Hormonal Acne: Causes & Probiotic Treatments

Phortify serum

Acne is a chronic skin disease driven by bacterial overgrowth. There are many factors that contribute to its occurrence and severity, including hormones. Hormonal imbalances can have a great impact on our skin chemistry. Hormones stimulate the sebaceous glands and provide more sebum for acne-causing bacteria, like C. acnes, to feed on. 

Phyla clears hormonal acne by targeting the acne-causing bacteria on your skin without interfering with your hormones or adversely affecting your skin’s microbiome. Read more about the science here. Taking a holistic, or whole-body approach, is key when clearing acne. Our diet can play a role too. Having food sensitivities and/or not eating balanced meals can have an impact on our skin. Acne is often an outward reflection of an internal imbalance or inflammation. 

Diversifying your diet is important, as it increases the diversity in your gut microbiome, which plays a role in your overall health. Typically, restricting certain food groups won’t heal acne. Instead, focus on consuming a supportive diet with a variety of nutrient-dense foods and consider the quality of the foods you are eating (e.g. organic + pasture raised if possible), and maintain discipline when addressing food sensitivities.

In order to address the root causes of acne, we must consider both external and internal factors. These factors include supporting our skin barrier through microbiome friendly skin care, maintaining whole-body health through diet, adequate sleep, and stress reduction. To accelerate your skin repair, avoid practices that harm your skin barrier and keep your skincare routine simple. And remember, progress over perfection. 


Changes in hormones during a menstrual cycle can cause flare-ups in acne. A woman's body typically runs on a 28 day cycle. Skin can fluctuate based on the stage of the cycle due to these hormone changes. 

Menstrual Phase (day 1-5 / going through your period): The menstrual phase is the first stage of the menstrual cycle. Hormone levels are at their lowest during this stage. This can cause dry, dull skin and can make lines or wrinkles appear more obvious. You may even experience acne breakouts before or during the first few days of this phase. 

Follicular Phase (day 6-13): This phase is the development of follicles in the ovaries. Estrogen levels slowly start to rise. Your skin will likely be at its best during this phase and irritation is less common. Escalating estrogen levels can reduce sebum secretions and stimulate collagen production, leaving you with glowing skin. However, if you have excess estrogen levels, this can cause an overproduction of sebum and lead to breakouts.

Ovulation Phase (day 14): This phase lasts for 16-32 hours. Estrogen levels reach a peak, which causes the pituitary gland to release a rush of Luteinising Hormone (LH). This causes the follicle in the ovary to rupture and an egg to release. Your skin will likely appear clear and bright over the next few days until testosterone and estrogen levels begin to fluctuate.

Luteal Phase (day 15-28): This is the longest phase of the menstrual cycle. Hormonal fluctuations during the luteal phase can have some less-than-desirable effects on the skin. After an egg is released and settled in the uterus during ovulation, progesterone and estrogen levels are high as your body starts to prepare for a possible pregnancy. Progesterone activates our oil glands, causing clogged pores. Progesterone can also increase inflammation and create a breeding ground for C. acnes. If the egg is not fertilized in the uterus, progesterone, estrogen, and testosterone levels will suddenly drop and your body starts to prepare for the menstrual phase, repeating the monthly cycle. 


PCOS can lead to acne because it causes the ovaries to produce more hormones called androgens, which stimulate the production of oil in the skin.

If you have PCOS, you may experience the following: Irregular or absent cycles/ovulation, cysts found on the ovaries via ultrasound, or signs of high androgens either on bloodwork (high DHEA, testosterone) or visibly through symptoms (like hair growing on the face, hair loss on the crown of the head, and acne on face, chest, and/or back).

Stressors on our body deactivates the parasympathetic nervous system. When this happens, it can cause dysbiosis (an imbalance of bacteria) in our gut microbiome. The overgrowth of bad bacteria in our microbiome impacts our bodies ability to detox excess hormones. Lack of gut microbial diversity can also lead to hirsutism, hair loss, and jawline acne associated with PCOS. Reducing external and internal stressors and fixing your gut (addressing constipation, food sensitivities, H. pylori, parasites, overuse of antibiotics, leaky gut, etc.) is at the foundation of repairing PCOS. 

When repairing PCOS, diet is foundational. An emphasis on animal proteins, healthy fats, vegetables, fruits, and whole grains is crucial. Looking at insulin levels, inflammation, adrenal health, vitamin D status, and fat consumption - is important as they all play a role in your hormonal health. Since acne is a sign that there is dysfunction below the surface, PCOS needs to be healed before the acne can clear. 


When treating hormonal acne, it’s better to address the root cause instead of a band aid solution. There’s a difference between suppressing the symptoms of acne and actually correcting the imbalances that are causing acne. Once you stop taking certain medications, your acne will typically return since the medication was only suppressing the symptoms. But, this is only temporary if the root cause is addressed. There can be a plethora of things at play when it comes to hormonal acne. Overall blood sugar dysregulation, estrogen dominance, and excess stress hormones can be factors that take time to heal. 


Traditionally spironolactone is a diuretic used to treat high blood pressure, fluid retention (edema), and high levels of the hormone aldosterone. Spironolactone works for hormonal acne or PCOS by suppressing your natural testosterone levels and blocks androgens from binding to sebaceous glands, minimizing oil production. Since spironolactone is suppressing your hormones, it’s not fixing the root cause. 

It can also come with some unpleasant side effects. Spironolactone is a category C medication, meaning it causes birth defects and has teratogenic effects. The side effects can range from a heavier menstrual cycle with intense cramps to mineral imbalances and gastrointestinal problems. 


Birth control doesn’t regulate your cycle. Instead, birth control suppresses ovulation by introducing synthetic forms of hormones into the system to disrupt the hypothalamic-pituitary-gonadal axis.

Birth control* can subside acne for some people for a short amount of time but doesn't address the root cause. Birth control works for hormonal acne by suppressing your androgen levels and blocks them from binding to sebaceous glands, minimizing oil production. However, acne can be caused by something unrelated to androgen hormones and birth control would be unable to solve this. 

Birth control also contains estrogen. Excess estrogen may make acne worse and leave us with other issues down the road due to neglect of the actual root causes. Estrogen can increase growth of fungus (like candida) and shift bacterial balance in the gut (SIBO & gut dysbiosis). It also depletes nutrients like Vitamins A, B, C, and E, Selenium, Zinc, and Magnesium. All of these nutrients are essential for liver detoxification and proper thyroid function.

Our liver will help remove many toxins, including excess estrogen. We can support our livers in this process through consuming adequate protein, carbs, vitamins and minerals, and having regular bowel movements. Furthermore, we can help the body fully excrete excess estrogen by eliminating foods that increase estrogen production, adverse hygiene products, and 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.


How does Phyla clear hormonal acne? The phage in Phyla's Phortify serum is a completely natural bacteriophage that exists in the microbiome of healthy individuals and keeps the skin acne-free (read more here). This phage keeps the inflammation-causing acne bacteria under control and allows your skin and its microbiome to thrive. Harnessing the natural power of these phages, Phyla gently treats acne – clearing your skin without the severe side effects of other acne treatments. 


The 3-Step Kit

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