Hormonal VS Bacterial Acne: What’s the Difference and How Do You Treat Them?

Tips and practices to identify and fight both types of break-outs

You’re not alone if you struggle with acne; over 80% of people will battle pimples in their lifetime. But treating your skin can be tough, especially if you’re unsure what type of zits you’re dealing with. While both are equally annoying, hormonal acne and bacterial acne are caused and eliminated differently. If you’re struggling to figure out whether your acne is hormonal or bacterial, keep reading. We’ll walk you through the differences between the two—and offer advice on how to get them off your face!

Things You Should Know

  • Hormonal acne is usually more frequent and severe than bacterial acne. If you suffer from cystic pimples that happen often, odds are your acne is hormonal.
  • Bacterial acne usually comes in the form of whiteheads and blackheads. Benzoyl peroxide is usually the best way of treating these types of zits.
  • There are several options available for fighting hormonal acne—from topical therapies like drainage and dermabrasion to hormone-regulating medications like birth control.
  • It’s possible (even likely) that you’re suffering from hormonal and bacterial acne. The sebum of hormonal acne makes skin easily susceptible to bacteria.
Section 1 of 5:

What’s the difference between hormonal and bacterial acne?

  1. Image titled Tell if Acne Is Hormonal or Bacterial Step 1
    1
    Hormonal acne is caused by excess oil in the skin. The main culprit of hormonal acne is sebum: the oily substance your sebaceous (fat) glands produce to keep your skin protected. When your hormones increase, your sebaceous glands get larger and create an overproduction of sebum. This sebum makes your skin oily, causing acne breakouts.[1]
  2. Image titled Tell if Acne Is Hormonal or Bacterial Step 2
    2
    Bacterial acne is caused by bacteria infecting your pores. We all have small amounts of natural, good bacteria on our faces. But if our pores become clogged with oils or dead skin cells (which our body sheds regularly), these microbes can infect our follicles, which results in pimples and zits.[2]
    Advertisement
  3. Image titled Tell if Acne Is Hormonal or Bacterial Step 3
    3
    Hormonal acne and bacterial acne can co-exist. Because hormonal acne clogs your pores, hormonal breakouts create perfect environments for bacteria to get into your skin and spread. Therefore, there’s a chance both sebum and bacteria are giving you pimples and you should be treated for both types of acne.[3]
    4. Advertisement
Section 2 of 5:

How to Tell if Your Acne is Hormonal or Bacterial

  1. Image titled Tell if Acne Is Hormonal or Bacterial Step 4
    1
    If you have acne flare-ups as an adult, it’s probably hormonal. While acne mostly affects people in their teen years, you become more hormonally active as an adult (especially if you’re an adult woman). You're biologically closer to reproductive age. You’re likely more sexually active. Because of this, your hormones are oscillating, causing acne.[4]
  2. Image titled Tell if Acne Is Hormonal or Bacterial Step 5
    2
    If your acne happens on a regular schedule, it’s probably hormonal. If your acne comes around the same time every month and a half or so, it’s probably due to your hormone cycle. (This is especially common for women on their periods.) On the other hand, if your acne pops up randomly and unpredictably, it’s probably bacterial.[5]
  3. Image titled Tell if Acne Is Hormonal or Bacterial Step 6
    3
    If you have a family history of acne, it’s probably hormonal. Sadly, genetics play a huge factor in our break-outs. If your parents had acne similar to yours, you’re probably suffering from a hormonal condition.[6]
  4. Image titled Tell if Acne Is Hormonal or Bacterial Step 7
    4
    If you’re stressed or sleep-deprived, it’s probably hormonal. Hormones react when we’re high-strung or we haven’t had enough rest. If you’ve been suffering from insomnia lately, or you’ve been suffering from anxiety or another stress-related problem, your skin has broken out as a response.[7]
  5. Image titled Tell if Acne Is Hormonal or Bacterial Step 8
    5
    If you’re taking hormone-altering medications, it’s probably hormonal. If you’re taking anabolic steroids, lithium, or estrogen/testosterone, it’s likely your hormones are fluctuating. This fluctuation is causing pimples and inflammation.[8]
  6. Image titled Tell if Acne Is Hormonal or Bacterial Step 9
    6
    If you have a hormone condition, it’s probably hormonal. If you are dealing or have dealt with PCOS (polycystic ovarian syndrome), acromegaly, or other hormone/endocrine-based disorders, there’s a good chance your androgen levels have been affected, causing overproduction of sebum and hormonal acne.[9]
  7. Image titled Tell if Acne Is Hormonal or Bacterial Step 10
    7
    If your diet is greasy, it’s probably bacterial. Greasy foods have been proven to clog pores. If you eat a lot of refined (non-complex) carbs, added sugars, or meals rich in omega-6, your body may be suffering from inflammation, which is causing bacterial acne.[10]
  8. Image titled Tell if Acne Is Hormonal or Bacterial Step 11
    8
    If you live in a polluted area, it’s probably bacterial. If your environment is clogged, unfortunately, your skin might be too. Studies have shown that air pollution has resulted in certain variants of acne and clogged pores.[11]
  9. Image titled Tell if Acne Is Hormonal or Bacterial Step 12
    9
    If it’s a singular whitehead or blackhead, it’s probably bacterial. Hormonal fluctuations likely cause acne to come in clusters or break-outs. If you notice a single, non-pustule zit, it’s likely caused by bacteria entering your pores.[12]
  10. Image titled Tell if Acne Is Hormonal or Bacterial Step 13
    10
    If it’s inflamed and cystic, it’s probably both. If you’re suffering from pustules (pus-filled pimples) or papules (pimples without noticeable heads), odds are an initial hormonal break-out has caused bacteria to enter your skin and block your pore. The contents of that pore have then spilled out and reddened the nearby skin, resulting in more cystic and painful zits.[13]
    • Getting rid of cystic acne is often a process combining hormonal and bacterial treatments. Since everyone’s acne is different, see a dermatologist to see which methods are best for your skin.
    11. Advertisement
Section 3 of 5:

