If you’re a woman struggling with hormonal acne, you may be interested in learning about the hormone that your body produces called progesterone and its effects on acne.
Next to estrogen, progesterone is the other most famous female sex hormone. It is produced in the ovaries and in lesser amounts in the adrenal glands.
Progesterone has a number of important jobs including normalizing blood sugar levels, facilitating thyroid hormone, regulating the menstrual cycle, allowing a woman to have a healthy pregnancy, as well as being a natural anti-anxiety and anti-depressant.
It also enhances the positive effects of estrogen, while preventing the state called estrogen dominance.
Your hormones never work alone; they always work in ratios. Often when a hormone goes out of whack, it causes symptoms (like acne) because it is out of ratio with its partner hormones.
In the case of progesterone, it’s important that it is in the right quantity in relation to estrogen.
Having low progesterone in relation to estrogen can lead to acne by way of increasing insulin which can lead to excess androgens, as well as amplify testosterone and DHT conversion in the skin.
DHT is a potent acne causing form of testosterone that other forms of testosterone get converted into in the skin via an enzyme called 5-alpha reductase. Having a normal progesterone level in relation to estrogen can prevent 5-alpha-reductase from converting testosterone to DHT, which will, in turn, prevent acne.
Progesterone that is out of sync with estrogen is usually the hormonal cause behind the dreaded pre-menstrual breakout that many of you are so familiar with. It also usually plays a role in the acne that people sometimes get when they go off hormonal birth control.
Symptoms of Low Progesterone
Symptoms of estrogen dominance (and acne) usually occurs when estrogens are high and progesterone is too low, but not necessarily. It all depends on the ratio. You can have normal estrogen and low progesterone and have symptoms, or you can have normal progesterone and high estrogens and have symptoms.
These are common symptoms of low progesterone:
- PMS (moodiness, cravings, cramping, bloating, etc)
- Belly-centric weight gain
- Low libido
- Difficulty handling stress
- Irregular or heavy periods
- Anxiety or depression
- Headaches; joint and muscle aches
- Painful or lumpy breasts
- Mental and physical fatigue
- Elevated cortisol levels
- Low bone density
You can take a stab at guessing if you have low progesterone or not. You may find it fairly obvious, and it does play a role in most women’s hormonal acne. But the only sure way to know is to get a hormone test done. I recommend saliva hormone testing.
My Experience with Low Progesterone
In November of last year, I got a saliva hormone test done and it said that I had very low progesterone. I wasn’t really surprised. I’m not sure if I always had low progesterone, but at that time I was really feeling it!
Progesterone has a very intimate relationship with stress. When you’re chronically stressed, your body actually steals the resources your body was going to use to make progesterone, and instead uses it to create stress hormones. This can result in low progesterone levels.
Ironically, at that time I was quite stressed because of writing my Female Hormonal Acne Guide! We were about to go to India for three months and I was overworking myself trying to get the book finished in time and do all the trip preparations.
The symptoms I ended up experiencing:
- One fairly big-ish pimple right before my periods
- Very sore breasts for quite a while before period
- A small benign lump in my breast called a fibroadenoma (which comes and goes with hormonal changes)
- Noticeably not sleeping as well as I normally do. Having a hard time getting to sleep; always waking up in the middle of the night.
Anyway – next post we’ll go over ways to treat this imbalance. And don’t forget to check out my Female Hormonal Acne Guide if you want an in depth look at how all your hormones work and how to stop hormonal breakouts for good!
Do you know or think you might have low progesterone?
I have terrible hormonal cystic acne. Tracy, I have struggled with this for several years, and I am so grateful for your blog. It has confirmed things I have thought were wrong with my body all along, that regular doctors would not address in much detail. It all started when I switched from the birth control pill I was on, Loestrin 24Fe. I switched to several other brands including one that was SUPPOSED to be (but was NOT) the generic/same as Loestrin 24 Fe. I am not on the generic of Ortho Tri Cyclen to help with the hormonal acne. It has improved slightly but is still not better. I have been using glycolic acid facewash and manuka honey for about a month now, it seems to maybe be helping but it hasn’t yet cleared up much at all. My next step is to try the BRAND name of Ortho Tri Cyclen (since I know the generics are not as effective). I will ask my doctor about the low progesterone and about a saliva hormone test as well. I don’t know what else to do…my acne is in the chin and cheek area, which is consistent with hormonal acne. So I know that is the cause. I have been to a dermatologist who agrees that it is hormonal, but only offers solutions of expensive creams which I refuse to buy and are not fixing the real problem. Any other advice??? I am depressed about this. I am a 30 year old female and to have to walk around with cystic acne is just awful. Thanks again.
