Acne isn’t just a teenage problem. Many adults — especially women in their 20s, 30s, and even 40s — experience breakouts that seem stubborn, painful, and resistant to standard skincare routines. If you notice deep cysts along the jawline, flare-ups before your period, or persistent breakouts despite good hygiene, chances are your acne has a hormonal root cause.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we frequently see patients struggling with hormonal acne. Instead of just masking the symptoms with creams or antibiotics, we take a functional medicine approach to uncover and correct the underlying hormone imbalances driving the problem.

What Is Hormonal Acne?

Hormonal acne is acne that is directly influenced by fluctuations or imbalances in your body’s hormones. While it can look similar to other types of acne, it often has distinct features:

• Location: Commonly along the jawline, chin, and lower cheeks.
• Timing: Flare-ups often occur around the menstrual cycle.
• Type: Deep, painful cystic lesions rather than small whiteheads or blackheads.
• Persistence: Resistant to over-the-counter creams and sometimes even prescription antibiotics.

These patterns are clues that your breakouts are connected to internal imbalances, not just clogged pores.

How Hormones Trigger Acne

Several hormones play a key role in skin health. When they are imbalanced, oil production and inflammation increase — setting the stage for breakouts.

1. Androgens (Testosterone, DHEA, DHT)

Androgens are “male” hormones present in both men and women. When levels are elevated, they stimulate the sebaceous (oil) glands to produce more sebum. Excess sebum mixes with dead skin cells, clogging pores and creating an environment where acne-causing bacteria thrive.

2. Estrogen and Progesterone

For women, estrogen and progesterone naturally rise and fall throughout the menstrual cycle. When progesterone is low and estrogen is dominant, inflammation may increase and acne often flares right before a period. Women with polycystic ovary syndrome (PCOS) are particularly prone to these shifts.

3. Cortisol (the Stress Hormone)

Chronic stress raises cortisol levels, which can increase oil production and trigger inflammation. This is why acne often worsens during stressful life periods.

4. Insulin and Blood Sugar Balance

High insulin levels — often seen with insulin resistance — increase androgen production. This link explains why acne is commonly associated with PCOS and metabolic syndrome.

Common Hormonal Conditions Linked to Acne

Hormonal acne often points to a deeper imbalance. Conditions we frequently evaluate at Sheen Vein include:

• PCOS (Polycystic Ovary Syndrome): Characterized by high androgens, irregular cycles, and insulin resistance.
• Perimenopause and Menopause: Shifting estrogen and progesterone levels can trigger breakouts later in life.
• Adrenal Dysfunction: Chronic stress alters cortisol rhythms, impacting skin health.
• Thyroid Disorders: Low thyroid function can indirectly affect hormone balance and skin turnover.

Functional Medicine Approach to Hormonal Acne

Instead of simply prescribing antibiotics or harsh topical creams, our approach focuses on identifying and treating the root cause of your hormonal imbalance.

Step 1: Testing and Assessment

We use advanced hormone testing, including blood and sometimes saliva or urine analysis, to assess:

• Estrogen and progesterone balance
• Androgen levels (testosterone, DHEA)
• Cortisol patterns
• Insulin sensitivity and blood sugar control

Step 2: Restoring Balance

Depending on the findings, treatment may include:

• Lifestyle and nutrition: Supporting stable blood sugar through diet, stress management, and exercise.
• Supplements: Key nutrients such as zinc, magnesium, and omega-3s support hormone metabolism and skin health.
• Bioidentical hormone therapy: In select cases, balancing estrogen, progesterone, or testosterone.
• Medications: For conditions like PCOS, targeted therapies may help.

Step 3: Skin Support

While we address the internal imbalances, we also offer aesthetic treatments to improve skin quality, such as:

• PRF facials for natural collagen stimulation.
• Fotona laser skin treatments to reduce scarring and improve tone.
• Personalized skincare routines to minimize irritation and support healing.

Why Acne Treatments Alone Don’t Always Work

Topical creams, antibiotics, or even isotretinoin (Accutane) can temporarily control breakouts, but if your hormones are the true driver, the acne often returns. Many patients we see at Sheen Vein have tried multiple dermatology prescriptions without success — because the underlying hormone imbalance was never addressed.

Why Choose Sheen Vein in St. Louis?

At Sheen Vein (Aesthetics and Functional Medicine), we combine medical expertise with a whole-body perspective. Our team looks beyond the surface to uncover why acne is happening in the first place. By addressing hormones, nutrition, gut health, and stress, we can help patients achieve long-term skin clarity and improved overall well-being.

We also integrate cutting-edge aesthetics to help reduce the appearance of existing scars, pigmentation, and skin damage once hormone-driven breakouts are under control.

Final Thoughts

Hormonal acne is frustrating, but it’s also your body’s way of signaling that something deeper is off balance. By uncovering and correcting hormone imbalances, you can achieve not just clearer skin but also better health overall.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we specialize in helping patients understand and treat the root causes of their symptoms. If stubborn acne is affecting your confidence, it may be time to consider a functional, hormone-focused approach.

Call to Action:
Ready to take control of your skin and hormones? Contact our St. Louis office today to schedule a consultation and learn how we can help you restore balance from the inside out.

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