If you’ve ever struggled with hormonal acne, then you know just how much of a pain it is.  But do you know what’s behind it or how to keep hormonal swings from ruining your skin and self-esteem?  It is hormones’ powerful control over sebaceous follicles (fancy talk for pores) that triggers acne.  Think of your pores as puppets and your hormones as the person behind the scenes pulling the strings.  When hormones are balanced, pores are calm and the puppets can put on a beautiful show. 

But when hormones swing too high or too low, the puppets are all over the place and mayhem ensues. When chaos happens on stage, people call the production a flop, but when it happens on your face, it’s called acne.  The first major acne-inciting hormonal event a lot of people go through is puberty.  This is the time when testosterone soars and acne appears out of nowhere. 

Boys and girls alike descend in massive droves on department and drug stores eager to buy acne fighting washes, toners, creams, and anything else that promises to return their skin to its pre-acne glory days.  Fortunately for boys, acne dies down as testosterone levels normalize.  But for us acne-prone ladies, puberty is just the beginning of a lifetime of wild hormonal swings. 

Think menstruation, ovulation, pregnancy, birth, lactation, perimenopause and finally menopause – all of these major events can trigger or worsen breakouts.  Over the course of our lives we have to manage other hormones besides testosterone that play an active role in dishing out hormonal acne.  Having an excess of estrogen, insulin, or cortisol can create the kind of environment hormonal acne thrives in.


During the first half of your cycle, your ovaries secrete estrogen which thickens the lining of the uterus. If you don’t become pregnant, the lining sheds and your period arrives.  If pregnancy occurs, the lining thickens to create a safe, comfy home for the egg to grow. Estrogen plays other roles as well.

It keeps your bones strong, and your joints lubricated.  The goodness doesn’t stop there.  Estrogen benefits our skin too by keeping it hydrated, smooth, and well-supported by collagen.  Estrogen is our friend, but too much of it can lead to acne.


1.     Buy organic produce.  If that isn’t an option, you can still remove some estrogen-mimicking pesticides, fungicides, and herbicides by washing fruits and vegetables thoroughly.  Simply soak fruits and veggies for 10 minutes in a sinkful of water containing one of the following: 4 teaspoons of salt and the juice from 2 or 3 lemons, or 1/2 cup white vinegar.

2.     Do not reheat food in plastic containers.

3.     Ditch plastic and choose a water bottle made of glass or stainless steel.

4. Skip over personal care products that include endocrine disruptors like parabens and phthalates.

5.     Sprinkle two tablespoons of toasted cold-milled flaxseeds on your morning oatmeal or cereal or blend them in smoothies.

6.     Fiber up with 2-4 tablespoons of chia seeds per day.  Along with flaxseeds, their fiber content helps sweep away harmful toxins found in the digestive tract.

7.     Grab 2-3 cardomon seeds and toss them in your soups to take advantage of its powerful ability to cleanse and detox the liver, which is necessary for balancing hormones.

8.     Decline that glass of wine. Alcohol can increase estrogen by disrupting the function of the liver, which can affect the natural metabolism and detoxification of estrogen.

9.     Cut back on how much red meat you eat to avoid bringing the animal’s own estrogen into your body. 

If you are concerned about your estrogen levels, ask your doctor to take a blood test on Day 21 of your cycle (Day 1 = first day of your cycle).


Cortisol is the hormone responsible for the way we react to stress.  It raises blood sugar and blood pressure as the body goes into survival mode to protect itself from danger.  This danger can be real or imagined.   Whether you’re being chased by a bear, or cramming for an exam, or trying to grab the last pair of gorgeous designer shoes at a huge semi-annual sale, your body responds by raising cortisol levels.

For those of us who are prone to getting acne, when the heat is on, our pressure levels escalate and produce more sebum/oil.  When this happens clogged pores and acne are just around the corner.   Now you can see why it’s so important to keep cortisol balanced since higher levels can trigger acne flare-ups.


10.     Rebound your way to lower cortisol.

11.    Practice pilates.  It isn’t as intense as other forms of exercise.  Light exercise is also linked to lower estrogen levels.  Doing low intensity workouts gives you the benefit of lowering cortisol and estrogen.

12.     Meditate daily to stay calm.

13.     Breathe deeply.

14.     Be positive.

15.     Put down the caffeine (coffee, energy drinks, and soda).

16.   Drink calming herbal teas like spearmintroasted dandelion, and chamomile  which have acne fighting properties.

17.    Give your electronic devices a rest.  Put them away one hour before bed.  Electromagnetic fields (EMFs) emitted from electronic devices like phones and computers affect the body on a biological level, raising cortisol.

If you think you have an issue with high cortisol levels, ask your doctor for a morning fasting blood cortisol test.


The pancreas makes insulin so our cells can absorb glucose from the blood to use as fuel.  The pancreas does this by pushing out insulin when our blood glucose spikes up after we’ve stuffed our faces with too much sugar or carbs.  Insulin balances the blood glucose levels.  Too much glucose in our bodies causes inflammation which promotes acne.  Insulin spikes are also responsible for creating excess oil that clings to dead cells in the pore.

When excess oil and dead cells stick together, they form a plug.  The plug sits there ready for infection by P.Acnes (the bacteria responsible for acne) and inflammation.  Now you’re ready to welcome cystic acne to your face.  Avoid  milk and dairy products since insulin is found in them. The last thing you need is more insulin floating around your body if you struggle with acne.


18.     Substitute stevia for sugar in baked goods and drinks.  Unlike white sugar, stevia does not increase blood sugar.  Stevia comes from the leaves of the plant stevia rebaudiana and has a long history of safe usage.  It was used for over 1,500 years by the South American Guarani people who called it sweet herb. In Brazil and Paraguay, the leaves have been used for hundreds of years to sweeten teas and medicines.  It has even been used as a sweet treat.

19.     Substitute that morning cup of coffee for hot lemon water when you wake up each day.

20.   Lower blood sugar by as much as 30% by sipping on a glass of water with one teaspoon of raw apple cider vinegar.  Do this during each meal to reap the full benefit.  Apple cider vinegar’s acidity slows the digestion of carbohydrates which helps keep blood sugar levels from spiking.

21.   Spice up your favorite dishes with cinnamon, cloves, bay leaves, and coriander.  Those seasonings will help your body metabolize sugar.

If you are concerned about your insulin levels, you can test your fasting blood glucose level, fasting blood insulin level, or get an oral glucose tolerance test.

Disclaimer: The information contained on this site is provided as an information resource only.  It is not to be used or relied upon for any treatment or diagnostic purposes.  This information is not intended to be patient education.  It should not be used as a substitute for professional diagnosis and treatment.  The statements on this site have not been evaluated by the Food and Drug Administration.   This product is not intended to diagnose, treat, cure or prevent any disease.  Please consult your healthcare provider before making any healthcare decisions or for guidance about a specific medical condition, such as if you are pregnant, nursing, taking medication, or have a mental condition.  Please read all product packaging carefully and consult with a healthcare professional before starting any diet, exercise, supplementation or medication program. Cosmetic products have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent disease.


Join the Conversation

My favorite part of doing these posts is engaging in the conversation they start. Each week, I ask one question. This week, it is this:

How will you balance your hormones?


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P. Sonksen and J. Sonksen, “Insulin: understanding its action in health and disease,” BJA: British Journal of Anaesthesia, Volume 85, Issue 1, 1 July 2000, Pages 69–79, Published: 01 July 2000

Michael Randall, “The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis,” Posted by In Fall 2010

Ann Louise Gittleman, PhD, CNS, “Resolution: Weight Loss,” Remedies, January 2018