Rosehip oil, Tretinoin, Accutane, Spironolactone, birth control, spearmint tea, lots of water, no sugar, no dairy, no meat, a biweekly glycolic peel: These are a few of the many, many treatments that people swear by for clearing up hormonal breakouts — almost undoubtedly the trickiest, wiliest species of breakout in existence. But regardless of what other products (or lifestyle changes) you choose to test out, every solid skin care regimen starts with a good cleanser. So to pin down the best cleansers for hormonal acne, and find out more about what causes hormonal acne in the first place, I reached out to celebrity esthetician and acne expert Renée Rouleau, and Dr. Joshua Zeichner, M.D., Director of Cosmetic & Clinical Research in Dermatology at Mt. Sinai Hospital in New York.
According to Rouleau, an uptick in progesterone at the start of a hormonal cycle increases water retention, which, in turn, “puts pressure on the pores and creates a narrower pore lining.” That’s in addition to an increase in testosterone that occurs right before menstruation, which basically makes oil thicker and more abundant. “When you have thicker oil trying to get through a narrower opening, this creates the ideal environment where breakouts can now begin,” Rouleau says. (Dr. Zeichner also pointed out that “emotional distress is directly tied to breakouts,” which I can personally attest to.)
But these breakouts, as you know, are not like the others: Typically, hormonal breakouts are cystic — underground, painful, and impossible to pop. Dr. Zeichner says the most effective treatment for cystic acne is prescription-based, whether that’s a medication like Accutane or hormonal birth control. That said, if you’re going the OTC route, both Rouleau and Dr. Zeichner recommend using a cleanser that contains chemical exfoliants, like AHAs and BHAs (or a combination of the two), which can help kill acne-causing bacteria, flatten raised pimples, and encourage cellular turnover for clearer, smoother skin overall.
With that in mind, take your pick from any of the five cleansers for hormonal acne featured below. They’re gentler than lots of acne cleansers on the market, which can be overly drying and stripping, but they’re all powerful enough to get to the literal root of the issue — and even prevent future breakouts from occurring.
1. The Best Gentle Cleanser To Use Alongside Intensive Acne Treatments
If you’re using intensive, leave-on acne treatments, such as prescription topicals or products that contain salicylic acid or benzoyl peroxide, Dr. Zeichner recommends complementing them with a gentle, non-foaming cleanser; he says that “a treatment cleanser and a treatment medication may be too irritating for the skin.” This cream cleanser from First Aid Beauty is fragrance-free, sulfate-free, and totally non-stripping. No exfoliating ingredients to be found in here, either. Instead, things like aloe, glycerin, and allantoin help soothe and calm stressed-out skin — the perfect antidote to any dryness or irritation that might crop up from topical acne treatments.
2. The Best Cleanser With Probiotics
If you want to clear up current breakouts and prevent future ones from cropping up (not sure why you wouldn’t), this TULA acne cleanser is your guy. The not-so-secret ingredient in here is probiotics, healthy bacteria that work to rebalance your skin microbiome and strengthen its natural protective barrier — both of which are necessary for staving off the bacteria that causes acne and other forms of inflammation. Beyond the brand’s signature probiotics, this cleanser contains 2% salicylic acid, lactic acid, and tea tree oil to clear away bacteria and unclog pores, while licorice extract and azelaic acid help fade signs of breakouts past. This cleanser contains gentle, non-stripping foaming agents; but like all TULA products, it’s suitable for dry, sensitive skin.
3. The Best Cleanser/Mask Hybrid (Also With Probiotics!)
You can use this multitasking clay cleanser from Dermalogica a few ways: If you have oily skin, you can use it as a balancing daily cleanser; if you don't, you can use it on an occasional basis as a mask to flatten existing breakouts. (If you have very dry skin, you may want to concentrate the mask just on your breakout, rather than all over your face.) In this formula, kaolin clay, Binchotan charcoal, and tea tree oil help purify clogged pores, while bioflavonoids promote a smoother texture and brighter complexion. (Also useful if you’ve been contending with breakouts in the past.) There are lots of nourishing ingredients in here too, including glycerin, murumuru seed butter, and botanically derived lipids, so your skin will still feel soft, moisturized, and basically coddled — exactly what distressed skin needs. This cleanser features prebiotics, too, which work similarly to probiotics in balancing your skin's microbiome (read: fewer breakouts in the future).
4. The Best Heavy-Duty Exfoliating Cleanser
If you’re all about heavy-duty exfoliation, go for an AHA/BHA cleanser, like this one from Murad. In here, lactic and glycolic acids work to gently polish the top layer of your skin, revealing brighter, smoother skin underneath; meanwhile, salicylic acid, the titular BHA, delves deep into your pores to unclog the bacteria, dead skin, and excess sebum that are probably contributing to your breakouts. Jojoba beads act as a nourishing physical exfoliant, too. It sounds pretty intense, and it is, but even Amazon reviewers with sensitive skin stand by this product — good to know, considering that the formula contains a sulfate. Use this scrub a couple of times a week until your flare-up subsides.
5. The French-Pharmacy Favorite
This La Roche-Posay cleanser is beloved across the internet and beyond for its ability to clear and prevent breakouts of all kinds, including tricky cystic breakouts. This unique “foaming cream” contains both salicylic acid and AHAs, but it’s gentle enough for daily use if you have oily skin. Beyond clearing up acne, reviewers love using this cleanser to thoroughly clear skin of makeup and grime without making their faces feel “squeaky” and tight. There is some added fragrance in here, but like all La Roche-Posay products, it’s formulated specifically for sensitive skin — meaning it works on all skin types (unless you have a known allergy to this fragrance, of course).
Of its ability to quell hormonal acne in particular, one Amazon reviewer wrote: “About a year ago, I developed hormonal acne and tried everything (oral prescriptions, expensive prescription creams, OTC products, etc.) to get it under control. Nothing worked. My dermatologist suggested Effaclar as a daily face wash for my anti-acne regimen. As far as anti-acne face washes go, I haven't found anything on the market that is more gentle, cleans better, and doesn't dry my skin out. It seems to soothe it and calm my breakouts with daily use.”
Renée Rouleau, celebrity esthetician and founder of Renée Rouleau Skincare.
Dr. Joshua Zeichner, M.D., board-certified dermatologist and Director of Cosmetic & Clinical Research in Dermatology at Mt. Sinai Hospital in New York.