If you told me at 16 that acne would be something so persistent in my early 20’s, I would have panicked, cried, and gone down an online rabbit hole searching “how to fix hormonal acne naturally.”

But, just having freshly turned 21, I find myself in that exact scenario.

Up until I started my first-year in college, I had little to no skin concerns. Oiliness and the occasional blemish from time to time, but clusters of red and painful pustules were far from what I considered my face capable of. 

From 2023 to now, my hormonal acne has been up and down and felt cyclical, manifesting itself as painful, sore and stubborn pimples on my T-zone area. The acne is often exacerbated during my period, leaving my skin inflamed and me an emotional wreck, desperate to pick at my skin.

After countless dermatologist visits, facials and pouring money into several products, I started contemplating whether a stronger, medical-grade solution that promised results was the way to go. Though that temptation was strong enough to unpack with my dermatologist, I still had my reservations. I did not want to get clear skin fast if it was at the cost of disrupting my hormones. 

Considering that I have been told that they are the root of my acne, I felt the urge to work alongside my hormones rather than suppressing them altogether — and that was something I was confident I could do sans prescription medication. But that realization didn’t come until after trying those treatments.

Read on for what I’ve learned and the products that actually helped.

Dabbling in hormonal and prescription treatments

Hormonal birth control

Just as a disclaimer, treatments for acne that are prescribed can be very effective when treating skin concerns. I’ve heard it from friends, I’ve read the articles and seen the before-and-afters on TikTok, so I have full faith that the prescription route can absolutely be the right decision for some. My experience is not a warning story against medication; instead, it’s a personal story of what I have learned works best for my body.

After being prescribed and starting a low dosage of birth control specifically for my acne concerns, I only lasted a week on it. Taking it for only a few days, I started to feel a little off, both mentally and physically. My appetite was ravenous, I was nauseous, my emotions were erratic and I felt a great deal of dissociation from my normal self — all side effects not uncommon with the pill.

While these changes weren’t unusual, they were intense enough to signal that this was not the ideal treatment for my body. 

Doxycycline

Less disruptive with hormones specifically, but still taken orally, derms often suggest antibiotics for persistent acne — though only for the short term. I was specifically placed on Doxycycline, an antibiotic intended to treat a variety of bacterial infections, like: 

• Acne
• Rosacea
• Gonorrhea 
• Chlamydia

While the antibiotic helped keep my skin stable, I did not find it to be improving anything, making it an option that didn’t seem sustainable for me to continue using.

Giving it a fair try for a few weeks, the unsuccessful trial period pushed me to keep looking for long-term fixes that weren’t just band-aids on the issue.

Tretinoin

Revered as a holy grail among the acne community, I wanted Tretinoin to be both effective and suitable for my skin’s needs. Being a concentration of pure retinoic acid, the topical cream is one of the strongest on the market for acne treatment, which makes it both effective and harsh.

Though the steroid works by speeding up skin cell turnover to promote clear skin, to get to that point, the skin barrier may experience side effects, like:

• Redness
• Dryness
• Itching
• Burning
• Increased sensitivity to UV

Even after following the derm’s instructions, my skin barrier felt damaged, with breakouts raging and more painful than ever. 

Accutane and more intense hormonal treatments

As my acne persisted, I questioned whether it was bad enough to be treated by more intense medication, like Accutane. After visiting a dermatologist for guidance, I was given a firm “no” on the potential of being a candidate for Accutane. She explained that while it reduces oil production significantly and stops acne at the source, it also disrupts the body far beyond the skin barrier. 

Some studies suggest that Accutane has the potential to cause hepatitis and other gastrointestinal side effects.  On the mental side, studies find that the drug can negatively interact with hormones and your mental health, potentially causing depression, psychosis and suicidal thoughts.

Aside from the mental and physical side effects, Accutane is also not compatible for treatment if you’re trying to conceive, with reports linking it to life-threatening birth defects. 

So, clear skin would eventually come if I were to have it prescribed, but at what price?

After the rejection, I decided to switch gears and take a more holistic approach to treatment.

How to fix hormonal acne naturally (what actually helped me)

A gentler skincare routine

Stopping the chase for the strongest treatments, I took a step back and slimmed down my routine. Rather than using various topical treatments, serums and harsh retinol pads, I reduced my routine to the bare bones. Feel free to steal my routine listed below.

Morning routine

1. Cleanser: To wake myself up and cleanse of any dirt and oil accumulated from the night. 
2. Sunscreen: Essential in my routine, especially when preventing further skin barrier damage from daily UVs. 

Evening routine

1. Micellar water: A little something to take off my eye makeup without ripping my lashes out. Part one of a nighttime double-cleanse system I have. 
2. Cleanser: Cleansing to ensure that I remove all the makeup, dirt and oil from the day.
3. Moisturizer: No SPF in this one. Just something to lock in that moisture for my skin.
4. Eye cream: I only put a dollop under each eye, patting it in to help with wrinkles and dark circles. 

Even after just a few weeks of doing that, my skin barrier felt significantly calmer and less irritated. 

My holy grails

Once the routine was simplified and my skin was regulated, I felt comfortable enough with slowly adding products that were directed towards treating acne.

Here are my top two.

2. One-time use compostable face towels

Before researching acne causes, I didn’t realize how much bacteria a dedicated face towel could hold. Being moist and used several times, cotton towels can hold microbes that can spread bacteria to the face and cause additional breakouts. So, I made the switch to one-time use compostable face towels that were able to sufficiently dry my face without spreading any bacteria in the process. 

These two simple tweaks were able to significantly soothe and improve my acne more than any other prescribed product, leaving my skin and hormones happy in the process.

Supporting hormones instead of fighting them

Other than just these topical solutions, I had to face the fact that my hormonal acne was caused by the natural changes my hormones were undergoing. So, rather than suppressing them, I wanted to create an environment in my body where they could be supported. 

For me, that looked like: 

• Tracking my cycle and understanding that certain breakouts were period-related and not worth freaking out over
• Nourishing my body and eating regularly to avoid spikes in blood sugar
• Managing my stress through self-care
• Getting proper sleep and allowing my body to recover after a long day
• Staying hydrated and prioritizing drinking water daily

Even just being small lifestyle changes, prioritizing these in conjunction with my products has improved my skin significantly. Physically, the change is evident but making these adjustments also rebuilt my confidence.

Keen to regulate and treat your hormonal acne, too?

There were times when I looked at my skin in the mirror and broke down crying. I’ve felt hopeless, angry and everything in between. This struggle and the idea, especially if it’s hormonal, that it’s not totally in your control, is overwhelming and frustrating. The conflicting advice from TikTok, the money poured into appointments and the trial and error with treatments that are “guaranteed to work” make enduring acne that much more difficult. 

When it comes down to it, there’s not a one-size-fits-all approach to treatment. Periods cause people’s skin to react in different ways and individualized hormonal issues can impact what is effective for your skin. Everyone’s skin has different triggers, different needs, different tolerances, so what matters when going about a treatment plan is picking what feels best and most comfortable for you.

The best place to start? Tune in to your body, listen and trust it. Working with it rather than against it can make a world of difference when it comes to treatment. 

Liked this feature? Read this next: My pregnancy-safe skincare routine, unpacked