Hormonal acne (acne vulgaris) has become increasingly common and typically appears as deep, painful cysts along the jawline and chin, but it can also be on the cheeks, forehead, shoulders, chest and back.
Conventional treatments like the birth control pill, oral antibiotics and Accutane offer temporary relief however, they’re not permanent treatments because they fail to correct root causes, consequently leading to relapses once they are discontinued.
This is why natural acne treatments that get to the root cause of hormonal acne, such as balancing blood sugar, reducing stress, and supporting the gut to improve hormone detox, can be a more sustainable solution.
However, treating hormonal acne (acne vulgaris) naturally takes time, requires consistency, and can be challenging without proper testing methods to pinpoint the root cause.
A rapidly growing area of acne research is the link between gut health and acne. This is because it has now been recognised that gut health is one of the primary drivers of hormone imbalance and hormonal acne.
Studies have confirmed that poor gut bacteria balance triggers systemic inflammation, hormone imbalances, and impaired detoxification, all factors that trigger breakouts. Therefore, strengthening gut health is a very effective way to help clear acne because it restores balance from within.
What is Hormonal Acne?
Hormonal acne isn’t just about breakouts—it’s your body’s way of telling you something is off balance.
Hormonal acne (acne vulgaris) is caused by imbalances in hormones like testosterone, oestrogen, progesterone, insulin, and stress hormones.
When hormones like testosterone, insulin, and cortisol get out of sync, it pushes your oil glands into overdrive, clogs your pores and causes pimples to break out. During a woman’s menstrual cycle, hormone fluctuations are powerful triggers of inflammatory acne flareups. Androgens (male hormones like testosterone and its more potent cousin DHT) are the biggest culprits because they rev up sebum production and trigger inflammation.
According to the American Academy of Dermatology, Insulin spikes from sugar and dairy fuel this fire, while stress hormones suppress female hormones, making things worse. Even sluggish liver detox and poor gut health can keep acne lingering.
The good news?
We’ve discovered from helping more than 2000 patients with acne, that balancing your hormones naturally by improving gut health with targeted dietary and lifestyle modification and supplements can be a way to clear your skin for good.
The Gut Microbiota and Its Role in Skin Health
The gut microbiota (the bacteria in your gut) plays a crucial role in skin health by regulating skin inflammation, hormone metabolism, and immune function. A Journal of Clinical Medicine study (2020) found that gut dysbiosis increases systemic inflammation and worsens acne.
Earlier research in Frontiers in Microbiology (2018) highlighted how imbalanced gut microbiota impairs detoxification and leads to hormone-driven breakouts.
Additionally, a British Journal of Dermatology (2019) study linked probiotics to reduced acne severity by restoring gut microbiota balance.
Research presented by the National Library of Medicine has also shown that poor gut health can trigger insulin resistance and excessive androgens, driving acne formation. Therefore, strengthening gut health is one way to fix acne and improving skin health naturally by healing from within.
Understanding the Gut-Skin Axis
The gut-skin axis is the link between gut health and skin health. It is influenced by the gut microbiome, a collection of beneficial and harmful bacteria in the gastrointestinal tract. An imbalance in the gut microbiome can cause inflammation, disrupt hormone detoxification, and trigger insulin resistance, all of which contribute to acne by increasing oil production and skin sensitivity.
This gut-skin connection is being validated by new research every year, particularly in relation to acne and acne vulgaris. A 2018 study published in Frontiers in Microbiology found that gut microbiome imbalances (dysbiosis) contribute to inflammation, increasing skin conditions like acne and eczema through immune system activation and altered intestinal permeability (leaky gut).
A 2016 review in Beneficial Microbes highlighted that probiotics can reduce acne severity by modulating gut bacteria, lowering systemic inflammation, and improving insulin sensitivity. A 2020 study in Nutrients linked high-glycaemic diets to gut microbiome imbalances, increasing insulin resistance and androgen production, all of which exacerbate acne.
