The Best Hormonal Acne Treatments, According to Experts

If you asked me what my longest relationship is to date, I wouldn’t mention the eight-year stint with my childhood sweetheart. Truthfully, my longest relationship is one I entered by force and that constantly pulls me to my mirror to revel (and loathe) in the evidence of our love affair: hormonal acne.

My years-long struggle with hormonal acne is what led me to become a beauty editor in the first place. Filled with questions and lacking sufficient answers from the unofficial experts I refer to as my parents, I left no gentle cleanser, exfoliating toner, reparative retinol serum, or sunscreen untested. As you can imagine, applying, wiping, and patting a multitude of formulas onto my skin in a desperate attempt to heal my acne left my skin barrier battered and bruised—quite literally (post-acne scarring is another relationship I’m eager to part with). It wasn’t until I consulted with a dermatologist and enhanced my skin care knowledge through years of work-related research that I finally cracked the code to effectively treating those pesky visitors. Our relationship persists, though not as strong as before, serving as a testament to the guidance from my skin experts. The flattened, slightly faded dark spots are a subtle but welcome sign that my goal of achieving clear, even, smooth skin is almost within reach.

If you’re dealing with hormonal acne and feel jaded from the lack of visible results, I polled dermatologists to learn about the most effective treatments and products to properly treat hormonal acne.

What is hormonal acne?

Hormonal acne isn’t brought on by anything other than what its name suggests—hormones. While it’s easy for experts to diagnose, treating it isn’t always a walk in the park. “Hormonal acne refers to acne that is thought to be influenced by hormones and typically appears along the jawline, chin, and lower face. It can also occur on the chest and back,” says Dr. Marisa Garshick, ELLE Beauty Advisory member and board-certified dermatologist of MDCS Dermatology. It results from fluctuations in the body, “particularly androgens (dihydrotestosterone),” adds Dr. Pooja Rambhia, board-certified dermatologist at Union Derm. Hormonal acne is typically prevalent among teenagers (for obvious reasons), but impacts “especially women in their 20s through 40s. Unlike typical breakouts, hormonal acne tends to be deeper and more inflammatory and presents as painful cysts beneath the skin,” Dr. Rambhia explains.

Similar to regular acne, the culprit is excess oil production. “Hormonal changes increase oil production and disrupt cell turnover, creating an environment where acne-causing bacteria thrive. While over-the-counter treatments may help mild cases, more severe hormonal acne often requires prescription medications that target the underlying hormonal imbalance,” Dr. Rambhia shares.

How can I tell if I have hormonal acne?

Hormonal acne initially exists under the skin, but materializes on the surface in the most visible area, or what Dr. Rambhia calls “beard area.” She suggests paying close attention to when you notice a breakout forming. “If you notice your breakouts follow a cyclical pattern, often flaring up before or during your menstrual cycle, this strongly suggests a hormonal component. You might also notice your acne worsening during times of stress or significant hormonal changes, such as pregnancy or starting/stopping birth control,” Dr. Rambhia adds.

You can also tell you have hormonal acne if none of your skin care products seem to be working. “Adult-onset acne, especially if you had clear skin as a teenager, often points to hormonal factors. You might also notice your acne appears alongside other hormonal symptoms like irregular periods or excess facial hair. If you recognize these patterns, I recommend consulting a board-certified dermatologist for proper diagnosis and treatment, as hormonal acne often requires a different approach than traditional acne care,” she advises.

What ingredients help stave off hormonal breakouts?

According to Dr. Garshick, you can treat hormonal acne similarly to regular acne. “The same ingredients that help to reduce acne in general can also be helpful for hormonal acne, including ingredients like salicylic acid, benzoyl peroxide, and retinoids. Ingredients that may be especially helpful for hormonal acne include spironolactone, clascoterone (a topical version of spironolactone, known as Winlevi) or certain oral-contraceptive pills,” she shares.

What does a standard skin care routine look like for someone with hormonal acne?

