Acne is a nightmare for millions around the world. Almost everyone suffers from acne at some point in time in their lives. Acne is chronic in nature and is characterized by skin breakouts especially on face, neck, shoulders, back and upper arm. Children, women, and men of any age can experience these skin breakouts. Teenagers suffer most from acne because of the increased hormonal fluctuations in their bodies.
According to the American Academy of Dermatology (AAD), around 40-50 millions of Americans have acne at any given time. 
Acne appears when the skin pores are blocked by dead skin cells or sebum (oil). Bacterial skin infections also cause acne. Hormonal changes, stress, sleep deprivation, hectic lifestyle, and consumption of highly processed junk foods are some of the other factors causing acne.
What is Hormonal Acne?
To be precise, most of the acne is hormonally driven including the acne experienced during puberty. According to Dr. Samer Jaber, Founder of Washington Square Dermatology, New York, people most commonly refer to acne in adult women as hormonal acne. He says that adult acne is quite common among women in their 20s, 30s, 40s and also 50s. According to another study cited by AAD, around 50% of women in 20s and 25% women between 40 and 49 are affected by hormonal acne. Dr. Jaber adds that hormonal acne needs to be treated with extra precaution and care.
Causes of Hormonal Acne
According to Dr. Jennifer MacGregor, dermatologist at Union Square Laser Dermatology, New York, hormonal acne is associated with menstrual cycle and the changes in estrogen and progesterone level. While another article says that hormonal fluctuations cause increased oil production in the skin pores leading to skin breakouts. Also, the ratio of progesterone to estrogen can have significant effect on the woman’s testosterone levels, also resulting in acne.
MacGregor describes that the hormonal acne occurs or gets worse with the menstrual cycles. Generally, hormonal acne is worst just before the period starts owing to the increased progesterone level.
Women might experience hormonal acne during menopause, as the female hormone drops drastically.
You can recognize hormonal acne by looking for its signs that include flares each month, distribution of painful and deeper pimples around jawline, mouth, or lower face. In case you have an oily skin, you might experience blackheads, whiteheads or T-zone acne which is not actually hormonal acne. MacGregor emphasizes that stress can aggravate all kinds of skin inflammation including all types of acne.
Treatment of Hormonal Acne
Unfortunately, hormonal acne is resistant to most of the over-the-counter treatments, but adding these to hormone-specific treatments ensures a complete treatment. Easily available toners and acne treatments are not strong enough to treat stubborn hormonal acne. There are few things you can try to treat hormonal acne. These include topical treatments, changing diet and consuming oral medications.
Jaber advises to cut down on dairy and sugar if you are suffering from hormonal acne. He also asks the patients to eliminate simple sugars from diet. These dietary changes can work for some people and might not for others. He also recommends using topical treatments such as antibiotics, retinoids, anti-inflammatories, benzoyl peroxide or salicylic acid.
MacGregor advises a two-month dairy-free and gluten-free diet for clearing acne. Blood sugar elevation can cause hormonal fluctuations and exacerbate acne. She recommends paleo diet with carbs that are mostly root vegetables like carrot and squash potato with quinoa, brown rice, or gluten free oats. She emphasizes the importance of oral medications in treating hormonal acne. The most common oral medications are the birth control pills that can regulate the menstrual cycle and eventually reduce acne.
Jaber believes that one possible treatment of hormonal acne is to use a birth control pill that has both progestin and estrogen. Another option is a blood pressure medication spironolactone, which can block the effects of testosterone and can reduce hormonal acne.
For very severe cases of hormonal acne, MacGregor recommends a trial course of a vitamin A derivative known as isotretinoin. However, isotretinoin might not always work. For mild cases, she recommends dapsone, an anti-inflammatory prescription medicine that is effective in treating hormonal acne.
Is It Actually Possible to Get Rid of Hormonal Acne?
By following a consistent therapy (oral, topical, or sometimes both), hormonal acne can be controlled. Treatment might also involve laser therapy and injections. However, if a person decides to discontinue the medications and topical treatment, the acne might or might not reoccur. Jaber recommends continued use of topical treatment, even if you wish to discontinue the oral medications.
Consulting a dermatologist to plan out an effective acne treatment is of utmost importance. The treatment requires persistence and a thorough expert guidance. While you might struggle to not pick at your skin for all the obvious reasons.
You can also refer home remedies for treating acne naturally.