Hormonal acne is commonly linked to changes in hormone levels that influence oil production and inflammation in the skin. While acne develops on the skin, researchers are increasingly exploring how internal factors — including the gut microbiome — may influence inflammatory pathways involved in acne.

The gut microbiome interacts closely with the immune system, metabolism and hormone signalling. Because of this, scientists are investigating how the gut–skin axis and gut–hormone axis may influence inflammatory skin conditions such as acne.

Understanding these connections may help explain how supporting gut health could play a role in maintaining overall skin balance.

Founder Insight

Hanna Sillitoe first became interested in the connection between gut health and skin while recovering from severe psoriasis. During this time she began exploring emerging research on the microbiome and its influence on inflammation and immune responses.

This experience sparked a long-standing interest in how the gut microbiome may influence inflammatory skin conditions and inspired Hanna’s work exploring the relationship between gut health and skin wellbeing.

What Is Hormonal Acne?

Hormonal acne refers to acne that is influenced by changes in hormone levels, particularly androgens such as testosterone. These hormones stimulate the sebaceous glands in the skin, increasing the production of sebum (skin oil).

Excess oil can combine with dead skin cells to block pores, creating an environment where bacteria can grow and trigger inflammation. This process can lead to the red, inflamed spots commonly associated with acne.

Hormonal acne often appears along the jawline, chin and lower face and may be influenced by hormonal fluctuations related to puberty, menstrual cycles, stress or metabolic factors.

Because acne involves both hormonal signalling and inflammatory responses, researchers are increasingly exploring how internal systems — including the microbiome — may influence the condition.

The Gut Connection

The Gut–Skin Axis and Hormones

The gut–skin axis describes the relationship between the gut microbiome, the immune system and the skin. The microbiome contains trillions of bacteria that help regulate immune responses, metabolism and inflammatory signalling.

Because acne is influenced by inflammation and hormone activity, scientists are investigating how microbiome balance may affect these processes.

Gut bacteria and inflammation

The gut microbiome plays an important role in regulating immune responses throughout the body. When the microbiome becomes imbalanced — a condition known as dysbiosis — inflammatory signalling may increase.

Inflammation is a key factor in acne development, which has led researchers to explore how microbiome imbalance may influence inflammatory skin conditions.

The gut–hormone connection

The microbiome also interacts with hormonal signalling pathways. Certain gut bacteria influence metabolic processes related to insulin sensitivity and androgen activity.

Because insulin signalling can influence androgen levels and sebum production, scientists are exploring how microbiome balance may influence hormonal pathways involved in acne.

The intestinal barrier

The gut lining acts as a protective barrier between the digestive system and the bloodstream. When this barrier becomes compromised, inflammatory molecules may enter circulation and contribute to systemic inflammation.

Researchers are exploring how these inflammatory processes may influence inflammatory skin conditions.

What Research Shows

Interest in the relationship between the microbiome and acne has grown significantly in recent years.

Several studies have explored how gut bacteria may influence inflammation, metabolism and hormone signalling associated with acne.

Key findings include:

• Microbiome imbalance and inflammation – Research suggests that disruptions in gut microbiome composition may influence inflammatory responses associated with acne.

• Gut–brain–skin connection – Early research proposed a relationship between stress, gut health and skin inflammation, highlighting the complex interactions between the nervous system, microbiome and skin.

• Insulin signalling and acne – Some studies have explored how metabolic pathways related to insulin sensitivity may influence acne development.

• Probiotics and inflammatory responses – Researchers are investigating how probiotics may influence immune regulation and inflammatory signalling.

Although research is ongoing, these findings highlight growing scientific interest in how gut microbiome balance may influence inflammatory skin conditions such as acne.

Sources

Bowe WP & Logan AC. Acne vulgaris, probiotics and the gut–brain–skin axis. Gut Pathogens, 2011.

Knackstedt R et al. The role of oral and topical probiotics in skin conditions. Journal of Clinical and Aesthetic Dermatology, 2020.

Dreno B et al. The skin microbiome and acne. Journal of the European Academy of Dermatology and Venereology, 2018.

Salem I et al. The gut microbiome as a major regulator of the gut–skin axis. Frontiers in Microbiology, 2018.

Supporting the Microbiome

Maintaining a healthy microbiome may help support immune balance and metabolic health.

Several lifestyle habits may help encourage microbiome diversity.

Eat a diverse range of plant foods

Plant diversity provides fibre and nutrients that nourish beneficial gut bacteria.

Increase fibre intake

Fibre acts as fuel for gut microbes that produce beneficial compounds involved in immune regulation.

Include fermented foods

Fermented foods such as sauerkraut, kimchi and kefir contain naturally occurring microorganisms that may help support microbiome diversity.

Support healthy lifestyle habits

Sleep, stress management and regular physical activity all influence microbiome balance and metabolic health.

Consider probiotic support

Some people choose to support their microbiome with probiotics — live microorganisms designed to help maintain microbial balance within the digestive system.

Common Questions About Hormonal Acne and Gut Health

Can gut health affect acne?

Emerging research suggests the gut microbiome may influence inflammatory pathways involved in acne development.

Can probiotics help acne?

Some studies have explored whether probiotics may help support immune regulation and inflammatory balance associated with acne. More research is needed to fully understand these effects.

What foods support gut health for skin?

Foods rich in fibre and plant diversity help nourish beneficial gut bacteria. Fermented foods may also support microbiome diversity.

Conclusion

Hormonal acne is influenced by a complex interaction of hormones, inflammation and metabolic processes. Increasingly, researchers are exploring how the gut microbiome may influence inflammatory and hormonal pathways linked to acne.

Supporting a healthy and diverse microbiome through diet, lifestyle habits and microbiome support may help maintain balance within these systems.

Understanding the connection between gut health, hormones and skin highlights how internal processes may influence visible skin conditions.

Some people choose to support their microbiome with probiotics — live cultures designed to help maintain a healthy balance of gut bacteria. Learn more about our Multi-Strain Biotic and how it supports gut health.