Stubborn acne on your chin, jaw, neck or back? It could be hormonal acne

Reviewed by Theresa H. Care Delivery Manager & Family Nurse Practitioner

Time saver 3 min read

Many people experience the occasional pesky pimple. But when acne breakouts are a constant occurrence, it can be super frustrating and lead you down the rabbit hole of trying every acne product on the market.

Not all acne is alike, though, and to treat it effectively, you need to know what’s behind your breakouts. And if you experience stubborn acne on your chin, jawline, neck, chest or back, you likely have what’s known as hormonal acne.

What causes hormonal acne?

Hormonal acne can affect anyone, but it’s much more common for people assigned female at birth, especially those who are in their 20s, 30s and 40s. That’s because hormones fluctuate greatly throughout a woman’s monthly cycle, with rising and falling levels of estrogen, progesterone and androgen hormones like testosterone. Medical professionals point to these shifts in androgen hormones as being the main culprit behind many cases of hormonal acne. As hormone levels increase, oil glands ramp up production, producing more sebum, which can clog skin pores and lead to pimples and acne outbreaks.

Cystic vs. hormonal acne

It can be hard to know whether severe, chronic acne breakouts are cystic or hormonal. One major clue is where the outbreaks occur. With hormonal acne, outbreaks tend to affect the lower part of the face, but may also occur on the neck, back and chest. Cystic acne outbreaks are more widespread, affecting the entire face and potentially skin on the buttocks, shoulders and upper arms as well as the neck, chest and back.

While hormonal acne is mainly caused by hormones, cystic acne is caused by bacteria that becomes trapped in skin pores. When trapped, the bacteria cause swelling in the skin’s layers, and cysts can form. Additionally, dermatologists point to family history, hormones and age as possible contributing factors. Cystic acne is considered the most severe form of acne and, due to its severity, prescription medications like isotretinoin are often needed to effectively treat and heal it.

How to treat hormonal acne

It’s difficult to treat hormonal acne on your own, because over-the-counter (OTC) acne medications don’t affect hormones and can actually dry out and irritate your skin, making acne worse. Thankfully, there are prescription medications that are very effective at clearing up and healing hormonal acne.

Treatment options for hormonal acne

Oral contraceptive pills – Certain birth control pills have been approved by the Food and Drug Administration for treating acne. These oral contraceptive and acne medications contain the hormones estrogen and progesterone, which help reduce androgen hormone levels. Oral contraceptive pills that only contain progesterone – also known as the mini pill – are not effective against acne and can even make acne worse.

It’s safe for most women to take oral contraceptive pills, but some women may experience side effects like nausea and an increase in blood pressure.

Spironolactone – Spironolactone is an oral high blood pressure medication that’s also commonly prescribed to treat hormonal acne. This medication helps clear persistent acne by reducing androgen hormones and the oil and sebum they trigger the skin to produce. According to the American Academy of Dermatology, people who took spironolactone to treat acne saw a 50 to 100 percent reduction in breakouts. Only women can safely take spironolactone, and it’s important to not become pregnant while taking this medication.

INSIDER TIP

In addition to consistently following the directions in your acne treatment plan, make sure any OTC products or makeup you use are labeled as oil free, non-comedogenic, non-acnegenic or products that won’t clog pores.

Online hormonal acne treatment that’s simple and affordable

Good news! You no longer have to wait for a dermatology appointment or drive to a clinic to get the acne care and treatment you need. With an online acne visit at Virtuwell, simply answer a few questions and upload photos of your skin from the comfort of your own home. One of our clinicians will provide an acne treatment plan that’s tailored to your skin’s needs, complete with medications and prescriptions and helpful skincare tips – all within about 24 hours.

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