Acne is often thought of as a teenage problem, but many women experience it well into adulthood — and it can be frustrating when the usual skincare approaches do not help. When breakouts are persistent, cluster along the jaw and chin, and flare with the cycle, hormones are frequently part of the story. A blood panel can help clarify whether an androgen imbalance is contributing.
The hormonal link to adult acne
Acne develops when oil glands in the skin become overactive and pores become blocked and inflamed. Androgens — sometimes called male hormones, though women produce them too — stimulate those oil glands. When androgen activity is higher than usual, or the skin is more sensitive to it, breakouts can follow. This is why hormonal acne often behaves differently from the acne of adolescence.
What the blood panel checks
An acne-focused hormone panel looks at the androgens and the hormones that regulate them:
- Testosterone — the main androgen, measured as total and sometimes free.
- DHEA-S — an androgen produced by the adrenal glands.
- Androstenedione — another androgen that can contribute.
- SHBG — a protein that binds hormones; when it is low, more free androgen is active.
- Prolactin — checked because it can influence cycles and skin.
The connection with PCOS
Persistent hormonal acne is one of the common features of polycystic ovary syndrome, alongside irregular periods and excess hair growth. If the panel shows raised androgens, your clinician may consider PCOS and look at the wider picture — cycle history, an ultrasound and metabolic markers. Identifying PCOS matters because it guides both skin treatment and longer-term health.
When cycle timing matters
Some of these hormones vary across the month, so results are most reliable when the sample is taken early in the cycle, typically day 2 to 5. If your periods are irregular, your clinician will advise on timing and interpret the results in that context.
Check acne hormones
An androgen hormone panel for persistent adult acne — checking testosterone, DHEA-S, androstenedione, SHBG and prolactin together.
Check acne hormonesWhat testing can and cannot do
A hormone panel can uncover an underlying imbalance and point towards conditions like PCOS, but many women with hormonal acne have normal blood results — the skin can simply be more responsive to normal hormone levels. Normal results are still useful, as they redirect attention to skin-based treatments and rule out other causes.
When to get checked
Consider testing if your acne is persistent despite standard treatment, appeared or worsened in adulthood, or comes with irregular periods, excess facial or body hair, or unexplained weight change. A clinician can decide which tests are appropriate and, importantly, guide treatment — this article does not replace personalised medical advice.
Check acne hormones
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Specialist interest: Cardiovascular Medicine · OneMedicine, CQC-registered clinic