Hormonal Acne: What Your Blood Tests Can Reveal About the Real Cause of Breakouts

Adult acne is one of the most common and most frustrating skin problems we see in clinic. For many, the issue isn’t poor skincare or diet, but hormone imbalance.

Understanding the role your hormones play can completely change how acne is managed. GP and medical adviser Dr Suzanne Wylie explains how hormonal acne blood tests can uncover the underlying cause, and point you toward lasting solutions.

Why Adult Acne Happens

Acne isn’t just a teenage problem. In fact, more than 40% of women and 25% of men continue to experience breakouts well into adulthood. Hormonal acne typically shows up around the jawline, chin, neck, and lower cheeks, often worsening around the menstrual cycle, during perimenopause, or in times of stress.

The Link Between Hormones and Acne

Hormones control how much oil (sebum) your skin produces. When they fluctuate or fall out of balance, the sebaceous glands can go into overdrive, clogging pores and triggering inflammation.

Key hormones involved include:

• Androgens (e.g., testosterone & DHEAS): Can increase oil production, leading to clogged pores and breakouts.

• Oestrogen and Progesterone: Their monthly rise and fall influence skin texture and inflammation.

• Cortisol (the stress hormone):  Chronic stress raises cortisol, which can worsen inflammation and acne severity.

• Insulin & IGF-1: Blood sugar spikes can also fuel excess sebum production.

When to Consider a Hormonal Acne Blood Test

If you’ve tried every cleanser, prescription cream, or antibiotic with little success, it might be time to look deeper. A hormonal acne blood test measures levels of key hormones that influence your skin,  giving a clearer picture of what’s really happening inside your body.

Common reasons to test:

• Acne that flares up around your period or mid-cycle

• Sudden breakouts in adulthood (especially post-30)

• Acne resistant to topical treatments

• Symptoms like irregular periods, hair loss, or weight changes

• Family history of PCOS or hormonal imbalance

Treating Hormonal Acne: Beyond Skincare

Once the cause is identified, effective treatment may include:

• Lifestyle adjustments: Managing stress, sleep, and diet (especially reducing high-GI foods).

• Targeted medication: Such as hormone-regulating options, prescribed only after proper testing.

• Supplements: Zinc, vitamin D, and omega-3s can support skin health.

• Professional skincare: Retinoids and gentle exfoliants may help alongside medical support.

Why Testing Saves Time and Frustration

Without testing, many patients spend years cycling through products and prescriptions that only treat the surface. A simple blood test for hormonal acne gives clear answers, helping you skip the trial-and-error stage and move straight to the right solution. Hormonal acne is a medical condition, not a cosmetic flaw. By understanding what your hormones are doing, you can take control of your skin from the inside out.