How to Treat Hormonal Acne

  1. Image titled Tell if Acne Is Hormonal or Bacterial Step 14
    1
    Develop a regular skincare routine. Since hormonal acne happens cyclically, treatment for it should be regular too. Find a facial cleanser with an acne-fighting chemical like salicylic acid and apply it to affected areas as often as twice a day (once in the morning, once at night). Dermatologists also recommend using a retinoid gel or cream a few times a week.[14]
    • Both salicylic acid and retinoid may cause redness or dry skin. Exposure to sunlight may worsen these side effects.
    • Do not use a retinoid product regularly while also using benzoyl peroxide to treat acne.
  2. Image titled Tell if Acne Is Hormonal or Bacterial Step 15
    2
    Use non-comedogenic products. Be careful when covering your skin with certain make-ups, sunscreens, and skin products as they may contain comedogenic (or pore-clogging) ingredients. In addition to a regular acne cleanser, switch to a non-comedogenic moisturizer to keep your skin healthy and refreshed.[15]
  3. Image titled Tell if Acne Is Hormonal or Bacterial Step 16
    3
    Try topical therapy. Make an appointment with a nearby dermatologist if you need help managing your hormonal acne. They offer several effective topical treatments like: drainage and extraction for popping whiteheads and blackheads, light therapy for blemishes, and even low-risk steroid injection for painful papules.[16]
  4. Image titled Tell if Acne Is Hormonal or Bacterial Step 17
    4
    If you’re a woman or AFAB, consider taking hormone-regulating pills. Certain oral contraceptives, like spironolactone and birth control, are recommended by dermatologists in treating hormonal acne for women. If your hormonal acne is severe and other treatments just aren’t working, these medications may be a good option. Just be sure to consult your doctor first![17]
    • In severe cases, hormonal therapy may cause blood clots or high blood-pressure. If you experience either of these symptoms, contact a medical professional immediately.
    5. Advertisement
Section 4 of 5:

How to Treat Bacterial Acne

  1. Image titled Tell if Acne Is Hormonal or Bacterial Step 18
    1
    Apply benzoyl peroxide. Using a benzoyl peroxide skin cleanser on its own or combination with another topical face-wash has been proven to help fight bacterial or mixed acne. Wash your face twice a day with benzoyl peroxide to help eliminate the spread of bacteria on your face.[18]
    • Only apply benzoyl peroxide to affected areas to avoid unnecessary redness and irritation.
  2. Image titled Tell if Acne Is Hormonal or Bacterial Step 19
    2
    Consider taking oral antibiotics. In intense cases, oral antibiotics like doxycycline and azithromycin can help fight the spread of bacteria in your body. However, these should be taken for as short a time as possible and used alongside other facial cleansers to prevent bacteria from developing a resistance to the medication.[19]
    • Oral antibiotics are available through prescription only. Consult your doctor first if you think you could benefit from this treatment.
  3. Image titled Tell if Acne Is Hormonal or Bacterial Step 20
    3
    Practice excellent hygiene habits. If you’re suffering from bacterial acne, you have to be extra diligent in maintaining good hygiene to prevent acne. Wash your face twice a day, avoid touching your cheeks and forehead, exfoliate regularly, and avoid irritants to your skin (tight clothing, severe sunlight) to keep break-outs in check.[20]
    • If you’re regularly getting acne in the same spot on your skin, you probably need to change your clothes to a more breathable type of fabric.
    4. Advertisement
Section 5 of 5:

Is fungal acne hormonal or bacterial?

