Acne flare-ups often happen around hormonal changes because these shifts boost oil production in your skin, clog pores, and spark inflammation. Hormones like estrogen, progesterone, cortisol, and androgens play key roles in this process, making breakouts more likely during certain life stages.
Think about puberty first. During this time, your body ramps up hormone levels, especially androgens. These tell your skin’s oil glands, called sebaceous glands, to make more sebum, that thick oil that keeps skin moist. Too much sebum mixes with dead skin cells and blocks pores, leading to pimples, blackheads, and cysts.[3]
Women see this a lot with menstrual cycles. Right before your period, progesterone rises while estrogen drops. This combo increases sebum and makes skin more prone to irritation. The result? Cystic acne along the jawline or chin that pops up like clockwork each month.[2]
Pregnancy brings big hormonal swings too. Early on, higher progesterone levels crank up oil production, often causing breakouts on the face or back. These usually calm down later, but they can feel frustrating when your skin changes so fast.[3]
Stopping birth control pills is another common trigger. These pills keep hormones steady to prevent acne, but quitting lets natural levels fluctuate wildly. Many women notice sudden breakouts after years of clear skin.[1]
Stress adds fuel to the fire. When you’re anxious, your body pumps out cortisol, a stress hormone. Cortisol boosts oil production just like androgens do, turning minor worries into major pimples.[1][2]
Perimenopause and menopause hit later in life. Estrogen drops while androgens stay steady or rise relative to it. This imbalance leads to adult acne that’s often deeper and harder to treat, with more sensitivity around the lower face. It’s on the rise, but doctors are still learning the best ways to handle it alongside skin thinning and dryness.[1][4]
These hormonal shifts don’t affect everyone the same. Some people have oily teenage skin that clears up, while adult acne feels drier but just as stubborn. The cycle of hormones, oil, clogs, and bacteria feeding on it all creates the perfect storm for flare-ups.[1][2]
Sources:
https://www.oreateai.com/blog/understanding-acne-causes-triggers-and-solutions/f88ee5ac12abf0411691321d54966900
https://glimmergoddess.com/pages/types-of-acne-explained-hormonal-vs-bacterial-vs-fungal-vs-sensitive-skin-acne
https://www.dermatologyadvisor.com/factsheets/diet-and-acne/
https://www.dermatologytimes.com/view/dermatology-times-2025-year-in-review-acne
