What Causes Breakouts After Hormonal Therapy
Hormonal therapy aims to balance hormones to clear skin, but sometimes it leads to unexpected breakouts. These flare-ups happen because the body adjusts to new hormone levels, causing temporary shifts in oil production and skin sensitivity.
Hormones like androgens, which include testosterone, tell your skin’s oil glands to make more sebum, the natural oil that keeps skin moist. When hormonal therapy starts, such as birth control pills, spironolactone, or treatments for menopause, it can disrupt this balance at first. For example, switching birth control methods might spike androgens briefly, leading to more oil and clogged pores.[1][2][4] This clogs hair follicles with dead skin cells and oil, creating a spot for bacteria like Cutibacterium acnes to grow and cause pimples.[1][3]
In women, common triggers include starting or stopping hormonal birth control, which mimics puberty-like changes and boosts oil in areas like the jawline and cheeks.[2][4] During perimenopause or menopause, therapy to replace dropping estrogen can leave androgens unchecked temporarily, making skin drier yet more prone to inflammation and breakouts.[5][6] Pregnancy-related therapies or those for polycystic ovary syndrome (PCOS) can also cause surges that overstimulate glands.[1][4]
Stress plays a role too, as it raises cortisol, which worsens oil production during therapy adjustments.[1][7] Other factors like comedogenic creams, sweat, or high-sugar diets can amplify these effects by adding inflammation or pore blockages.[2][7]
These breakouts often appear as red, inflamed pimples or cysts because excess sebum feeds bacteria and triggers immune responses.[1][2] The good news is they usually fade as your body adapts to the therapy, often within weeks to months.[3]
Sources
https://www.medicaldaily.com/hormonal-acne-adults-acne-causes-skin-hormones-explained-474128
https://www.draliabadi.com/blog/hormonal-acne/
https://pmc.ncbi.nlm.nih.gov/articles/PMC12691598/
https://www.tuftsmedicine.org/about-us/news/acne-over-30
https://www.newriverdermatology.com/blog/how-to-manage-hormonal-acne-during-menopause
https://www.draliabadi.com/menopause/perimenopause-and-acne/
https://www.westchestercosmeticdermatology.com/blog/adult-acne-why-it-happens-and-how-to-treat-it/