typo – not=now. The current birth control pill I am on is TriNessa, the generic of Ortho Tri Cyclen. Just to clarify
Hi Marcia, I feel ya!! Sending my love, I know how much it hurts to struggle with this. Well, check out my resources for hormonal acne… these blog posts:
And my hormones ebook: https://thelovevitamin.com/female-hormonal-acne-guide/
Hello, I had cystic acne really bad after quitting BC and nothing helped except Magnesium Oxide. I still get some acne at 33 yrs old so I am also thinking I have low Progesterone. You have taken BC that I have taken and Im going to assume you have other medical issues you fight!? Please be tested for Candida overgrowth. Good luck to you! 🙂 Anyone know how to do the saliva test at home?
Try getting on acutane if you are not having kids or done, it works!!! I think the progestrone sounds like it works too and might be more natural, but I haven’t tried that yet
I had low progesterone and acne and my gyno put me on Folic Acid because we were trying to conceive. ? Acne was gone in 2 months.
Wow, I was not aware that progesterone and estrogen worked in ratios, like other hormones. I am definitely getting a test done to check if my progesterone levels are in order, as I am experiencing many of these symptoms. Thanks for the helpful info!
Marica- you are not alone! I too am almost 30 and suffer from hormonal acne. I’ve been excercising, trying to eat a more balanced, organic diet, and taking vitamins. It has helped a lot, but hasn’t gotten rid of it all yet.
So I have been wondering about progesterone, and here is my question:
Say you get tested and you find out you have low progesterone, you start taking a supplement or cream or some sort of treatment to boost your levels. When you go off taking the progesterone cream, wouldn’t your body feel all out of whack again because it wasn’t having to produce progesterone by itself because of the cream? Or maybe your body has to kick into overdrive to make all that progesterone, or maybe it just won’t make the progesterone because it has gotten lazy because you’ve given your body all it needs through the cream or supplementation….ahhhh so confused please help! thanks tracy!
Hi River, good question. I obviously don’t know for sure what really happens but from what I have heard / read…. they say that progesterone cream will help your body “kickstart” into making its own… and vitex, it can help you correct the imbalance and then you can slowly wean off it so as to not “shock” your body”… I’ve also heard that it is best to take Vitamin B6 and magnesium along with it as to support the process since these are the building blocks of progesterone itself. And of course… the best way is to lower stress, but not exactly the easiest
Hey Tracy, I really think you should look at the pages that Seppo created for hormonal acne:
Thanks for sharing Adel 🙂
Yes most of them have females in the studies, but I think men should benefit from them too, even though we don’t have as many problems regarding hormones and women do. 😛
I’m keeping an eye on this and looking forward to the next post. And Tracy, I wanted to explain that I did go ahead and write that gut healing article for your blog, and was super excited to send it…but then I didn’t. Because my acne has relapsed. It’s not cystic or anything – definitely mild – but stubborn as hell and constant and won’t budge despite what I thought was my wealth of knowledge on the subject. Being humbled is a bitch. My skin just isn’t responding to dietary changes the way it used to, I have a bunch of new health symptoms I’ve never had before, and it’s absolutely devastating to me no matter how stupid and vain it may sound to anyone else. I’m back to a naturopath again, dropping money on blood tests to try to figure things out.
So, maybe hormones. Who knows. I’m still reading, and still a fan, but I feel like a jerk for all the advice I’ve put out there through comments here when apparently I don’t really know much of anything.
