Acne

Why Adult Women Get Hormonal Acne

Acne in adult women — particularly breakouts along the jawline, chin, and lower face — is one of the clearest indicators of hormonal imbalance. Unlike teenage acne, which is driven primarily by a surge in androgens during puberty, adult hormonal acne often results from fluctuating or excessive androgen levels relative to estrogen throughout the menstrual cycle, perimenopause, or conditions like PCOS (Polycystic Ovary Syndrome).

When androgens like testosterone and DHEA-S are elevated relative to estrogen, oil glands in the skin produce excess sebum, which combines with dead skin cells and bacteria to cause breakouts. Surface treatments often provide only temporary relief because they don't address the hormonal root cause.

Signs of Hormonal Acne

• Breakouts primarily along the chin, jawline, and lower cheeks
• Acne that worsens in the week before your period
• Deep, cystic, or painful pimples rather than surface whiteheads
• Acne accompanied by irregular periods or other hormonal symptoms
• Adult-onset acne that began in your 20s, 30s, or later
• Skin that does not respond well to topical treatments alone

The PCOS Connection

PCOS is one of the most common hormonal disorders in women of reproductive age and is a frequent underlying cause of persistent hormonal acne. Women with PCOS often have elevated androgens, insulin resistance, and irregular cycles — all of which contribute to breakouts. Dr. Risher is experienced in evaluating and managing PCOS as part of a comprehensive hormonal wellness plan.

Our Approach to Hormonal Acne

Dr. Risher begins with a comprehensive hormone panel to identify the specific imbalances driving your skin concerns. Treatment may include targeted BHRT to balance estrogen and androgen levels, nutritional strategies to support healthy hormone metabolism, and additional therapies tailored to your full clinical picture. Most patients see meaningful skin improvement alongside broader improvements in energy, mood, and wellbeing.