The Glow Guide To Hormones & Your Skin: The Twenties

Your skin is many things, but consistent isn’t one of them. Everything from the weather to your sleep habits (or lack thereof) can have an impact on its condition. One major player that doesn’t get nearly enough attention is your hormones. Starting in your teenage years and well into middle age, your hormone levels fluctuate and can cause a host of complexion changes along the way. While men also have issues with hormone changes, they are not as wide-ranging and do not have the same impact on the skin as fluctuations for women do.  

In this new series, we’ll explore the effects hormones have on women’s skin at every age, plus what you can do to manage those swings and keep your skin sane. Because puberty, periods, and menopause are bad enough without adding skin troubles on top of them.


The teen years get most of the hormonal hype (thanks, puberty, for awkwardly hogging the spotlight), but for women, the hormonal journey of your twenties is just as complex. That’s because from a biological perspective, this decade is your body’s prime time for making babies. Your eggs will never be so healthy, your progesterone and estrogen levels are peaking, and — regardless of your personal feelings on parenthood — your hormones are here for it.

What does that mean for your skin? It depends. On the plus side, says Jessie Cheung, MD, a board-certified dermatologist in Willowbrook, Ill., twenty-somethings have had a few years to get a sense of how their skin behaves. “People in their twenties feel a bit more at home in their skin,” she says. “Hopefully, their acne has started to settle down.” And for some lucky people, leaving the teen years does mean getting back to a calmer complexion.

“People in their twenties feel a bit more at home in their skin,”

Jesse cheung, md

For most women, however, hormonal breakouts may intensify, thanks to our periods. During the first half of your cycle, the pituitary gland produces more estrogen (the primary female hormone) than progesterone (which helps prepare the body for possible egg fertilization). Midway through the cycle, at ovulation, progesterone becomes the dominant hormone — and with that switch comes a rise in sebum production, which is like feeding acne bacteria a delicious feast. That’s why, in the seven to 10 days before your period, you’re more likely to wake up with a new “friend” (or three) on your chin.

One thing all women in their twenties need to remember is that hydration is an absolute necessity, regardless of how oily your skin is. Incorporating a lightweight moisturizing lotion into your daily routine will help keep your skin balanced and counteract some of the more drying acids and exfoliators that you might be using to control acne and blackheads. When you don’t regularly hydrate, your skin’s moisture levels drop and it will actually produce more oil to make up for it. And, as we all know, more oil equals more opportunities for your pores to clog.

How to manage hormonal acne

Since each month brings a new cycle of hormonal fluctuation, managing adult acne is an ongoing endeavor. But, says, Cheung, it can be done. Success starts with a gentle, calming skin-care regimen. “It doesn’t need to be harsh to be effective,” she says. Dr. Cheung favors a gentle AHA cleanser to remove makeup and oil, plus a prescription retinoid or retinol to keep pores from filling up with dead skin and sebum. (And of course, sunscreen with SPF 30.) 

For persistent hormonal acne, another option involves oral contraceptives, aka The Pill. The Pill uses synthetic hormones to prevent ovulation, and the different hormonal mix typically reduces the number of period-driven pimples. Another medication, spironolactone, blocks the androgen receptors, which keeps skin from overproducing sebum. These are prescription medications, so as with any medication, you should ask your doctor about potential risks and side effects.

And don’t discount the value of slowing your pace, cutting back on sugar, and making other lifestyle changes.  “In our practice, we talk about holistic approaches,” Dr. Cheung says. “I find that people in their twenties often wear a lot of makeup, they stay up late, they’re stressed from school and work. All of that that makes acne worse.” So while you may not be able to control your hormones, you can aim to get a full night of regenerative sleep—and be rewarded with the skin of your dreams.

We’re sure you’ve got questions, so ask away! Tell us in the comments what issues you’re facing or what else it is you want to know.

And, check out our other guides to learn what hormones are doing to your skin at every age:

The Glow Guide To Hormones & Your Skin: The Teen Years

The Glow Guide To Hormones & Your Skin: The Thirties

The Glow Guide To Hormones & Your Skin: The Forties

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