Treating Hormonal Acne in Women

Woman examining face in mirror
Photo: Vladimir Godnik / Getty Images

Ladies, adult acne is a common problem.  It can also be tough to treat.  Those acne washes and astringents you used as a teen probably won't work for the type of breakouts you're having now.

That's because adult female acne is more likely to be inflamed, deep, and hormonally-driven (like those pimples that appear every month around your period).

But if you're dealing with hormonal acne, there are plenty of treatments that can help get it cleared up and under control.

Topical Treatments for Hormonal Acne

Topical treatments can be effective, especially for mild to moderate acne.

Topical retinoids are a good choice, especially if you also have blackheads and bumpy skin (comedones).  Topical retinoids, like Retin-A and Differin, also have the added benefit of being great age-fighters.

Azelaic acid is another commonly prescribed medication for adult acne.  It treats both inflamed pimples and non-inflamed blemishes.  It can also be used to treat post-inflammatory hyperpigmentation, those dark marks left on the skin after a pimple heals. 

Acne treatments that are becoming more and more popular are combination medications.  These blend two different acne treatments into one medication, clindamycin and tretinoin, for example. 

Many ladies like these medications because they're so quick and simple to use.  And, these combo treatments can work better than the individual medications alone.

Oral Medications for Hormonal Acne

If topical treatments just aren't cutting it, your dermatologist will probably add an oral acne medication to your treatment plan.  Oral medications are commonly used for moderate to severe inflammatory acne, especially nodular acne.

Oral medications aren't used alone.

  You'll probably be prescribed a topical acne mediation, too.

Oral contraceptives (AKA birth control pills) have been used to treat acne for decades, simply because they help to regulate hormone fluctuations. And if you need a birth control option anyway, consider it a win-win.

Spironolactone is another hormonal regulator that is commonly prescribed for adult acne in women.  It can be prescribed along with birth control pills, but is typically reserved for more stubborn, severe breakouts.

If your acne is very inflamed, your dermatologist may also prescribe oral antibiotics.  These are only taken for a short period of time (ideally) just to get a jump start on treatment.

And, if nothing else is working, isotretinoin may just be your best bet.  Also known as Accutane, this medication clears up severe acne that hasn't improved with any other treatment. 

Treating Premenstrual Acne

Does your acne flare every month right before your monthly cycle?  Premenstrual acne is a real phenomenon and can be a maddening problem.  

Want to know what to do for these PMS breakouts?  Here's the article for you:  Premenstrual Acne.

Treating Acne During Pregnancy

There's another time in a woman's life where hormones can trigger acne and wreak havoc on your skin -- pregnancy.

  But treating acne during pregnancy takes special care.  Here's what you need to know about treating pregnancy pimples, Mama: Safely Treating Acne During Pregnancy.


Botros PA, Tsai G, Pujalte GG.  "Evaluation and management of acne."  Prim Care. 2015 Dec; 42(4):465-71.

Dreno B, Layton A, Zouboulis CC, et. al.  "Adult female acne: a new paradigm."  J Eur Acad Dermatol Venereol.  2013 Sep;27(9):1063-70.

Dreno B.  "Treatment of adult female acne: a new challenge."  J Euro Acad Dermatol Venereol.  2015 Jun;29 Suppl 5:14-9.

Lessner e, Fiusher S, Kobraei K, et. al.  "Spironolactone and topical retinoids in adult female cyclical acne."  J Drugs Dermatol.  2014 Feb;13(2):126-9.

Tanghetti EA, Kawata AK, Daniels SR, et. al.  "Understanding the burden of adult female acne."  J Clin Aesthet Dermatol. 2014 Feb; 7(2): 22–30.

Continue Reading