Sorry to hear, Kit! Give yourself a break though, we’re all learning all the time and our journeys go through ups and downs and are always evolving (yes even mine). You don’t have to be perfect to give value 🙂 It’s not like I’ve never had any breakouts at all since starting this blog! And yes I’ve felt the same thing you seem to be feeling now. But we have to be kind with ourselves and remember that HOLY CRAP!! Look at how far we’ve come!!! You and I used to have severe, devastating acne, and now we definitely don’t. So you do know plenty, and your knowledge is far from worthless. There’s something going on now that you are going to uncover and afterwards you’ll know even more about your own health and body than before… it’s all just building on top of each other. Good luck x
Thanks for the response and support, Tracy. You’re right…I have learned a lot and come a long way, and I think I am just being too hard on myself. I was in a pretty bummed out place when I wrote that! Last year was quite possibly the most stressful year of my life, in terms of my job and going through/ending a heart-wrenchingly painful relationship. I also have to admit that I don’t really eat enough…I probably don’t consume more than 1,000 calories on any given day, just due to stress and running around and being busy. Which probably isn’t enough, right?
I kind of suspect that I’ve starved and stressed my thryoid to death. Do you happen to have an article on this sort of thing? I don’t remember ever reading one. I hope this naturopath can get me sorted out. Anyway, I still really do appreciate all this wonderful information you put out for us. I do still really want to write for your blog, and when I get more of an idea of what’s going on in my body, I plan to alter what I’ve already worked on and send it your way. Your blog has made a tremendous difference in my life and I have a really strong desire to contribute and possibly help even just one other person the way you’ve helped me. Cheers and much love 🙂
Hi Tracy –
I stumbled upon your website a few months ago when I searched for hormonal acne cures. I am 27 years old and have been experiencing cystic acne on my chin and forehead for the past 4 years. I exercise regularly and eat a pretty healthy diet. I also drink a gallon of water a day, but can not seem to maintain/cure my embarrassing acne.
I have never had a hormone test done, but based on reading hormonal acne articles, I self diagnosed myself with hormonal acne. I read your article about female hormonal acne and the estrogen supplements you take to help balance out your hormones. I have been taking Estroblock plus, Burdock and Thorne S.A.T for 3 months now. I also started the caveman regime 3 weeks ago, but I am still experiencing cystic acne.
I am responding to this article because I am confused about the difference between progesterone and estrogen. I have a lot of the symptoms that you described above that can be a result of having low progesterone (stress, insomnia, anxiety, low libido, headaches). Should I stop taking the Estroblock supplements and try something different? I don’t want to keep wasting money on supplements that aren’t right for my body.
Thank you so much for all of your help and advice!
Hi Jessica, I’m really sorry to hear you’re still struggling so much! Hmm I can’t really say what’s going on either, I would suggest a hormone test… and yes perhaps it is that you have low progesterone that isn’t being treated. This week’s blog post will talk about options for treating low progesterone.
Hi again Tracy!
I have recently read your guide to female hormonal acne and noted down a lot about supplements I could be taking, I had already been taking quite a few on and off ( including omega 3, vit d, vit c, alpha lipoic acid, zinc) I think low progesterone looks likely for me and I was wondering, how long do you think it will take for these supplements, and other ones in your book which I have just started taking (milk thistle) to make a noticeable difference to my acne, and will they help progesterone levels? I want to get a saliva test done but even the £100 for the one you recommend in your book is a bit of a stretch on my student finances! 🙁 I also wondered, if I start taking vitex chaste berry for making/balancing progesterone that you mention, could there be adverse affects if I am wrong about my low progesterone? I wish there was a cheap way of finding all of this out! Thanks in advance and sorry for the long message! xxx
sorry just noticed your above comment! i can wait to see what you say in your next post 🙂
Hi Suzanna, the cheapest way would probably just be to try vitex and watch for negative symptoms or signs it’s not for you… if you experience them, you can just quit and the side effects will go away very quickly
okay I will give it a go! Thanks so much Tracy, its so nice that you reply! xxx
I have been following your blog for a number of months now, its just a great resource, thank you for all that you do. I have had acne my entire life, but have experienced severe breakouts for about 8 months now. Two things I did – change my diet completely (very healthy, clean, no processed foods or refined sugars, lots and lots of water) and then went off the pill a month or two after that. My breakouts started when I switched to a healthy diet and have now continued. I exercise regularly, am in good shape and have a healthy body weight. Have tried the candida cleanse, liver detox, 10-12 different supplements, completely organic face washing regime (and dont cleanse only moisturize in the morning). Nothing has even made a dent in my acne, it is actually getting worse. Its red, inflamed and itchy (maybe because of dryness?). I am now taking Vitex (has been a month) and Estroblock (has been 2 weeks – no changes yet). I got a saliva test done a few months ago and both my progesterone and estradiol levels are below normal range. I also have only gotten my period once since going of the pill 8 months ago. So at this point it seems like its going to be a waiting game again to see if the Estroblock works. Have you seen cases like mine that are very stubborn despite all the best efforts?
