Hormonal Acne: Causes & Probiotic Treatments

Acne is caused by an overgrowth of bacteria, including the acne-causing C. acnes. Hormonal imbalances can exacerbate acne severity by increasing the production of sebum that feeds these bacteria. Phyla's approach to clearing hormonal acne is unique, as it targets the bacteria directly, without interfering with hormones or disrupting the skin's microbiome. Read more about the science here.

A comprehensive approach that takes into account the entire body is crucial in addressing acne. Diet is a factor that cannot be overlooked as food sensitivities and imbalanced meals can affect the skin. The presence of acne may be an indicator of internal inflammation or an imbalance.

To promote a healthy gut microbiome and support overall health, it's important to consume a diverse range of nutrient-dense foods. Restricting specific food groups may not necessarily cure acne, so it's best to focus on incorporating high-quality, organic, and pasture-raised foods into your diet while addressing any food sensitivities with discipline.


To effectively tackle the underlying causes of acne, it's crucial to take into account both external and internal factors. This includes nurturing our skin barrier through the use of microbiome-friendly skincare, prioritizing our overall well-being through a healthy diet, sufficient sleep, and stress management. It's important to avoid any practices that may damage the skin barrier and maintain a simple and consistent skincare routine. It's also worth remembering that progress, even if it's gradual, is more important than striving for perfection.


Fluctuations in hormone levels during a menstrual cycle can trigger acne flare-ups. Generally, a woman's body operates on a 28-day cycle, and changes in skin condition can occur depending on the stage of the cycle, which is attributed to hormone fluctuations.

Menstrual Phase (day 1-5 / going through your period): 

During the menstrual phase, which marks the beginning of the menstrual cycle, hormone levels are typically at their lowest. This can lead to dry, lackluster skin, as well as the exacerbation of fine lines and wrinkles. Additionally, it's not uncommon to experience acne breakouts before or during the initial days of this phase.

Follicular Phase (day 6-14 / after your period):

During the Follicular Phase, the follicles in the ovaries begin to develop and estrogen levels gradually increase. Skin during this phase is typically in its prime condition and is less prone to irritation. With the rise in estrogen, sebum production decreases and collagen synthesis increases, resulting in radiant and youthful-looking skin. However, excessive levels of estrogen can stimulate sebum production, leading to breakouts.

Ovulation Phase (day 14):

During the ovulation phase, which lasts for 16-32 hours, estrogen levels peak, triggering the release of Luteinising Hormone (LH) from the pituitary gland, causing the follicle in the ovary to rupture and release an egg. Skin during this phase is typically clear and bright, but this can change as hormone levels begin to fluctuate, specifically testosterone and estrogen.

Luteal Phase (day 15-28):

The luteal phase is the longest stage in the menstrual cycle and can lead to hormonal changes that affect the skin negatively. Following ovulation, when the egg is released and settles in the uterus, progesterone and estrogen levels rise in preparation for a possible pregnancy. These hormones can activate oil glands, leading to clogged pores and increased inflammation, creating an ideal environment for acne-causing bacteria like C. acnes to thrive. If the egg is not fertilized, hormone levels will drop suddenly, and the body prepares for the menstrual phase, starting the cycle anew.

Polycystic Ovary Syndrome (PCOS)

PCOS can trigger acne by inducing the ovaries to generate an excess of androgen hormones, which can stimulate the production of sebum in the skin.

This can manifest in several ways, including irregular or absent menstrual cycles, ovarian cysts detected via ultrasound, or indications of high androgen levels that may be evident through symptoms like facial hair growth, hair loss on the crown of the head, and acne on the face, chest, and/or back.

When our body is under stress, the parasympathetic nervous system is suppressed, leading to dysbiosis or an imbalance of bacteria in our gut microbiome. The overgrowth of harmful bacteria in our microbiome can affect the body's ability to eliminate excess hormones. In addition, a lack of diversity in gut microbes may cause hirsutism, hair loss, and jawline acne associated with PCOS. To address PCOS, it is crucial to reduce external and internal stressors and improve gut health by addressing issues such as constipation, food sensitivities, H. pylori infection, parasite infestations, antibiotic overuse, and leaky gut.

