What is the Difference Between Hormonal and Bacterial Acne?

Our board-certified dermatologists and physician assistants at Dermatology Associates of Atlanta are constantly seeing patients who ask, “My friend used this facial wash and it cleared his acne right up, but I’ve been using it for months with no results. Am I doing something wrong?” The reality is that acne is a much more complex condition than patients realize, and even though it can look the same to the untrained eye, each patient’s acne has its own unique set of causes. Today, we’ll delve a little deeper into some of these causes and how they affect your acne treatment options.

One of the key players in acne is sebum—the oil your skin naturally produces. Acne blemishes can form primarily from one of two different issues:

  1. A hormonal imbalance is causing your body to produce more sebum than it needs. The excess sebum then clogs your pores, cutting off their oxygen and leading to the inflammation that makes a pimple look red and puffy.
  2. Certain types of bacteria infect your pores and create acne blemishes.

For some, acne is actually a combination of both hormones and bacteria. Sebum allows acne-causing bacteria to thrive, so if you have excess sebum, not only could it clog your pores on its own but it also provides an excellent environment for the acne-causing bacteria as well.

The first step toward treating your acne is determining the underlying causes that are contributing to your condition, because different treatments address different causes, from acne laser treatments to topical and oral antibiotics for acne and other types of medications like spironolactone (diuretic), Aczone® (antibacterial & anti-inflammatory), and even Accutane if necessary. Check out our chart below to get a better idea of which acne treatment options are well-suited for the various types of acne:


The explanations above are a bit simplified in order to make them more clear and accessible to patients who haven’t had the years of specialized training and experience our providers have. Still, they’re a great starting point to help you better understand your acne and why it’s so important to use treatments that are recommended for your specific condition—because your friend’s acne may have an entirely different cause than yours. To start treating your acne in a more targeted and personalized way, schedule an appointment at Dermatology Associates of Atlanta. Or, for more skin care tips and our monthly special offers, follow us on Facebook, Twitter, and Google+.