Hormonal Acne in Women: What Causes It and How to Support Clearer Skin Naturally

What Is Hormonal Acne in Women — and Why Is It So Persistent?

Hormonal acne isn’t just a teenage issue. Many women in their 20s, 30s, and even 40s experience recurring breakouts — especially around the chin, jawline, neck, and back. This type of acne often flares before your period, worsens with stress, and doesn’t always respond to standard skincare. Unlike surface-level acne, hormonal acne is driven by deeper imbalances — including androgens, inflammation, insulin resistance, and poor hormone clearance. To truly support clearer skin, we need to work from the inside out.

What Causes Hormonal Acne in Women?

While hormonal acne may look like surface-level congestion, it often reflects complex internal processes involving the endocrine, immune, and digestive systems. Let’s break down the key contributors:

1. Androgens and Excess Sebum Production

Androgens like testosterone stimulate the skin’s sebaceous glands, increasing oil (sebum) production. Too much sebum can clog pores and feed acne-causing bacteria.

Androgen activity is often elevated in conditions like:

• Polycystic Ovary Syndrome (PCOS)

• Insulin resistance or high blood sugar

• Chronic stress or poor sleep (which disrupt the HPA axis)

Some women have normal hormone levels but heightened sensitivity to androgens at the skin level — meaning even small fluctuations can trigger breakouts.

2. Low Oestrogen and Hormonal Imbalance

Oestrogen plays a key role in skin hydration, barrier function, and inflammation regulation. When oestrogen is low — as can occur post-pill, during perimenopause, or in restrictive diets — skin becomes more reactive and acne-prone.

Women who stop hormonal birth control may experience a rebound effect known as post-pill acne, often caused by a temporary surge in androgens and low oestrogen.

3. Insulin Resistance and Blood Sugar Dysregulation

Blood sugar imbalances affect hormones in multiple ways. High insulin levels (from frequent snacking, refined carbs, or stress) increase androgen production and boost IGF-1, a growth factor that contributes to:

• Increased skin cell turnover

• More blocked pores

• Inflammation

Stabilising blood sugar is a foundational part of managing hormonal acne naturally.

4. Inflammation: The Common Denominator

Regardless of what triggers a breakout, inflammation determines its severity. Systemic inflammation increases the likelihood of red, painful, cystic acne — and slows healing.

Inflammation can be driven by:

• Poor gut health

• Ultra-processed foods and high sugar intake

• Sleep disruption

• Stress and overtraining

• Environmental toxins

Anti-inflammatory strategies go a long way in calming the skin and supporting resilience.

5. Gut Health and Skin: The Gut–Skin Axis

The gut and skin are closely connected. Imbalances in gut bacteria (dysbiosis), poor digestion, or increased intestinal permeability (“leaky gut”) can contribute to:

• Systemic inflammation

• Impaired detoxification

• Altered hormone metabolism

• Immune overactivation

Supporting the gut with prebiotic fibre, diverse plant foods, digestive support, and fermented foods (if tolerated) often leads to improvements in skin clarity and mood.

6. Impaired Hormone Clearance

Your liver and bowels are responsible for clearing excess hormones — particularly oestrogen. If detox pathways are sluggish or bowel movements irregular, hormones may be reabsorbed and recirculated, worsening breakouts.

To support healthy hormone clearance:

• Include cruciferous vegetables (e.g. broccoli, cauliflower, kale)

• Aim for regular, daily bowel movements

• Stay hydrated and include adequate fibre

Natural Remedies for Hormonal Acne

Supporting hormonal acne from the inside out involves a whole-body approach. While supplements may help, foundational lifestyle and nutrition strategies are key.

✅ Nutrition for Skin Support:

• Zinc: reduces inflammation and supports healing

• Omega-3s: reduce sebum and calm inflammation

• Vitamin A: regulates skin cell turnover (from food or safe supplementation)

• DIM (from cruciferous veg): supports oestrogen metabolism

• Polyphenols: found in berries, green tea, olive oil

✅ Daily Lifestyle Strategies:

• Stabilise blood sugar with protein, fibre, and healthy fats at each meal

• Prioritise sleep and stress management to regulate cortisol and inflammation

• Support gut health and microbial diversity with anti-inflammatory wholefoods

• Choose gentle, non-stripping skincare and avoid over-cleansing

• Avoid dairy or high-histamine foods if you notice a pattern of flare-ups

When to Seek Help

If your acne is painful, persistent, or taking a toll on your confidence, it’s worth seeking support. Conventional treatments like antibiotics or the pill may offer short-term relief but don’t address the underlying imbalances. A naturopathic consultation allows for a thorough assessment of your hormones, gut health, diet, stress, and other factors — so you can get to the root cause and find a solution that actually lasts. You can book in here.

Clear Skin Comes From Within

Hormonal acne is more than skin deep. It's a sign that your body — particularly your hormones, metabolism, and gut — needs support. While topical products can help, true transformation starts on the inside. With the right nutrition, lifestyle changes, and personalised care, it’s absolutely possible to achieve clearer, calmer skin — naturally.

Ready to uncover what’s driving your breakouts? Book a 1:1 naturopathic consultation or explore my ebooks for evidence-based support you can start today.