Aesthetic Treatments for Hormonal Acne

Last updated: 5 August 2026

Understanding hormonal acne

Hormonal acne is a common condition that predominantly affects adult women, often persisting well beyond the teenage years or appearing for the first time in the twenties, thirties, or even forties. Unlike adolescent acne which tends to affect the entire face, hormonal acne typically presents along the lower face, the jawline, chin, and perioral area, and follows a cyclical pattern linked to the menstrual cycle.

We understand the significant impact that hormonal acne has on confidence and quality of life. Clinics offer a range of aesthetic treatments that complement medical management to address both active breakouts and the scarring they leave behind.

The hormonal mechanism

Hormonal acne is driven by androgens, particularly testosterone and its derivative dihydrotestosterone (DHT), which stimulate sebaceous gland activity:

• Androgen sensitivitywomen with hormonal acne often have normal hormone levels but increased sensitivity of their sebaceous glands to circulating androgens
• Sebum overproductionandrogens stimulate sebaceous glands to produce excess sebum, creating an environment favourable for bacterial overgrowth
• Follicular hyperkeratinisationhormonal influences cause excessive keratinisation of the follicular lining, leading to pore blockage
• Inflammationblocked, sebum-filled pores become inflamed, particularly when colonised by Cutibacterium acnes (formerly Propionibacterium acnes)
• Cyclical patternbreakouts typically worsen in the luteal phase of the menstrual cycle (the week before menstruation) when progesterone levels rise, stimulating sebum production

Common hormonal triggers

• Menstrual cycle fluctuations
• Polycystic ovary syndrome (PCOS)
• Starting or stopping hormonal contraception
• Perimenopause and menopause
• Pregnancy and postpartum hormonal shifts
• Stress (cortisol stimulates androgen production)
• Insulin resistance (elevated insulin increases androgen activity)

Aesthetic treatment options

Chemical peels for active acne

• Salicylic acid (BHA) peelsoil-soluble, penetrate into pores, reduce sebum production, and have antibacterial and anti-inflammatory properties. The first-choice peel for active acne
• Mandelic acid peelsgentle enough for sensitive, acne-prone skin with antibacterial properties
• Azelaic acidanti-inflammatory and antimicrobial, also helps with post-inflammatory hyperpigmentation
• Jessners peelcombination of salicylic acid, lactic acid, and resorcinol for more stubborn acne

LED Light Therapy

• Blue light (415nm)targets and destroys Cutibacterium acnes through photodynamic activation of bacterial porphyrins. Evidence-based treatment for mild to moderate inflammatory acne
• Red light (633nm)anti-inflammatory effects, promotes healing, and can be combined with blue light for enhanced results
• Treatment protocol: Typically 2-3 sessions per week for 4-6 weeks

Microneedling for acne scarring

• Creates controlled micro-injuries that stimulate collagen remodelling
• Effective for ice pick, rolling, and boxcar acne scars
• Can be combined with PRP for enhanced results
• Not suitable during active breakouts, treat active acne first
• Course of 3-6 sessions spaced 4-6 weeks apart

Laser Treatments

• Fractional CO2 or Erbium laserfor significant acne scarring, creates controlled thermal zones that trigger deep collagen remodelling
• Non-ablative fractional laserless downtime, stimulates collagen without removing surface skin
• 1450nm diode lasertargets and reduces sebaceous gland activity
• Pulsed dye laseraddresses persistent post-acne erythema (redness)

Skin boosters and regenerative treatments

• Polynucleotidesanti-inflammatory properties may help calm acne-prone skin whilst improving skin quality
• Profhiloimproves skin quality and may be used once active acne is controlled. Not suitable during active breakouts

Complementary skincare for hormonal acne

A well-designed skincare routine is essential for managing hormonal acne alongside in-clinic treatments:

• Gentle cleansernon-stripping, pH-balanced cleanser (avoid harsh soaps that strip the barrier)
• Niacinamide (5-10%)reduces sebum production, minimises pores, and has anti-inflammatory properties
• Salicylic acid (2%)daily BHA to maintain clear pores
• Azelaic acid (15-20%)prescription or over-the-counter, addresses inflammation and post-inflammatory hyperpigmentation
• Retinoidsvitamin A derivatives normalise follicular keratinisation. Start with retinol and progress to prescription tretinoin if tolerated
• SPF 50essential, particularly as many acne treatments increase photosensitivity. Choose oil-free, non-comedogenic formulations
• Non-comedogenic moisturisereven oily, acne-prone skin needs hydration. Barrier damage worsens acne

Medical Management

Aesthetic treatments work best alongside appropriate medical management. We encourage patients to work with their GP or dermatologist for:

• Hormonal assessmentblood tests for testosterone, SHBG, DHEAS, and other markers if hormonal imbalance is suspected
• Anti-androgen therapyspironolactone (off-label) or co-cyprindiol (Dianette) can reduce androgen effects on the skin
• Topical prescription treatmentstretinoin, adapalene, benzoyl peroxide, or topical antibiotics
• Oral antibioticsfor moderate inflammatory acne (not long-term due to resistance concerns)
• Isotretinoin (Roaccutane)for severe or treatment-resistant cases, prescribed by dermatologists

Lifestyle and dietary considerations

• Dairyemerging evidence links dairy (particularly skimmed milk) to acne exacerbation through IGF-1 pathways
• Glycaemic indexhigh-GI diets increase insulin and subsequently androgen activity. Low-GI diets may improve acne
• Stress managementchronic stress elevates cortisol and adrenal androgens
• Sleepadequate sleep supports hormonal balance and skin repair
• Gut healththe gut-skin axis is an area of active research; probiotics may have a role

“Hormonal acne requires a multimodal approach that addresses the underlying hormonal drivers whilst simultaneously treating the skins manifestation of the condition. Aesthetic treatments matters alongside medical management.”, British Association of Dermatologists

Frequently asked questions

Summary

Hormonal acne is a complex condition that benefits from a comprehensive approach combining aesthetic treatments, medical management, targeted skincare, and lifestyle modifications. We work with each patient to develop a personalised treatment plan that addresses their active acne, treats existing scarring, and establishes a maintenance strategy for long-term skin health and confidence.