When it comes to acne, all forms have one thing in common: clogged pores. It’s the substances and underlying causes of clogged pores that differentiate inflamed acne from non-inflamed acne. Inflamed acne consists of swelling, redness, and pores that are deeply clogged with bacteria, oil, and dead skin cells. Sometimes, bacteria called Propionibacterium acnes (P. acnes) can cause inflamed acne, too. Non-inflammatory acne, also called comedonal acne, is closer to the surface of the skin and doesn’t have a bacterial basis.

Keep reading to learn about the different types of inflammatory acne and find out which treatments actually work.

What are the different types?

Different types of inflammatory acne require different treatments, so it’s important to start by correctly identifying the kind of inflammatory acne you have.

The main types include:

  • Inflamed comedones. These are swollen blackheads and whiteheads.
  • Papules. These small, pus-filled red bumps appear on your skin’s surface.
  • Pustules. These are similar to papules but larger in size.
  • Nodules. These small, pus-filled bumps lie below the surface of your skin.
  • Cysts. Cysts are the most severe type of inflamed acne. Like nodules, they sit below the surface of your skin. They’re filled with pus and are usually large and painful when touched.

While inflamed acne is common on the face, it can also affect your:

How’s it treated?

Inflamed acne* can spread and eventually cause scarring, so it’s best to start treating it as soon as possible. Depending on the type of acne you have, your doctor might suggest starting with over-the-counter (OTC) treatments before moving on to stronger prescription treatments.

Talk to your dermatologist about all of the following options for inflamed acne* treatment. Keep in mind that it can take several weeks for each treatment to take full effect.

OTC treatments

There are tons of OTC treatments for inflamed acne*, which can make choosing one feel overwhelming. Here are three of the main ingredients you’ll likely find in these products:

  • Benzoyl peroxide. This ingredient works by killing off p. acnes that might be trapped in your pores, and reducing inflammation. It can be drying for your skin, so it’s best to use it as a spot treatment.
  • Salicylic acid. This ingredient has a shedding effect and removes dead skin cells from deep inside your pores. It can also help to break down inflamed acne* lesions while preventing them from coming back. You can use it all over your skin, but make sure to follow up with a moisturizer, because it can cause dryness over time.
  • Sulfur. You’ll find this ingredient in many acne-treating products, but it works best for mild, non-inflamed acne*. While it won’t make your inflamed acne worse, it probably won’t do much to treat it.

Start by adding a cleanser containing salicylic acid and a benzoyl peroxide spot treatment to your skincare routine. It may be a few months before you start to notice a difference. Keep in mind that inflamed acne doesn’t always respond to OTC treatment, especially if it’s widespread and reoccurring. If you’re not seeing a change after three months, consider seeing a dermatologist or asking your doctor for a referral to one.

Medical treatments

Depending on your symptoms, your dermatologist may recommend one or a combination of prescription medications or topical creams, including:

  • Topical retinoids.Retinoids are powerful vitamin-A derivatives that remove dead skin cells. While you might see them in some OTC anti-aging products, prescription-strength retinoids, such as Differin and Retin-A, are most effective for inflamed acne. Aside from some initial redness and peeling, retinoids also make your skin more sensitive to UV rays, so make sure to wear sunscreen when using them.
  • Isotretinoin. Derived from vitamin A, this oral medication is one of the most powerful treatments prescribed for acne. It can cause a range of , so it’s usually reserved for severe cases, usually those involving inflamed cystic acne, that don’t respond to retinoids. Avoid isotretoinoin if you’re pregnant, breastfeeding, or think you might become pregnant.
  • Oral antibiotics. If your dermatologist suspects that excessive p. acnes are causing your breakouts, they might prescribe a round of antibiotics. These are used temporarily to get the bacteria under control, usually in cases of widespread cystic acne.
  • Topical antibiotics. Unlike oral versions, you can only take for a short period of time, topical antibiotics can be used twice a day for up to two months. However, they aren’t as strong as oral antibiotics, so they’re best for less severe types of inflamed acne, including nodules, pustules, or papules.
  • Hormonal treatments. Some cases of inflamed acne are caused by hormonal imbalances. In these cases, your dermatologist may prescribe hormone-reducing medications. In addition, birth control pills work for some women who experience more inflamed acne before and during their menstrual cycles. Spironolactone, an anti-androgen medication, may also help with nodules and cystic acne caused by unusually high androgen levels.
Skincare tips

