1. Stress

The stress hormone, also called Cortisol can get in the way of other hormones. Women who usually have intense hormonal fluctuations are likely to have an acne flare caused by hormones. Stress is a factor that leads to acne, and you could stay off stress if you want to keep acne off.

2. Painful cysts instead of blackheads and whiteheads

Acne caused by hormones is different from the blackheads and white bacterial dots that you are used to. If your cysts are painful, then they are most likely hormonal. Those painful cysts are more deeply rooted and are located far from the skin’s surface. These bumps are also softer and tender to touch because they have gathered oil over time which leads to inflammation. These painful cysts usually come up in the same place every time and tend to become chronic or subacute.

The inflammatory component in them also makes it impossible to treat topically. A more clinical acne scar treatment is required to get rid of them completely.

3. You get breakouts once a month every month.

Hormonal acne breakouts occur cyclically similar to menstrual cycles. This happens more in women who have reached menopause because their progesterone and estrogen levels fluctuate. These breakouts also tend to pop out in the same place every time, and this is often due to a pore being enlarged by a previous breakout.