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How to Get Rid Of Hormonal Acne

You feel bloated, tired, grumpy and crampy and to make matters worse, you see zits all over your face before your period starts. Acne before your period is common occurring in 50-80% of women. So what’s up with acne and your hormones?

Many of us remember (not so fondly) having breakouts during puberty, but unfortunately many women also experience hormonal acne in their 20s-40s due to hormonal fluctuations during our cycle. This typically occurs along the jawline, chin, cheeks, and neck often up to 10 days before your period when estrogen drops. 

Testosterone and progesterone are the key players in hormonal acne. The drop in estrogen leading up to menstruation causes testosterone levels to be higher relative to estrogen which causes sebaceous glands in your skin, this happens to produce more sebum (which is oil)Additionally, after ovulation occurs, estrogen levels drop and progesterone should significantly increase, which can also make your skin more oily. The excess of oil creates the perfect environment for acne causing bacteria to reside in your skin pores, which triggers inflammation and eventually acne. To make matters worse, the pimples that form around your period are often painful, deep forming cysts. 

While topical steroids, harsh cleansers, oral antibiotics and hormonal birth control are often common treatments for hormonal acne, the best treatment is preventative working from the inside out, getting to the root cause. Antibiotics can destroy the beneficial microbes in your gut that supports your immune system and skin health. Moreover, antibiotics are often over-prescribed and can cause a rise in antibiotic resistance pathogenic bacteria which is becoming a global health concern. 

The pill is another band-aid treatment for acne that also disturbs your gut microbiota (also known as intestinal flora), which can lead to skin issues. It also depletes several important micronutrients like zinc and B vitamins, which are crucial for skin health. What’s worse is when women go off the pill, they often suffer from acne that’s the same or worse than before. Why is this? Well, the pill suppresses sex hormones and androgens like testosterone, and when you go off the pill your body experiences androgen rebound where your body starts producing higher levels of testosterone leading to acne.

So: what’s a girl with acne to do?

Balance testosterone levels

Signs of high testosterone include:

  • Acne
  • Hair loss on the scalp and excess body hair on the upper lip, face, chest and abdomen
  • Infertility
  • Oily skin
  • Increased body odor
  • PolyCystic Ovarian Syndrome (PCOS)
  • Aggression 

Often, imbalanced blood sugar such as insulin resistance and, in extreme cases, Type 2 diabetes, can cause elevated testosterone levels in women. Balance blood sugar by not skipping meals, and eating fat, fiber, and protein with every meal and snack. Switching coffee for green tea can also help because it increases the amount of Sex Hormone Binding Globulin (SHBG), which is a protein that binds to excess testosterone to help cleare it from the body. Consuming flax seeds, omega 3 fatty acids, and the herb Saw Palmetto also helps reduce testosterone levels. 

Ditch refined sugar and processed oils from your diet

Eating refined sugar and flours found in packaged foods like crackers, cookies, white bread and pasta, sodas and sweets cause your blood sugar and insulin to spike which triggering testosterone levels to increase. Swap out white bread and sweets for whole grain alternatives and legumes. Instead of eating just plain toast, be sure to eat it with some healthy fat like extra virgin olive oil or avocado and protein like an egg to stabilize blood sugar. 
Refined oils like sunflower, safflower, and partially hydrogenated oils (trans fats) have little nutritional value and are highly inflammatory, which can provoke skin issues like acne since glowing skin requires a nutrient dense diet high in healthy essential fats like avocado, olive oil, coconut oil, grassfed butter or ghee, raw nuts and seeds, and omega 3 fatty acids from fatty fish or supplements.

Eat nutrient dense diet

Healthy skin requires zinc, vitamine A (retinol from animal based foods such as dairy, eggs, liver, and cod liver oil or supplements, as well as carotenoids and lycopene from red, orange and yellow plant based foods), C, and E, and antioxidants. Consider incorporating more whole foods into your diet and eating the rainbow to ensure that you are consuming a broad spectrum of nutrient and antioxidant dense foods such as avocados, raw nuts and seeds, fatty fish such as sardines, broccoli, tomatoes, orange squash and yellow bell peppers.

Support liver health

Proper liver function is needed in order to break down excess estrogen, which can prevent hormonal acne. Foods and herbs that support liver health include:

  • Green tea
  • Beets
  • Bitter greens like dandelion greens
  • Citrus fruits
  • Cruciferous vegetables (broccoli, cauliflower, radishes, arugula, etc)
  • Nuts
  • Blueberries, cranberries and red grapes
  • Garlic
  • Ginger
  • Turmeric
  • Olive oil
  • Omega 3 fatty acids

Milk thistle and burdock root are herbs that are used to support healthy liver function. Additionally, eating at least 25g of fiber daily prevents constipation which also helps eliminate excess estrogen. 

Consider going dairy free

Many women with acne also have a dairy sensitivity. Try going dairy free for at least a month to see if your acne clears up. Cow milk can be especially inflammatory, whereas goat and sheep milk tend to be better tolerated due to differences between the milk proteins. 

Reduce stress

Stress is skin’s worst enemy! You can eat the cleanest diet, but if your body senses it’s in a state of fight or flight, your skin will likely take a toll. Some great ways to reduce stress are:

  • Being in nature
  • Laughing
  • Enjoying an activity or hobby
  • Exercise
  • Meditation
  • Yoga
  • Acupuncture


By Allison Clark, AURA’s official nutrition expert.



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