No inflamed acne treatment will work if you don’t properly care for your skin. Follow these tips to ensure you get the most out of the treatment options you try:

  • While you shouldn’t try to pop any type of acne lesion, this is especially important for inflamed acne. Doing so can increase inflammation and cause it to spread.
  • Wash your face morning and night with a gentle, gel-based cleanser.
  • Shower immediately after working out.
  • Follow your cleansing routine with an oil-free moisturizer, even if it feels counterintuitive. Skipping this step can deplete natural oils and water from your skin. In response, your sebaceous glands produce more oil, which leads to more acne.
  • Wear a sunscreen-based moisturizer or foundation every single day. While this will help to protect your skin from UV rays, it’s also a must if you’re using retinoids or other treatments that make your skin more sensitive to the sun.
  • If you wear makeup, look for oil-free and non-comedogenic options that won’t clog your pores or make your acne worse. Also, be sure to thoroughly remove your makeup before washing your face at night.

Treating inflamed acne can sometimes feel like an impossible task. Start by adopting a simple skincare routine that includes an oil-free moisturizer, gel-based cleanser, and benzoyl peroxide spot treatment. If you don’t notice any improvement after a few months, make an appointment with your doctor. There are several prescription treatments that can help when OTC ones don’t.

Hormonal acne is exactly what it sounds like — acne tied to fluctuations in your hormones.

Although it’s typically associated with hormone fluctuations during puberty, hormonal acne can affect adults of any age. It’s especially common in women. A number of factors may contribute to this, including menstruation and menopause.

It’s estimated that 50 percent of women ages 20 to 29 have acne. It affects about 25 percent of women ages 40 to 49.

Expert opinions are mixed when it comes to hormonal acne. Although the Mayo Clinic says hormones generally aren’t a factor in adult acne, hormonal imbalances may contribute to acne in adults with underlying medical conditions.

In other cases, adults with acne may not have any “measurable” hormone issues. This can make diagnosis and treatment challenging.

Keep reading to learn what hormonal acne looks like, what causes it, and how to clear up breakouts.

What are the characteristics of hormonal acne?

During puberty, hormonal acne often appears in the T-zone. This includes your forehead, nose, and chin.

Hormonal adult acne typically forms on the lower part of your face. This includes the bottom of your cheeks and around your jawline.

For some people, hormonal acne takes the form of blackheads, whiteheads, and small pimples that come to a head, or cysts.

Cysts form deep under the skin and don’t come to a head on the surface. These bumps are often tender to the touch.

Hormonal acne may be caused by influxes of hormones from:

Specifically, these hormone fluctuations may aggravate acne* issues by increasing:

  • overall skin inflammation
  • oil (sebum) production in the pores
  • clogged skin cells in hair follicles
  • production of acne-causing bacteria called Propionibacterium acne*s
Is menopausal acne a form of hormonal acne*?

Many women begin to experience menopause in their 40s and 50s. This causes a natural decline in your reproductive hormones, resulting in an end to menstruation.

Some women experience acne during menopause. This is likely due to a drop in estrogen levels or an increase in androgen hormones like testosterone.

You may still experience menopausal acne even if you’re using hormone replacement therapies (HRTs) to ease your menopause symptoms. This is because some HRTs use an influx of the hormone progestin to replace the estrogen and progesterone your body loses. Introducing this hormone to your system can cause your skin to break out.

In most cases, prescription medication can clear up menopausal acne. Some women may find success using natural treatment methods. Talk to your doctor about which options may be right for you.

Traditional treatments for hormonal acne

Unless your hormonal acne is mild, over-the-counter (OTC) products usually aren’t successful.

This is because hormonal acne* typically takes the form of cystic bumps. These bumps form deep under the skin, out of reach of most topical medications.

Oral medications can work from the inside out to balance your hormones and clear up the skin. Common options include oral contraceptives and anti-androgen drugs.

