Androgen excess
Elevated testosterone, DHEA-S, or 5-alpha reductase activity (which converts testosterone into the most acne-driving form, DHT). Common in PCOS, post-pill rebound, and women under chronic stress.
Functional Medicine Treatment
Hormonal Acne Treatment
Cystic breakouts on your jawline, painful and timed with your cycle. Or acne that started after you came off birth control and never quite settled. Or skin that’s been a struggle since your 30s, even when you eat clean and use every product on the market.
You’ve tried antibiotics, spironolactone, tretinoin. Maybe Accutane. Maybe back on the pill.
The skin is a window. What you see on your face is often a hormone, gut, or insulin signal showing up at the surface. When we resolve the signal, the skin clears.
What's Actually Driving It
Adult hormonal acne is rarely one thing. The most common drivers we find on testing are:
What Most People Don't Know
A few things we want you to know going in.
Birth control is a treatment, not a resolution
It suppresses ovarian hormone production. When you stop, the underlying pattern is still there. That’s why post-pill acne is so common.
Spironolactone works, until it doesn't
It blocks androgen receptors, which is helpful, but it doesn’t address the reason your androgens are elevated in the first place. If you stop, breakouts often return.
Accutane is the right call sometimes
We don’t reflexively oppose it. For severe cystic disease, it can be life-changing. We work with clients who are on Accutane to optimize the experience and address the underlying pattern so it’s less likely to re-fire afterward.
Diet matters, but blanket elimination is a blunt tool
“Just cut dairy and sugar” works for some women and does very little for others. Testing tells us why, and what to focus on for you.
You'll get the most out of this approach if:
Your acne tracks with your cycle (worse the week before your period)
It started or got worse after you stopped birth control
It's concentrated on your jawline, chin, or lower face
It comes with other hormone signals (PMS, irregular cycles, hair loss, weight changes)
You've cycled through dermatology medications and they keep failing or you'd like a different approach
You're not the right fit if:
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You haven't tried foundational dermatology and want to skip straight to functional work (we want a derm in your team)
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Your breakouts are clearly fungal acne (we'll spot this and refer)
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You have severe nodulocystic disease that needs Accutane evaluation now
How We Work
We don’t recommend supplements or protocols based on symptoms alone. We test, we read the cascade, then we treat the root cause.
Step 1
Free discovery call
We confirm hormonal acne is the right framing for your case and not, for example, fungal acne or a contact reaction.
Step 2
Targeted testing
A DUTCH test maps your hormones across the cycle (or across the day, if you're not cycling). A GI-MAP shows gut involvement. A blood panel adds insulin, HbA1c, ferritin, vitamin D, and inflammatory markers. We choose the panels your case calls for.
Step 3
Comprehensive review
A 60-minute visit to walk through findings together. You see exactly what's driving the breakouts.
Step 4
The protocol
Targeted supplements for the specific hormone or gut driver. Anti-androgenic herbs if needed. Insulin-supportive nutrition if labs call for it. Specific food adjustments. Skincare guidance if you'd like it (we don't sell skincare).
Step 5
Follow-up
Skin responds in cycles. We give it 8 to 12 weeks before judging the protocol. Adjustments along the way as you change.
Most hormonal acne cases fit cleanly inside one of two programs.
Foundation
The right starting point for most cases. DUTCH, blood panel, two clinical visits, and a 90-day protocol.
Restoration
Adds GI-MAP and 6-month support. Recommended when there's clear gut involvement, post-pill complexity, or autoimmunity in the picture.
Please note specialty laboratory testing, insurance-related copays, and supplements are not included and vary based on individual needs.
Frequently Asked Questions
Skin runs on roughly a 6-week cycle. Most clients see meaningful change at 8 to 12 weeks. Full clearing takes 4 to 6 months in most cases.
Probably some, probably not all, probably not forever. We make decisions based on what your labs actually show.
Many clients work with us while on the pill or while transitioning off. We coordinate with your prescribing physician where appropriate.
Yes. We work alongside dermatology. The two approaches complement each other well.
Almost never. We may suggest small adjustments, but we're not pulling you off topicals.
Why Well Empowered?
25 years of devotion to people thriving
IFM Certified Practitioner
Doctor of Chiropractic Medicine
Certified Nutrition Specialist (CNS)
Licensed Dietitian Nutritionist (LDN)
Masters of Science in Nutrition & Functional Medicine
Personalized, root-cause approach
Virtual consultations available
Find the Driver
Free 15-minute call to outline what testing your case calls for and what your next step looks like.
