgen activity without systemic effects. It's a great option for teens or adults who want a non-pill solution.


4. Hormonal Birth Control Pills

Certain combination birth control pills help regulate hormones that cause acne. Those containing ethinyl estradiol paired with norgestimate, norethindrone, or drospirenone are FDA-approved for acne treatment. These can be especially helpful in managing cyclical flares.


5. Isotretinoin (Accutane)

In severe or treatment-resistant cases, isotretinoin may be considered. Although it’s not hormone-specific, it drastically reduces oil gland activity and often results in long-term acne clearance.


6. Evidence-Based Dietary Adjustments

While diet alone won’t cure hormonal acne, research suggests some changes may help reduce inflammation and androgen-related flare-ups:

  • Low-Glycemic Diet: Reducing sugar and refined carbohydrates may lower insulin levels and help balance hormones.

  • Dairy Reduction: Skim milk in particular has been associated with acne in some studies. Consider switching to dairy alternatives.

  • Omega-3 Fatty Acids: Foods like salmon, walnuts, flaxseeds, and chia seeds may help reduce inflammation and support skin health.


7. Supportive Skincare Routine

Daily skincare habits matter. Use products that support your treatment plan, such as:

  • Salicylic acid or benzoyl peroxide cleansers

  • Non-comedogenic moisturizers like Cetaphil or Vanicream

  • Mineral-based sunscreen (with zinc oxide or titanium dioxide)

Avoid harsh scrubs or pore-clogging oils that may worsen hormonal acne.


When to See a St. Louis Dermatologist for Hormonal Acne

If you’ve tried multiple products with little success, if your acne is causing scarring, or it is affecting your confidence, it’s time to visit a board-certified St. Louis dermatologist.

Hormonal acne often requires a comprehensive plan that combines medical treatment, skincare, and lifestyle guidance. That’s what we deliver at Mid-County Dermatology.


Schedule Your Hormonal Acne Consultation in St. Louis

Our team at Mid-County Dermatology—led by Dr. Feigenbaum and Dr. Gibstine—offers personalized care for teens and adults with acne, including effective treatments for hormonal breakouts.

📍 Conveniently located in Missouri Baptist Hospital

📞 Call us at (314) 994-0200

 
 
 

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