To heal PCOS and clear acne, it is crucial to prioritize diet. A healthy diet that includes animal proteins, healthy fats, vegetables, fruits, and whole grains is foundational. Additionally, it is important to consider factors such as insulin levels, inflammation, adrenal health, and vitamin D status, as they all play a role in hormonal health. As acne is a manifestation of underlying dysfunction, addressing PCOS is necessary for acne to heal.


To effectively treat hormonal acne, it's important to address the underlying issues rather than resorting to temporary solutions. Addressing the root causes of acne is different from suppressing its symptoms. Simply suppressing the symptoms through medication will not provide a long-term solution as the acne is likely to return once the medication is stopped. However, correcting the underlying hormonal imbalances can provide a more permanent solution. Hormonal acne can be caused by various factors such as blood sugar dysregulation, estrogen dominance, and excess stress hormones, which require time to heal.


Spironolactone is commonly used as a diuretic for conditions such as high blood pressure, edema, and high aldosterone levels. However, it can also be used to treat hormonal acne or PCOS by reducing the levels of natural testosterone and preventing androgens from binding to sebaceous glands, thereby reducing oil production. While spironolactone can be effective for managing hormonal acne, it does not address the underlying cause of the issue.

Spironolactone may also lead to undesirable side effects. As a category C medication, it can result in birth defects and have teratogenic effects. The potential adverse effects of spironolactone range from a heavier menstrual cycle accompanied by severe cramps to mineral imbalances and gastrointestinal issues.


Rather than regulating the menstrual cycle, birth control* works by inhibiting ovulation through the introduction of synthetic hormones that interfere with the hypothalamic-pituitary-gonadal axis.

While birth control can temporarily improve acne for some individuals, it does not address the underlying cause. Birth control works by suppressing androgen hormones and blocking their effects on sebaceous glands, thereby reducing oil production. However, if the root cause of acne is unrelated to androgen hormones, birth control may not be effective.

Birth control contains estrogen which can have adverse effects on acne and lead to other problems in the future if the root causes are ignored. Estrogen can promote the growth of fungi such as candida and disrupt the balance of bacteria in the gut, leading to SIBO and gut dysbiosis. It can also deplete important nutrients like Vitamins A, B, C, and E, Selenium, Zinc, and Magnesium, all of which are necessary for liver detoxification and optimal thyroid function.

The liver plays a crucial role in eliminating toxins, including excess estrogen, from the body. To support this process, we can ensure that our diets contain sufficient amounts of protein, carbohydrates, vitamins, and minerals, and promote regular bowel movements. Additionally, we can aid the body in fully excreting excess estrogen by avoiding foods that increase estrogen production, as well as refraining from using harmful hygiene products and minimizing exposure to plastics.

*Not intended to be anti-birth control, however, it is important that we are informed about the effects of certain medications on our bodies.


The bacteriophage found in Phyla's Phortify serum is a natural organism that targets and kills the specific bacteria responsible for causing acne. These phages exist naturally in the microbiome of healthy individuals and help to keep the skin free of acne. By introducing this natural bacteriophage into the skin, Phyla's Phortify Serum can effectively control and reduce the inflammation caused by acne, without harming the beneficial bacteria that make up the skin's microbiome.

Unlike other acne treatments that can have harsh and potentially harmful side effects, Phyla's Phortify serum works gently and effectively to clear hormonal acne. It does not contain any harsh chemicals or synthetic ingredients, making it a safe and natural alternative for those looking to treat their acne without causing damage to their skin. By harnessing the natural power of bacteriophages, Phyla's Phortify serum can help to clear hormonal acne and promote healthy, glowing skin.


The 3-Step Kit

Phyla | Acne-Fighting Probiotic Kit, $99.00 (with subscription)

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