At the heart of the connection between the gut and hormonal acne are gut dysbiosis and inflammation.
Gut dysbiosis occurs when harmful bacteria outnumber beneficial ones, weakening the gut barrier and causing increased intestinal permeability (leaky gut). This allows toxins, undigested food particles and bacterial fragments to leak into the bloodstream, disrupting hormone detoxification and triggering an inflammatory response.
Inflammation can create insulin resistance in acne patients, even when they’re on a low GI diet. Insulin resistance then triggers androgen overproduction and increases the androgen sensitivity of skin cells. The result is excess oil production, clogged pores, and hormonal breakouts.
The Role of Hormones and Gut Health
Your gut and hormones are in constant conversation, and when gut health suffers, your hormones follow, often showing up as stubborn acne lesions (pimples). The gut microbiome plays a key role in breaking down and eliminating hormones.
When gut microbes are unbalanced, hormone detox slows, causing excess oestrogen and androgens to recirculate into the body. This causes hormone overload, leading to oilier skin and clogged pores.
Take oestrogen, for example. When gut bacteria overproduce an enzyme called beta-glucoronidase, oestrogen is reabsorbed instead of being excreted, creating oestrogen dominance. This hormonal imbalance contributes to premenstrual breakouts and stubborn jawline acne.
Another key player is insulin, poor gut health can lead to insulin resistance, which stimulates excess testosterone production. Elevated testosterone means increased oil production, clogged pores and acne lesions (pimples).
Then there’s cortisol, the stress hormone. When stress levels rise, cortisol skyrockets, disrupting gut microbes and causing increased intestinal permeability (leaky gut). This leads to more inflammation, making your skin extra sensitive to hormonal fluctuations. Worse still, cortisol suppresses progesterone and allows androgens to take over. Another major trigger for hormonal acne.
By nurturing your gut health, you don’t just improve digestion, you balance your hormones, reduce inflammation, and create the perfect environment for clear, glowing, healthy skin.
Signs and Symptoms of an Unhealthy Gut
Here are 10 common signs your gut is wrecking your skin –
- Breakouts That Won’t Budge – No matter what skincare you try, stubborn acne (especially on your jawline and chin) could mean your gut isn’t clearing excess hormones properly.
- Bloated Belly, Bumpy Skin – Constant bloating, gas, or constipation? Poor digestion means toxins and hormones get reabsorbed, triggering breakouts and inflammatory lesions.
- Acne Flare-Ups Before Your Period – If your skin freaks out pre-period, your gut might be struggling to balance oestrogen and testosterone levels.
- Red, Angry Skin – A leaky gut lets toxins escape into your bloodstream, causing immune reactions that show up as inflamed, irritated skin.
- Craving Sugar Like Crazy – Your gut bacteria control your cravings! Bad bacteria thrive on sugar, which spikes insulin and testosterone, making acne worse.
- Dairy & Gluten Don’t Sit Right – Food sensitivities mean your gut is struggling, leading to inflammation, poor detox, and hormonal acne.
- Constantly Tired & Foggy – If your gut can’t absorb key skin-loving nutrients, you’ll feel drained—and your skin will suffer too.
- Stressed & Breaking Out – High cortisol from stress damages gut bacteria, fuelling inflammation and oil production.
- Always Getting Sick – Your gut houses 70% of your immune system. If it’s weak, breakouts and skin infections become more common.
- Your Skin is Too Oily… or Too Dry – A messed-up gut affects sebum production, leaving you with either greasy, clogged pores or dull, flaky skin.
Causes of Poor Gut Health
Sugar Overload – Love sweets? So do bad gut bacteria! They thrive on sugar, triggering insulin spikes, testosterone surges, and—you guessed it—breakouts.