  1. Image titled Tell if Acne Is Hormonal or Bacterial Step 21
    Fungal acne is neither hormonal or bacterial. If you’re suffering from itchy, red bumps on your skin, chances are you’re not suffering from a break-out, but from folliculitis (an inflammation of your skin’s hair follicles). While sebum production and bacteria exacerbate fungal acne, it’s mainly caused by yeast infecting your pores. The good news: this means it’s unlikely you’ll suffer from any pimples or zits. The bad news: fungal acne cannot be treated like hormonal or bacterial acne, and anti-yeast remedies are necessary.[21]
    • Usually, fungal acne can be treated with regular use of antifungal shampoos and soaps, which are available online and in most grocery stores.
    • In severe cases, fungal acne may require oral antibiotics. Consult your doctor if your folliculitis is particularly severe, long-lasting, or painful.

How Do I Get Rid Of Hormonal Acne?

You Might Also Like

Use Salicylic Acid on Your Face
How to
Use Salicylic Acid on Your Face
Remove the Redness of a Pimple
How to
Remove the Redness of a Pimple
Dry Out a Pimple
How to
Dry Out a Pimple
Get Rid of Acne
How to
Get Rid of Acne
Hide Pimples
How to
Hide Pimples
Cover Acne Scars with Makeup
How to
Cover Acne Scars with Makeup
Stop or Cure Pimples
How to
Stop or Cure Pimples
Reduce the Swelling and Redness of Pimples
How to
Reduce the Swelling and Redness of Pimples
Stop Armpit Pimples
How to
Stop Armpit Pimples
Get Rid of Red Acne Marks
How to
Get Rid of Red Acne Marks
Get Rid of Pimple Redness Overnight
How to
Get Rid of Pimple Redness Overnight
Get Rid of Acne Redness Fast
How to
Get Rid of Acne Redness Fast
How to
Conceal Red Spots on Your Face
Shrink Pimples
How to
Shrink Pimples
Advertisement

References

  1. ↑ https://www.niams.nih.gov/health-topics/acne
  2. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560440/
  3. ↑ https://my.clevelandclinic.org/health/diseases/12233-acne#symptoms-and-causes
  4. ↑ https://my.clevelandclinic.org/health/diseases/21792-hormonal-acne
  5. ↑ https://www.health.harvard.edu/blog/adult-acne-understanding-underlying-causes-and-banishing-breakouts-2019092117816
  6. ↑ https://my.clevelandclinic.org/health/diseases/21792-hormonal-acne
  7. ↑ https://www.health.harvard.edu/blog/adult-acne-understanding-underlying-causes-and-banishing-breakouts-2019092117816
  8. ↑ https://pubmed.ncbi.nlm.nih.gov/19932324/
  9. ↑ https://pubmed.ncbi.nlm.nih.gov/19932324/
  1. ↑ https://health.clevelandclinic.org/5-foods-that-can-cause-inflammation/
  2. ↑ https://www.tandfonline.com/doi/full/10.4161/derm.1.3.7862
  3. ↑ https://my.clevelandclinic.org/health/diseases/12233-acne
  4. ↑ https://www.goodrx.com/conditions/acne/acne-types-how-to-treat
  5. ↑ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
  6. ↑ https://www.aad.org/public/diseases/acne/skin-care/habits-stop
  7. ↑ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
  8. ↑ https://www.aad.org/public/diseases/acne/derm-treat/hormonal-therapy
  9. ↑ https://www.aad.org/member/clinical-quality/guidelines/acne
  10. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585707/
  11. ↑ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
  12. ↑ https://wexnermedical.osu.edu/blog/fungal-acne

About This Article

Mohiba Tareen, MD
Co-authored by:
Mohiba Tareen, MD
FAAD Board Certified Dermatologist
This article was co-authored by Mohiba Tareen, MD and by wikiHow staff writer, Finn Kobler. Mohiba Tareen is a board certified Dermatologist and the founder of Tareen Dermatology located in Roseville, Maplewood and Faribault, Minnesota. Dr. Tareen completed medical school at the University of Michigan in Ann Arbor, where she was inducted into the prestigious Alpha Omega Alpha honor society. While a dermatology resident at Columbia University in New York City, she won the Conrad Stritzler award of the New York Dermatologic Society and was published in The New England Journal of Medicine. Dr. Tareen then completed a procedural fellowship which focused on dermatologic surgery, laser, and cosmetic dermatology. This article has been viewed 1,638 times.
How helpful is this?
Co-authors: 4
Updated: March 12, 2023
Views: 1,638
Categories: Acne
If you buy through links on our site, we may earn a commission.
Advertisement