Why You Still Have Acne When Your Hormone Test is "Normal"
If you've been told your acne is caused by "hormone imbalance," you're not alone. It's one of the most common explanations out there—and also one of the most frustratingly vague.
Balance your hormones. Get your hormones in check. Hormone imbalance is causing your breakouts.
But what does that actually mean? Which hormones? What kind of imbalance? And more importantly—what can you actually do about it?
Let's get specific.
Your Body Has Over 70 Hormones (Yes, Really)
Here's something most people don't realize: the human body produces over 70 different hormones. These chemical messengers regulate everything from your sleep cycle to your appetite, mood, metabolism, growth, and yes—your skin.
And here's another important fact: everyone has the same hormones, regardless of gender. Men, women, and intersex individuals all produce the same hormones, just in different amounts. The idea that "hormone imbalance" only applies to women is a myth. Men are just as susceptible to hormonal acne and imbalance as anyone else.
With over 70 hormones at work in your body, it's easy to see why "hormone imbalance" feels like an overwhelming, impossible-to-solve puzzle.
But when it comes to acne, you don't need to worry about all 70.
Only 3 Hormones Control Your Oil Production
Of those 70+ hormones, only three are directly responsible for signaling your oil glands and causing acne:
- Testosterone
- DHT (Dihydrotestosterone)
- IGF-1 (Insulin-like Growth Factor 1)
These three hormones are the master controllers of your sebaceous glands—the tiny oil-producing glands in your skin. When functioning at healthy levels, they do exactly what they're supposed to: signal your oil glands to produce sebum, the natural oil that keeps your skin moisturized, protected, and healthy.
These hormones aren't the enemy. In fact, you need them.
The problem starts when these three hormones become elevated beyond normal levels. When that happens, they over-signal the oil glands, causing an excess of sebum to be produced. This excess oil clogs your pores, creates the perfect environment for bacteria, and leads to those red, inflamed, painful breakouts we call hormonal acne.
Your Body Isn't Creating This Imbalance on Its Own
Here's the good news: your body wants to be hormonally balanced. It's not randomly deciding to overproduce testosterone or IGF-1 just to ruin your skin.
Hormone imbalances don't happen in a vacuum. They're triggered by outside factors—things you're consuming, lifestyle habits, and sometimes medications. These triggers cause your body to produce more of these three acne-causing hormones than it normally would.
The most common culprits? Hidden aspects of your diet, stress, sleep disruption, and certain lifestyle patterns.
And because these triggers are identifiable, the imbalance is correctable. That means your acne can be healed.
The Truth About Hormone Testing
Many people wonder if they should get their hormones tested to identify the problem. It's a reasonable question, and testing can be helpful—but it also has significant limitations.
Here's why: a hormone test is mostly only going to identify chronic hormone imbalance.
Hormones fluctuate throughout the day based on what you eat, drink, how you sleep, and your stress levels. For example, alcohol has been scientifically shown to raise testosterone by 200% just one hour after drinking—but levels normalize again within five hours of stopping.
This is what I call acute hormone imbalance. Unless you take a hormone test within the exact timeframe when the trigger is affecting your body, it's unlikely to show up on the test.
So you can have hormonal acne—clear as day on your face—and still get test results that say your hormones are "normal."
If your doctor has told you your hormones are fine, but you're still dealing with painful, inflamed breakouts, your acne is telling you a different story. Don't let a "normal" test result be the end of the conversation. There are more answers available to you.
What Hormonal Acne Actually Looks Like
Not sure if your acne is hormonal? Here are the telltale signs:
- Red, inflamed breakouts
- Painful cystic bumps, especially along the jawline, chin, and lower cheeks
- Breakouts that coincide with your menstrual cycle (for those who menstruate)
- Persistent acne that doesn't respond to typical topical treatments
If this sounds like your skin, you're dealing with a correctable hormone imbalance.
Ready to Identify What's Triggering Your Hormones?
You now know the three hormones behind your acne—but what's causing your testosterone, DHT, and IGF-1 to elevate?
That's exactly what we uncover in my 90-Day Acne Detox Program. Through a personalized approach, we identify your specific triggers—whether they're hidden in your diet, lifestyle, or elsewhere—and create a targeted plan to reverse them.
The results? 100% of program graduates achieved clear skin in 2025!
Every single client who has completed the program this year has seen significant improvement in their skin. Because when you address the root cause of hormone elevation, your body does what it naturally wants to do: balance itself and heal.
Learn more about the 90-Day Acne Detox Program →
The Bottom Line
If you have hormonal acne, it's not a life sentence. It's a sign that three specific hormones are elevated, and that elevation is being triggered by something correctable in your diet, lifestyle, or environment.
You don't need to feel lost in the fog of "hormone imbalance" anymore. You need specific answers, a targeted plan, and the right professional to help you identify what's driving your unique hormone elevation.
If you've been trying to do this yourself for months (or years) and feeling stuck, it may be time to work with a holistic acne specialist.
Your skin is trying to tell you something. It's time to listen—and take action.
In love, health, and community,
Elise May, CN + LE, is a holistic esthetician, acne nutritionist, wellness coach and founder of Skin Nutritious. Since 2011, she has helped over 1,800 clients finally overcome acne with a unique blend of holistic skincare, treatments, and wellness coaching.
Work with Elise at her San Francisco acne clinic or virtually worldwide! Get started on your Clear Skin Journey here >
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