Hi Rachel , so sorry to hear how much you’ve been struggling and nothing seeming to work! Yeah I would just keep up with the supps you’re taking and see what happens…. you haven’t been on them long enough to really say yet. Hopefully raising your progesterone will help, although I don’t know why your estrodial would be low…. usually the reason this happens in younger women is due to excessive exercising / not eating enough / low body weight but you say that isn’t you. When you got your hormones tested, did you just get the straight test done or did you get any interpretation on the results ie. what to do?
THis might be old news now, but you may have rosacea or perioral dermatitis – which can happen after going off the pill. Try NOT moisturizing or usinga n oil free moisturizer and no makeup for a few months – the itchiness is what makes me think this could be it. Also – doxycycline will clear it up. Jsut thought i would mention…
Do you know if the herb Lady’s Mantle helps with balancing hormones?
So what is the correct ratio of progesterone to estrogen? I just had a hormone test done and they put me on meds to lower my testosterone (which they said was in the normal range but maybe just high for me?) but didn’t say anything about the other hormones.
Hmm well on my saliva hormone test it says normal range (for the ratio) is 45 to 450…. another lab I say said it was 100 to 500
Hi Tracy! Can you direct me to a place to purchase a trustworthy saliva test for hormones? Thanks!
Hi Kristine, you can get them through the Delgado Protocol
Hi I am 15 year-old girl and my face is always broke out. I workout everyday, drink a gallon of water everyday, get at least 30 minutes of sunshine, I take my vitamins everyday, and my diet is only whole foods (or no gluten, dairy, soy, no sugar most of the time. So my acne is obviously because of my hormones. Is it ok for be to be using progesterone cream or something like that? If not what do you recommend for teen hormonal acne?
I can’t really recommend any hormonal helper supplements for teenagers unless you’re an older teen… not to say they’re a bad idea, but i just don’t know. Although when I called the makers of Estroblock to ask about this, they did say not younger than about 14, so maybe it’s okay. I don’t know about progesterone cream. Normally for teenage acne I just recommend the same thing as everyone else – healthy lifestyle, good diet, low stress, self love, gentle skin care … it’s only the supplements I don’t know about
Thanks for the reply 🙂 I had the tests done with my naturopath – she didnt seem overly concerned, thought the results made sense with someone coming off the pill, but she did say that nothing in the results screamed hormonal acne to her…She asked if I wanted to try the progesterone cream to which I said yes. I then decided I was going to add in the Vitex and Estroblock on top of that. I see an endocrinologist as well, the only discussion of my weight was he asked me if my weight now is similar to when I first started getting my periods and it is. I am thin, my BMI is 20 but its still in the normal range. I think that I eat enough, I don’t ever go hungry, I eat good fats and in general a wide variety of very healthy foods. In terms of exercise, I work out 5 days a week on average, but mix it up – running on some days, weight training with relatively low weights on other days.
Hi I’m wondering if anyone can help I’m having trouble with my skin I have had blood tests at the hospitals as I have polysistic ovarian syndrome and my progrestone level is abnormal … Im wondering what natural product is best for me I’m not sure if my progesterone level is too high or too low … As I didn’t really understand the doctor when he was explaining
I am currently trying to conceive also if any recommendations would benefit me balancing my hormones that way I think my skin/ fertility problems would sort themselves out thankyou
At the the beginning of this year I was told I had cysts on my ovaries (had stopped the pill for about 2/3 months previously) so they gave the the pill to ‘help’ with my apparent PCOS(even though they had not tested my hormones etc) I had only a few spots around my chin at that point but have suffered with mild acne since I hit puberty. Gradually as time went on I have developed acne on my cheekbone area, around my mouth and my forehead, lots of little spots forming big red patches. I have now been off the pill for nearly two weeks and informed my doctor this and when she checked the ingredients this pill was high. In progesterone causing this acne! I have changed my diet in the past 2 months mostly paleo and taking maca, omega 3,evening primrose, I was taking DIM for 2 weeks then was told to take. Vitex instead. I haven’t had my hormones tested but do you think because I had a bad reaction with high progesterone pill Vitex will make my acne worse? I also feel very sad and angry recently along with tiredness both mentally and physically. When I was on this pill I had 3 weeks on, each week getting higher in progesterone and each week skin getting worse and when I had the withdrawal period my skin got better, and then repeat! I definitely read too much into things but thought it can’t hurt to ask another opinion! Sorry about the long message!