Antibiotics – Ever taken antibiotics? Many of our patients with acne have, and while they can provide temporary relief, their big downside is they wipe out the good bacteria in your gut and on your skin. Reduced skin barrier function leaves your skin vulnerable to inflammation and hormonal chaos.
Chronic Stress – Chronic stress pumps out cortisol, weakening your gut lining (hello, leaky gut!) and making your skin extra reactive.
Dairy & Gluten Sensitivity – If these foods leave you bloated, they’re likely irritating your gut, spiking inflammation, and making acne worse.
No Fibre, No Detox – Your gut needs fibre to flush out excess hormones. Without it, toxins stick around, fuelling oiliness and clogged pores. Fibre is also critical for production of short chain fatty acids (SCFAs). SCFAs keep your gut microbiome and skin microbiome in a healthy balance.
Late Nights & Netflix Binges – Poor sleep messes with your gut microbes and hormone balance, leading to tired, breakout-prone skin.
Toxins Overload – Plastics, pesticides, and processed foods sneak harmful chemicals into your body, disrupting gut bacteria and throwing your skin out of balance.
Improving Gut Health to Manage Hormonal Acne
Clear skin starts in the gut and is a way to heal hormonal acne from the inside out. Optimising gut health keeps your hormones balanced, inflammation in check, and detoxification efficient, three key factors that determine whether your skin stays clear or breaks out.
Eat Your Way to Clear Skin
Start by feeding your gut the good stuff! Probiotics (found in kimchi, sauerkraut, and kefir) repopulate your gut and skin microbiome with skin-friendly bacteria, while prebiotics (from garlic, onions, and asparagus) keep them thriving.
Anti-inflammatory foods like leafy greens, turmeric, and wild-caught salmon calm redness, reduce breakouts, and support hormone balance.
Destress to Detox
Stress wrecks your gut, raises cortisol, and fuels hormonal acne. Prioritise self-care with meditation, deep breathing, or a simple walk in nature. Regular exercise not only busts stress but also boosts digestion, helping your body eliminate acne-triggering toxins.
Ditch the Skin-Sabotaging Foods
Processed foods and excess sugar feed bad gut bacteria, spike insulin, and flood your body with androgens, the hormones responsible for overstimulating sebaceous glands and clogging pores.
Healing your gut is like upgrading your skincare routine from the inside out. A happy gut means balanced hormones, less inflammation, and naturally glowing skin!
So if you’ve had enough of treatments that don’t fix the root cause of your hormonal acne and you’re ready to dig deeper and fix your gut to fix your acne then we’re here to help you just like we have with more than 2000 other patients.
To get our help, all you have to do is contact us by calling +61 2 9524 2471 or clicking here to book your initial consultation.
Frequently Asked Questions
Does gut health affect hormonal acne?
Absolutely! Your gut controls hormone detox, insulin regulation, and inflammation. When it’s off-balance, androgens spike, oil production increases, and acne flares up, making gut health the secret weapon for clear skin.
With our acne patients, we’ve discovered that the best way to check their gut health is with a microbiome test. This test assesses the levels of the distinct gut microbiota (good and bad bacteria, parasites, worms and yeasts) in a patient’s gut. Armed with this precise information, we are able to tailor them a personalised acne and gut natural treatment plan.
What is the science behind hormonal acne?
Hormonal acne happens when androgens overstimulate oil glands, clog pores, and trigger inflammation. Factors like insulin resistance, stress, and poor gut health fuel these imbalances, making the skin a battleground for breakouts.
How does gut health affect hormones?
Your gut acts like a hormone traffic controller—when it’s sluggish, toxins and excess hormones recirculate, leading to oestrogen dominance, high testosterone, and breakouts. A happy gut means balanced hormones and clearer, healthy skin.
Can probiotics clear hormonal acne?
Oral probiotics help restore gut balance, improve hormone detox, and calm inflammation. While they won’t magically erase acne overnight, they’re a powerful tool when combined with a gut-friendly diet and lifestyle.
