Hormonal-type acne is linked to male sex hormones (androgens) and insulin. These hormones stimulate skin cell growth and sebum production that results in acne.

Here are signs that indicate you have hormonal-type acne:

• Women with hormonal-type acne often get premenstrual breakouts.
• Acne gets worse after eating foods that increase insulin levels; such as sugar and carbohydrates, dairy products and protein powders (especially whey protein).
• Hormone tests show androgen levels are elevated or towards the high end of the normal range. Estrogen levels are often low or towards the low end of the normal range.
• Women, you get acne from soy or other phytoestrogen-rich foods.
• You are diagnosed with PCOS or other diseases linked to high androgen levels; this is almost a dead giveaway of hormonal-type acne.
• Elevated blood sugar or insulin levels. Has a doctor given you an oral glucose tolerance test (they ask you to drink a sugary solution and check your blood sugars 2 hours later) or do you monitor your blood sugar levels? If these tests show that your blood sugars are towards the high end of the normal range, or above the normal range, this is a sign that you may struggle with hormonal-type acne.
• Male pattern baldness, often an indicator of metabolic syndrome and higher than normal insulin levels.
• Overweight with an inactive lifestyle. People who carry extra weight and are inactive are at higher risk of insulin resistance.

Most women with acne have hormones ‘within the normal range’

Please note that you can still have hormonal-type acne if your hormones are within the normal range. Most women with adult acne have normal hormone levels, and yet their acne still gets better when they are given insulin or androgen-lowering drugs/treatments.

Hormonal-type acne doesn’t always come down to absolute levels of hormones; we also have to consider how sensitive the skin is to the hormones.