Thank you 🙂
Your blog was really helpful in explaining all the hormones that can pay a huge part in acne. My acne is all around my chin, lower cheek area and jawline. I have been to a gynecologist and got everything checked – PCOS and blood tests and everything seemed to come back normal. I got a thyroid test and hormonal tests done and nothing came back as irregular. It is so frustrating as it must be hormonal acne but nothing medically is confirming this for me.
What is the reason that you recommend a saliva test? Is it more accurate than blood tests? I am getting a bit desperate to find out what to do to balance my hormonal levels or just find out what is going wrong.
Hi Sarah, yes this is why I recommend saliva tests… so many times, people with clear hormonal problems come back from blood tests at the doctor’s saying all their hormones are in normal range… clearly inaccurate!
Where is the second part of the article to this? That explains the next step in how to fix the progesterone imbalance?
Sorry, I never added the link to the article! Whoops! https://thelovevitamin.com/14075/how-treat-low-progesterone/
I stumbled across this page. I have read many of the replies, seems helpful.
I have a similar issue.
I am 29 and have 4 kids. (started early). I’ve had major problems with all my pregnancies. My the 3rd one we figured out a lot of the issues is because I have such a low progesterone and my body wasn’t making anymore, so I took the progesterone shots which seemed to help a little. But after my pregnancies nothing was done, my doctor just ignored it. My youngest in now 2 1/2 and I had an extremely hard pregnancy with her so after it I was still having so many symptoms of low progesterone. Its has been getting worse each year. After a super stressful year in 2014/15 by body has gotten even worse. For a while they thought it was thyroid related, then deficiency in vitamin D, and so on. Now for the past 7 months my acne is so super horrible! ( I have never ever had acne in my life!)
Since I’m young my doctor is not convinced in giving me any hormonal tests. so i’m not sure what to do.
I need my super energy and clear skin back pronto!!! 🙂
I’m taking lots of vitamins and trying to get back into the routine of working out (its been hard since I’ve had 4 kids) and not having the energy.
I am thinking about trying a progesterone essential oil.
Looking for advice!
Hi! I am currently working with a naturopath, and waiting for my saliva hormone test results to come back BUT I wanted to get your opinion on this very big clue that I am getting every 16th, 17th, and 18th day of my cycle (Luteal Phase) Just a few days after ovulation, my nipples are extremely tender and sore to even brush up against them. And I have a pretty bad break out of cystic acne along with this. What I can’t figure out in my research, is if this is a sign of low or high progesterone. What are your thoughts on this?
Would taking progesterone only birth control pills help?
Hi Tracy. I got off birth control 2 years ago. After a few months I got really bad hormonal acne. I started on Vitex, that I took for about 10 months until I realised that my acne had actually gotten a lot worse. I stopped taking Vitex and the acne got a bit better. My acne is particularly bad during the luteal phase. What would you recommend that I take… I have har my hormones checked and the were all normal. Best regards A
I had been on primoult n for two months and suffered a weird outbreak. Do you think too much progesterone can cause acne?
Hi I just came across your website and I love it ! Long story short a short of the beginning of this year after I turned 24 I have had such horrible acne around my cheeks and around my mouth area and chin and I have never had acne this horrible .i am on a progesterone only pill and have been for quite some time …I stopped taking it in late feb I believe because I thought it was making it worse bc I was off on my times I took it lately but then I went back on it in May to pray it would help again but I broke out recently and now I’m on a retinoid and clindamycin …I am confused because o think I may have a bad hormonal imbalance because I experience really bad pms