Dealing with Hormonal Acne in Your 20s, 30s,

Another painful, angry pimple has appeared along my jaw, joining a crowd of nine or ten others.

Their existence has become a regular occurrence in my life, along with blackheads, congestion, and excess oil.

At 33 years old, I thought my relationship with Hormonal acne was over. Like at-home highlights and popstar posters on my bedroom wall, I assumed I’d left spotty Skin in my teenage years.

Unfortunately, as I’ve gotten older, my skin has only gotten worse.

I’ve had luck soothing my skin with the contraceptive pill, but if I go birth-control-free, my skin goes haywire.

As health concerns go, hormonal acne isn’t a particularly debilitating one. Still, it often leaves me embarrassed to go out without a full face of makeup.

Social media certainly doesn’t help. It’s rare to log on to Instagram or TikTok and see anything other than perfectly clear, glowing complexions. This is especially challenging when your skin looks anything but.

So, why do “teenage” skin problems persist into adulthood, and — crucially — what can you do about it? Read on to find out.

Hormonal acne involves breakouts tied to fluctuations in your hormones, typically experienced during puberty.

However, hormonal breakouts can happen well into adulthood, and it’s most common in women.

According to a 2008 studyTrusted Source, about 50 percent of women between ages 20 and 29 and 25 percent of women between ages 40 to 49 have acne.

Typically, hormonal acne is characterized by:

acne around the cheeks and jawline
blackheads, whiteheads, or cysts
oily skin
inflammation
sensitivity

Most breakouts happen when the oil glands in the skin become more sensitive to a group of hormones known as androgens, explains Natalia Spierings, a consultant dermatologist and author of “Skintelligent: What You Really Need to Know to Get Good Skin.”

Androgens drive the enlargement of oil glands and increase the production of oil in the skin. All people have some level of androgens and these increase during puberty.

“Some women are more sensitive to androgens throughout their lives than others, and hormone sensitivity also changes as we get older,” Spierings explains.

Sometimes lifestyle choices can worsen the problem too.

“The use of multiple skin care products contributes to this problem by irritating the skin, leading to redness and often [triggering] an underlying predisposition to acne vulgaris,” says Spierings.

I certainly didn’t expect to still be experiencing hormonal breakouts in my 30s. Surely by the time I hit menopause, my problem skin will be a thing of the past, right?

Unfortunately, Spierings says this isn’t necessarily the case.

“There’s no age at which [hormonal acne] necessarily stops or starts,” she says.

“Every woman is different and unfortunately it isn’t possible to predict if or when a woman will develop acne. Some women never do.”

For some, hormonal acne can continue well into later life.

“In my clinical experience, women who have oily, acne-prone skin throughout their 20s and 30s continue to have it even after menopause,” Spierings says.

While that might not be the news you were hoping for, Spierings says there are plenty of steps you can take to manage hormonal skin.

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Try these options to keep hormonal acne at bay.
Pare back your skin care routine

If you spent a lot of time on Instagram or TikTok, you may have seen influencers share elaborate skin care routines involving a long list of products.

In Spierings’ professional opinion, simple is best.

“The overuse of too many products can definitely irritate [the skin] and make acne appear worse or actually worsen it,” she explains. “Facials can also have a negative effect.”

Spierings advises minimizing your skin care routine to a basic cleanser, moisturizer, and sunscreen.
Try one treatment at a time

The good news? There are loads of acne treatments on the market today, some of them available over the counter.

However, that doesn’t mean you should try multiple solutions at once.

When it comes to treating hormonal skin, Spierings warns against overloading your skin with too many treatments at one time.

“Start with something simple like salicylic acid 2 percent in a lotion, which is easily available and non-irritating. Use it for a few weeks and see if you have any improvement,” she suggests.

Additional options include:

benzoyl peroxide
adapalene, or Differin Gel
azelaic acid
beta hydroxy acid

See a dermatologist

Sometimes your skin issues can feel like too much to deal with alone.

“If your skin is really affecting your quality of life, go and see a dermatologist and get a definitive treatment plan,” Spierings advises.

She points out that there are great treatments for acne available, and you don’t have to go it alone. A dermatologist can help you sort through the option out there to find one that works for you.
Consider hormonal birth control

If nothing else seems to work, hormonal birth control may offer relief.

Spierings says the contraceptive pill may be worth trying as part of a treatment regimen for acne, as long as your healthcare professional says it’s safe to do so.

She says there isn’t one brand that’s recommended for acne treatment. However, she warns that the progesterone-only minipill could actually worsen acne.

The pill won’t be right for everyone and can come with its own set of uncomfortable, inconvenient, and even painful side effects, so balancing your desire for clear skin with good overall well-being is key.

Spierings adds that it may not be effective against acne for everyone.

It’s been a painful realization for me, but I’ve learned that hormonal skin may just be a part of my life. Sure, I can take steps to minimize it, but hormonal breakouts may be something I always have to manage.

Learning how to manage hormonal skin while also trying to accept it may seem like a bit of a paradox, but it can be freeing.

When it comes to accepting — or even embracing — your hormonal skin, Anupa Roper, a body image educator, suggests removing the expectation of perfect skin.

“When we scroll through social media and see images that show flawless skin, it can make us feel less worthy in the skin that we’re in,” she says. “Many photos we see online are filtered and, besides that, we are all beautiful and unique just the way we are.”

She advises finding accounts that make you feel positive about your skin — ideally ones that showcase skin that’s just like yours.

Roper also suggests focusing on a part of your appearance you feel good about.

“What do you like about your looks? Is it your curly hair? The freckles on your nose? Maybe it’s your figure? Whatever it is, concentrate on that,” she says.

Experiencing hormonal skin well into your 20s, 30s, and beyond is more common than you might think.

The good news is there are plenty of ways to manage it.

Whether you choose to manage hormonal skin with treatments or by learning the art of self-acceptance, you can feel good about your skin at any age.

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