Still breaking out even though your teen years are long behind you? You’re not alone. If it feels like your skin didn’t get the memo that puberty is over, you're in good company.
Hormonal acne is super common in your 20s, 30s, and even beyond – especially for women navigating things like period changes, birth control, stress or other hormonal curveballs. And while it’s seriously frustrating (especially when nothing seems to work), understanding what’s going on beneath the surface can help you take back control. You can support your skin – yes, from the inside out.
Let’s Clear Up a Few Acne Myths
There’s a ton of bad info out there about acne – like the idea that it’s caused by dirty skin or that a miracle cleanser will fix everything overnight. The truth? Your skin is your body’s largest organ, and what’s going on internally shows up externally.
Myth 1: Acne only happens to teenagers.
Nope. While it often starts in your teens, adult acne is incredibly common. Many women break out for the first time in their 20s or 30s – especially during hormonal shifts like pregnancy, coming off the pill or perimenopause
Myth 2: It’s just about your bad diet.
Food can play a role (especially if it spikes blood sugar or ramps up inflammation) but acne usually runs deeper. Hormones, stress and genetics are big players. That chocolate bar isn’t solely to blame. That said, a balanced, nutrient-dense diet does help support clearer skin – more on that below!
What’s Actually Happening in Your Skin?
Acne is an inflammatory skin condition that starts deep in the pilosebaceous unit – a fancy term for your hair follicle and the oil gland attached to it.
The Acne Timeline
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Your skin starts producing more oil (hello, hormones).
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Dead skin cells don’t shed properly, clogging a pore.
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Bacteria move in, overgrow and cause inflammation.
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Result? Spots, redness and sometimes deeper cysts.
Why Are You Breaking Out?
There’s no single cause, which is exactly what makes acne so tricky to treat. What triggers one person might do nothing to another. That said, these are common factors behind adult acne:
Genetics
If acne runs in your family, you might be more prone to it. Some people naturally produce more oil or have skin that reacts more intensely to hormonal shifts. It’s not your fault – just your biology.
Hormonal Changes
One of the biggest drivers of adult acne is hormones. Androgens (like testosterone) increase oil production, clog pores and initiate the acne cycle – often leading to deep, stubborn breakouts.
Triggers: Stress, Sleep & Lifestyle
Chronic stress can spike cortisol, which throws your skin off balance. Toss in poor sleep, gut issues, or environmental toxins, and your skin has a lot to deal with. These factors don’t cause acne alone but they can definitely amplify it – especially if your skin is already struggling with hormonal fluctuations.
Hormones & Acne: What’s the Connection?
Stress spikes cortisol, which can mess with your skin’s balance. Add in poor sleep, gut imbalances or environmental toxins, and your skin is working overtime. These don’t cause acne outright, but they can definitely make it worse – especially if your skin is already struggling to cope with hormonal fluctuations.
Here’s why:
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As your period approaches, oestrogen and progesterone levels drop.
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Meanwhile, testosterone (an androgen) stays relatively steady.
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The result? A relative increase in androgens, which ramp up your skin’s oil production.
More oil = more clogged pores = more breakouts.
This hormonal pattern is why many women see acne popping up around the jawline and chin – the classic zone for hormonal breakouts. These spots can feel deep, painful and seriously stubborn.
Now, it’s not necessarily about having abnormally high hormone levels. In fact, research shows that many people with hormonal acne don’t have sky-high androgens – they believe they may just have skin that’s extra sensitive to even normal hormonal changes. So it’s not just what’s happening in your body, but how your skin reacts to it.
Is Your Acne Hormonal?
Wondering whether your breakouts are linked to your hormones? Hormonal acne often follows a distinct pattern – and once you recognise the signs, it becomes easier to understand what your body might be trying to tell you.
Ask yourself:
✔️ Does your acne flare before or during your period?
✔️ Is it focused around your jawline or chin?
✔️ Did it first appear (or return) during puberty, pregnancy, after stopping birth control, or during perimenopause?
✔️ Have you noticed more breakouts since starting or changing hormonal contraception, such as the pill, implant, coil, or HRT?
✔️ Do you also experience symptoms like irregular periods, mood swings, bloating, hair thinning, or excess facial/body hair?
If you answered yes to a few of these, your hormones are likely playing a significant role in your breakouts.
What This Means
Hormonal acne isn’t just about what you put on your skin – it’s about what’s going on inside your body. Hormonal shifts can trigger excess oil, inflammation and throw your skin rhythm out of whack. And if your skin is particularly sensitive to those changes? You might keep breaking out at the same time month after month. That’s why surface-level treatments (like harsh cleansers or spot treatments) often don’t do much long term.
What You Can Do
The good news: you can support your skin and hormones with some smart lifestyle shifts. Supporting your hormones through lifestyle, nutrition, and targeted supplements can help bring your skin back into balance. By working with your body (not against it), you can reduce the severity and frequency of breakouts – and take steps toward clearer, calmer skin over time.
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Nutrition Matters: what you eat doesn’t just fuel your body – it also influences your hormones, gut health, and ultimately, your skin. A nutrient-rich diet full of whole foods, healthy fats, fibre, and diverse plant foods can help keep your hormones more stable and your gut microbiome in check – two major players in clearer skin. Load up on skin-supporting nutrients like antioxidants (think vitamin C and E), zinc, and omega-3 fatty acids. These help reduce inflammation and support your skin’s natural healing process.
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Stress Management: Stress is a sneaky skin disruptor. When you’re stressed, your body pumps out more cortisol, a hormone that can throw off your skin’s balance, ramp up oil production and inflammation. Build in calming habits – whether it’s yoga, journaling, meditation, or just getting outside for a walk. A few mindful moments each day can make a big difference – not just for your mind, but for your skin too.
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Prioritise Quality Sleep: Never underestimate the power of a solid night’s sleep – your skin depends on it. While you rest, your body shifts into repair mode, rebuilding and renewing everything from your immune system to your skin barrier. Getting 7–8 hours of quality sleep each night gives your skin the downtime it needs to regenerate and fight inflammation. You’ll wake up not just feeling better, but looking better too!
When to Get Help
While a lot of people can manage mild acne at home, there are times when it’s best to speak to a doctor or dermatologist. Reach out if:
🚩 Acne is impacting your mental health, confidence, or mood
If acne is taking a toll on your confidence, self-esteem, or is causing you anxiety or depression, it's worth getting professional support. Your mental health is just as important as your skin health, and there’s no shame in asking for help.
🚩 You have painful cysts or deep nodules under the skin
These are the deep, painful lumps that sit under your skin and can be especially hard to treat. If you’re experiencing these, it’s a good idea to see a doctor, as they can lead to scarring if not treated properly.
🚩 You’re seeing other signs of hormonal imbalance (like irregular periods or hair growth)
If you’ve noticed additional symptoms like hair loss, irregular periods or extra hair growth on your face or body, your acne might be a sign of an underlying hormonal imbalance. It’s important to get checked out, as these could be signs of conditions like polycystic ovary syndrome (PCOS).
Dealing with acne in your 20s or 30s can feel unfair but it doesn’t mean you’re doing anything wrong. Your skin is often a reflection of what’s happening inside, and with the right support, from nutrition and sleep to stress management and hormonal balance, you can make meaningful progress. Be patient with yourself, stay curious about your body, and don’t hesitate to ask for help when you need it. Clearer, calmer skin is absolutely within reach – it all starts with understanding what your skin is trying to tell you.