To avoid aggravating the skin further, Dr. Rambhia suggests a “gentle and strategic” approach. “Remember, consistency is more important than complexity,” she says. Your checklist should hit all these points:

Cleanser: “Generally, a standard skin care routine includes a gentle or medicated cleanser containing acne-fighting ingredients, like benzoyl peroxide or salicylic acid,” says Dr. Garshick. A gentle, hydrating cleanser removes dirt and debris without stripping your skin. Since the other areas in the routine might require a more potent formula, cleansing should be as gentle as possible, whether morning or night.

Targeted serum: Several reparative serums help brighten the skin, including vitamin C, retinol, and Dr. Rambhia’s favorite, azelaic acid, which “helps fight bacteria and fade dark spots.”

Moisturizer: Look for the words “non-comedogenic” when shopping for a moisturizer, as it doesn’t clog the pores and features lightweight ingredients perfect for acne-prone skin.

Sunscreen: “Sunscreen is vital in an anti-acne regimen, as some acne-fighting ingredients make the skin more sensitive to the sun and it also helps to prevent pigmentation associated with acne scars,” shares Dr. Garshick.

The same rules apply for the evening. However, you can skip the sunscreen—just double-cleanse in the evening to eliminate all traces of sunscreen, makeup, and anything else on your skin.

Beyond products, what in-office treatments are worth it?

In my experience, I didn’t start seeing a drastic improvement in my hormonal acne until I incorporated derm- and esthetician-backed treatments into my routine. The most common treatments to address hormonal acne are laser facials and chemical peels, two powerful therapies that flattened my breakouts and faded post-acne scarring.

“Laser technology can safely and painlessly penetrate the surface layers of the skin to reach the dermis where it can reduce sebum production, suppress inflammation, and destroy p.acnes (or Propionibacterium or Cutibacterium acne) bacteria, clearing current acne and preventing future breakouts. Its deep heating energy also helps to build collagen, reducing the appearance of acne scars,” explains Dr. Roberta Del Campo, chief medical officer of Skin Laundry.

At Skin Laundry, the viral Signature Laser technology “bypasses that top layer of skin, the epidermis, and targets that second layer to hit three different types of chromophores. Most lasers might treat one chromophore or two, but the wavelength of our lasers targets all three chromophores, allowing us to treat different skin concerns at once,” she adds.

Dr. Ken Rothaus, co-founder and chief medical officer of Telo Labs, concocted a menu of laser services focusing on skin longevity. The clinic offers guests various laser services, including my favorite, the Signature Facial. “The Telo Signature Facial is a great addition for someone looking to help control their acne, tighten pores, or decrease hyperpigmentation to add to their skin care regimen,” Dr. Rothaus adds. The non-ablative laser uses a 1064nm Nd:YAG wavelength to “stimulate collagen production, leading to a smooth, glowing complexion.”

If lasers sound intimidating, skin peels can be beneficial, too. “Chemical peels represent a cornerstone of professional treatment. Salicylic acid peels are particularly effective because this beta-hydroxy acid is oil-soluble, allowing it to penetrate deep into pores where hormonal breakouts begin. Typically administered in concentrations of 20 to 30 percent, these peels clear current congestion and help fade the stubborn post-inflammatory hyperpigmentation that makes hormonal acne so frustrating. A series of treatments spaced four to six weeks apart often yields optimal results,” says Dr. Rambhia.

Many skin spas offer chemical options, but if you’re looking for a non-chemical option, a herbal alternative exists: the Schrammek Green Peel. “First and foremost, it consists entirely of natural ingredients. The blend of herbs is free of acids, synthetic peeling agents, and any harmful substances; it encourages the skin’s natural regeneration process, promoting the growth of healthy new skin cells and activates new collagen production,” says Samantha Susca, lead esthetician at Casa Cipriani New York. Green in color and composition, the peel also reduces redness and inflammation.

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As a leading publisher of fashion, lifestyle, and beauty content, ELLE.com is committed to highlighting the best products in various categories by personally testing the latest and most innovative products, interviewing countless experts, and vetting customer-loved items. For this piece, beauty editor Nerisha Penrose polled skin experts about the best practices and products for treating hormonal acne.