How to Naturally Treat Hormonal Acne

How to Naturally Treat Hormonal Acne

There are a variety of acne types and postulated causes, however, at the root of them all is an imbalance of hormones. Hormones are the chemical messengers of the body. They are how every cell, tissue, and organ communicate with one another. And as it turns out, people with acne appear to have a certain hormonal environment that contributes to the development of pimples.

In this article, we will be taking a look at some of the key hormones known to contribute to acne and how to balance them naturally.

boy standing in the desert looking down with acne on his cheeks

The Hormones of Acne

Before we look at the individual hormones involved in acne, keep in mind that one of the common denominators amongst these hormones is that they all tend to dramatically increase sebum (skin oil) production, which clogs the pores. When the pores become clogged with skin oil, they tend to accumulate bacteria and dirt. This causes them to become inflamed.

Here are a few key hormones that have been found to contribute to this problem:

Luteinizing Hormone, DHEA and Sex Hormone-Binding Globulin

In study, the pituitary function of female and male acne patients was investigated. Researchers looked specifically at the serum levels of dehydroepiandrosterone sulphate (DHEA-S) and sex hormone-binding globulin (SHBG) prior to treatment. What they found was that people with acne had 60% higher levels of luteinizing hormone, significantly lower levels of SHBG and higher levels DHEA-S compared to those without acne.

To determine the acne-causing effects of these hormones, patients were treated with oral contraceptives and synthetic birth control to significantly increase the levels of SHBG and decrease in DHEA-S, which was found to improve acne. 1

This study concluded that elevated levels of DHEA-s and low levels of SHBG appear to be the most common hormonal changes in acne. However, the use of oral contraceptives, (although capable of inducing an increase in SHBG and decrease in DHEA-S) is not a recommended treatment for acne.

Although they may treat acne, oral contraceptives mostly do so by dramatically increasing cortisol (by 75-100%) and estrogen. This elevation in stress hormones treats acne by atrophying the oil gland. This isn’t a safe or healthy way to treat acne for a variety of reasons. One reason is that oral contraceptives also lower testosterone (by 30-40%), which can lead to metabolic issues, and as discussed in an earlier article on our blog, can potentially accelerate skin aging and wrinkling. 2


Prolactin is a pituitary stress hormone that tends to rise under hypothyroidism and is known to contribute to acne.

In a study, twenty female patients with late-onset acne and hyperprolactinemia (without elevated DHEA-S or decreased levels of SHBG) were treated with bromocriptine (a dopamine agonist). Dopamine is the natural regulator of prolactin, so treatment with prolactin in all patients induced a fall of basal prolactin levels to normal range, which was found to significantly improve and even completely cure their acne. 3

The way prolactin contributes to acne is by its effect on adrenal steroids. Prolactin receptors are well expressed in the adrenal glands. In hyperprolactinemia, prolactin stimulates the further production of adrenal androgens are secreted in an increasing fashion, which contributes to the rapid development of acne.

teenage girl with glasses and acne


High levels of estrogen can have negative feedback on the gonadal axis. When estrogen is elevated, it can shrink the sebaceous gland size and therefore reduce sebum production. On one hand, this may help to treat acne driven by high sebum. On the other hand, estrogen can cause other hormonal imbalances that may contribute to acne.

For example, estrogen increases the production of sex hormone-binding globulin (SHBG) by the liver, decreasing levels of free serum testosterone. SHBG has a high binding affinity for testosterone, and an outstanding estrogen affinity. Since testosterone and dihydrotestosterone are the primary androgens involved in acne, low levels of SHBG tends to lead to poor response to treatment.

Additionally, estrogen stimulates the production of prolactin, which can cause a rise in DHEA to counteract the stressful effects of estrogen. In other words, high estrogen can be the cause of elevated androgens seen in acne. 4, 5


In another study, serum cortisol levels were measured in patients with acne. As it turns out, hypercortisolism was found to contribute to excessive sebum secretion. Additionally, cortisol also greatly suppresses immune function, which allows acne-causing bacteria to multiply, causing acne. In conclusion, cortisol is well known to increase during stress, which might explain the exacerbation of acne during times of stress. 6

Treating Hormonal Acne

Mainstream medicine and marketing will have you believe that acne is a localized issue that can be treated solely by medication and topicals. However, as it turns out, acne appears to be a sign of a systemic disease state, involving an imbalance of stress hormones. Therefore, to properly treat acne it should be viewed as a sign of stress and imbalance rather than a localized problem.

With that being said, here are some things to consider for treating acne, naturally and at the root:


This is an ayurvedic herb that has the ability to lower some of the stress hormones involved in acne. For example, studies have found it can lower cortisol and prolactin, two acne-causing hormones. Ashwagandha is an adaptogen and helps to prevent your adrenal glands from going on overdrive, which would contribute to high levels of acne-causing adrenal steroids. We suggest supplementing with it regularly to mitigate the effects of stress. You can find it in our Revitalize formula.

Boost Dopamine

Dopamine is an antagonist to most stress hormones – cortisol and prolactin in particular. In most disease states, dopamine tends to be lower. Increasing dopamine can help to lower prolactin and therefore help treat acne.

Fortunately, simple things like drinking organic coffee, getting sunlight, eating zinc-rich foods (beef, liver, oysters) and herbs like and He Shou Wu (found in Revitalize) can all increase dopamine levels and help treat acne.

Ditch Estrogenic Products

Most conventional skincare products are doing more harm than good due to their estrogenic qualities. As we discuss frequently, industrial personal care products tend to have estrogen-mimicking substances known as xenoestrogens, which can increase levels of estrogen and contribute to hormonal imbalances that cause acne. This is one of the major reasons we started our Alitura skincare line. Our products are free of these harmful substances and contain proven, natural substances for supporting skin health.

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