So you escaped acne in your teens.  You did it!  You’re home free. You made it!

Well…not so fast.  Instead of celebrating your good luck, reality strikes and you start to notice the beginnings of acne in your 20s, 30s or even 40s.  You think to yourself, is this possible? Can I actually be having acne at my age?

The unfortunate answer is…Yes.  Not only is it possible, it’s actually very common.

Experiencing acne for the first time in one’s 20s, 30s or 40s happens all the time.

But wait.  There’s more.  Not only is acne common later in life, but hormonal acne commonly rears its head for the first time in 20 year olds…30 year olds…and believe it or not, even in 40 year olds.

But you’re still not buying it.  Just wait one minute, you think to yourself.  Everybody knows that acne is supposed to happen to teenagers.  It’s a rite of passage in high school, isn’t it?   Acne is not something that happens to grown ups…is it?

Hormonal acne can happen to adults

Well, now’s a good time to learn more about hormonal acne.  For a more detailed explanation of this form of acne, please visit our prior blog post here.

Generally speaking, there is no absolute definition of hormonal acne.  In fact, all acne is rooted in the activities of hormones.  Furthermore, there are different scenarios that can fit into the hormonal acne column.

Nevertheless, we typically refer to hormonal acne as a recognizable pattern of acne breakouts usually along the jaw lines and lower face of female acne sufferers.  We further consider acne that flares along with a woman’s menstrual period to be within the overall grouping of hormonal acne cases.

So besides its tendency to show up in a recognizable context or pattern of breakouts, what makes hormonal acne so different than run-of-the-mill acne?

Well for one, hormonal acne is a form of acne that doesn’t follow the rules.

For example, hormonal acne keeps its cards close the vest.  Instead of showing up when acne is usually expected in teenagers, it typically strikes when we’re least prepared.  Acne sufferers commonly experience the onset of hormonal acne in their 20s, 30s or even in their 40s.

And after catching us off guard, it frustrates us even further as it pays no attention to proven therapies.  It shrugs-off conventional prescription treatments such as topical prescription gels, creams and lotions which typically provide almost no relief from hormonal acne.

Likewise, oral antibiotics which are commonly prescribed for many forms of acne are no match for this acne type.  Hormonal acne is mostly unaffected by antibiotic pills.

Options for treating hormonal acne

So what can you do when hormonal acne enters your life?

Well, the good news is that we do have some very effective therapies.

For hormonal acne that mostly features breakouts surrounding the menstrual period, oral contraceptive pills (OCPs), also known as birth control pills, can often be very helpful.  Because of their ability to regulate acne causing hormones, OCPs can often lead to significant improvement of hormonal acne.

Another effective treatment for hormonal acne is a pill called spironolactone.  Spironolactone is a prescription pill that can be very effective for stopping hormonal acne.  It works by interfering with the actions of acne-causing hormones to prevent acne from starting in the first place.

Spironolactone is a very old pill that was originally developed many years ago as a blood pressure medication for which it is still commonly used.  However, acne dermatologists take advantage of an unrelated activity of spironolactone in which it interferes with androgenic hormones which are the hormones that cause acne.

Spironolactone is a very helpful treatment for hormonal acne in women because it works at the very source of this acne type.  It is generally very effective for women with hormonal acne and is usually tolerated very well.  Spironolactone can often maintain clear skin in many women who take this medication.

One of the downsides of spironolactone for hormonal acne, however, is the drawback that once the medication is discontinued, there is a reasonable chance that acne will return.  Because of this, many women dicide to take spironolactone for a long time.

In the case that spironolactone doesn’t prove effective for some cases of hormonal acne, a medication called Accutane can be a very effective option.

Accutane is considered by most dermatologists to be the most effective treatment for hormonal acne that exists.  Unlike spironolactone, there is a defined endpoint in the treatment course, usually between 6 and 8 months.  At the conclusion of treatment, there is a good chance of remaining clear without an acne relapse.

With this information in hand, acne sufferers can seek treatment with an acne dermatologist to take back control over the unexpected occurrence of hormonal acne.

The Advanced Acne Institute is a unique dermatology practice located in Miami, Florida specializing only in the treatment of acne.   We focus solely on providing the most effective treatments to help our patients achieve clear skin.  We are pleased to share our insights and perspectives in acne treatment as an educational service, however this information is provided strictly for educational purposes only and should not be considered medical advice and is not a substitute for seeking the advice and treatment by an appropriate medical professional.


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