Oral contraceptives

Oral contraceptives specifically used for acne treatment contain ethinylestradiol plus one of the following:

  • drospirenone
  • norgestimate
  • norethindrone

Together, these ingredients target the hormones that can contribute to acne. This can be especially helpful during peaks in hormones, such as during ovulation.

Oral contraceptives may not be an option for you if you have a history of blood clots, high blood pressure, or breast cancer. You also shouldn’t take these if you smoke.

Learn more: How birth control affects acne »

Anti-androgen drugs

Anti-androgen drugs work by decreasing the male hormone androgen. Both men and women have natural levels of this hormone. Too much androgen, though, can contribute to acne issues by interfering with hair follicles that regulate skin cells and increasing oil production.

Although spironolactone (Aldactone) is primarily used to treat high blood pressure, it has anti-androgen effects. In other words, it can prevent your body from producing more androgen and allow your hormone levels to stabilize.


If your hormonal acne* is mild, you may be able to use topical retinoids. Retinoids are derived from vitamin A.

Many retinoid creams, gels, and lotions are available over the counter. But you may want to see your doctor about a prescription-strength formulation. A prescribed product is often the most effective way to keep your skin consistently clear.

If you add a topical retinoid to your regimen, it’s important to apply sunscreen daily. Retinoids can increase your risk of sunburn.

How to treat hormonal acne naturally

In some cases, plant-based treatment options may be used to clear up mild hormonal acne*.

Natural treatments are usually free of the side effects sometimes caused by prescription options. But they may not be as effective. Research on natural options is lacking, and at this time nothing has been proven to produce results. Talk with your doctor about potential risks and to ensure the treatment won’t interact with any medications you’re taking.

Tea tree oil

Tea tree oil works by decreasing inflammation that can contribute to acne. One studyTrusted Source found that 5 percent topical tea tree oil relieved symptoms in participants with mild to moderate acne.

Tea tree oil is available in many of skin care products, such as cleansers and toners. You can also use tea tree essential oil as a spot treatment.

You should always dilute tea tree essential oil with a carrier oil before use. Popular carrier oils include coconut, jojoba, and olive. The general rule is to add about 12 drops of carrier oil to every one to two drops of essential oil.

It’s also important to do a skin patch test before using diluted tea tree essential oil. To do this, apply the diluted oil to the inside of your forearm. If you don’t experience any irritation or inflammation within 24 hours, it should be safe to apply elsewhere.

Alpha hydroxy acid

Alpha hydroxy acids (AHAs) are plant acids derived mostly from citrus fruits. AHAs can help remove excess dead skin cells clogging pores. As a bonus, AHAs can help minimize the appearance of acne* scars.

AHA can be found in many OTC masks and creams. As with retinoids, AHAs can increase your skin’s sun sensitivity. You should always wear sunscreen when using products with AHA.

Green tea

Green tea is known for decreasing inflammation in the body. For a more holistic approach, consider drinking a few cups per day besides practicing your topical skin care regimen. You can find a great selection of green teas here. Lotions and gels containing at least 2 percent green tea extract may be beneficial.

Hormonal acne: Diet do’s and don’ts

The exact role between diet and hormonal acne isn’t fully understood. Some foods may help prevent acne — particularly inflammation-fighting foods.

Plant-based foods high in antioxidants may help reduce inflammation and promote clearer skin. Omega-3 fatty acids may also decrease skin inflammation.

Contrary to popular belief, junk food alone doesn’t cause acne. But overdoing it on certain foods may lead to increased inflammation.

You may consider limiting the following:

  • sugar
  • dairy products
  • refined carbs, such as white bread and pasta
  • red meats

What else can I do to clear hormonal acne?

To clear up hormonal acne* and keep it at bay it’s important to establish an appropriate skincare routine.

You should

  • Wash your face in the morning and again in the evening.
  • Apply no more than a pea-size amount of any acne product. Applying too much can dry out your skin and increase irritation.
  • Wear sunscreen every day.
  • Use only noncomedogenic products to reduce your risk of clogged pores.


Though the exact timeline for hormonal acne* varies from person to person, being proactive can help prevent related breakouts. It typically takes about eight to 10 weeks for a new acne* treatment plan to take full effect.

If your acne persists, talk to your doctor or dermatologist about a long-term treatment plan. They can revise your current regimen and incorporate different treatments to maximize your results.