What is the Difference Between Hormonal & Bacterial Acne?

Because there are so many different types of acne that look similar to each other determining what type of acne you have and how to treat it properly can prove challenging.

A good example is hormonal and bacterial acne, which many people are unable to distinguish from each other due to their similar appearance and severity.

But misinterpreting these symptoms often leads to incorrect diagnosis and unsuccessful treatment as a result. The causes you to lose time, money, and increases the chances of scarring and hyperpigmentation.

In this article, we will discuss the differences between hormonal and bacterial acne, how to differentiate them, the best available treatment based on severity and cost, and how to eliminate the root cause so that breakouts stop permanently.

What is Hormonal Acne?

Hormonal acne appears on the skin when there has been a prolonged state of hormonal imbalance.

Certain hormones, such as androgens (the group of male hormones responsible for regulating the metabolism as well as aiding bone and muscle development) can become imbalanced or overactive due to various internal and external factors, including health conditions, diet, lifestyle habits, the use of certain medications, etc.

When this happens, the imbalanced androgens can cause internal issues ranging from high cholesterol, glucose intolerance, diabetes and external issues such as inflammatory skin conditions like acne.

What is Bacterial Acne?

Bacterial acne is caused by an overgrowth of the C. acnes bacteria inside the pores.

C. acnes is a strain of bacteria that resides on our skin; however, the ideal environment for them to thrive involves a small, airless space, such as a hair follicle clogged with excess skin oil and dead skin cells.

The C. acnes bacteria proliferate by feeding off the hardened plug composed of cellular debris, and this overgrowth triggers the immune system to react by creating inflammation and sending white blood cells to the area to fight against the abnormality.

This “fight” then manifests on the skin as the swollen, red, and sometimes pus-filled lesion we recognize as a pimple.

The Difference Between Hormonal vs. Bacterial Acne

The main difference between hormonal and bacterial acne is the actual trigger that causes the condition to form.

As we already mentioned, hormonal acne is typically caused by hormonal imbalance, while bacterial acne is caused by an overgrowth of bacteria.

However, while the triggers of the condition are different, the process of pimple formation is pretty much the same.

Hormonal acne, while triggered initially by hormones, also has to do with bacterial overgrowth inside the pore and the subsequent symptoms that include redness, swelling, and sometimes pus.

This happens because the overactivity of certain hormones can stimulate the sebaceous glands into producing excess oil that, instead of traveling to the skin’s surface and serving as a barrier between the skin and the environment, will remain stuck inside the pores and mix with dead skin cells into forming a hardened plug that will serve as food for the acne-causing bacteria that already reside on our skin.

Therefore, while the condition is the same, the difference between hormonal and bacterial acne comes down to the trigger that caused it in the first place.

Best Ways to Treat Hormonal Acne

The best way to reduce inflammation and treat hormonal acne is to tackle the main trigger while nourishing the skin externally.

You can achieve this by doing the following:

Making Dietary & Lifestyle Changes

An inflammatory diet consisting of foods containing refined sugar, dairy, and other processed particles can directly cause hormonal acne because these components can stimulate the hormones and influence their activity.

As we already mentioned, the overactivity of certain hormones is the main cause of what we identify as hormonal acne, which is why minding your diet or making significant changes, especially if your daily menu consists of anything that can trigger hormonal imbalances and inflammation, is crucial.

On the other hand, certain lifestyle factors, such as poor sleep quality, prolonged periods of stress, or habits such as excessive alcohol drinking and smoking, can also have an extensive effect on our hormones and even throw them into an imbalance by increasing their activity, which will result in inflammation.

Conversely, positive lifestyle habits such as adequate sleep, eating healthy meals, and drinking enough water will help keep the hormones balanced and sufficiently active to regulate our metabolism, support healthy cell growth, and keep our body functioning as it should.

Trying Prescriptions

Trying prescriptions is another option for treating hormonal acne and can be helpful for severe cases of the inflammatory condition that need to be treated fast to minimize the risk of scarring.

Some common medications used to balance the hormones and reduce the appearance of hormonal acne include birth control pills and spironolactone for women and steroid injections or isotretinoin (Accutane) for men due to the risks of side effects hormonal medications can have on the latter demographic.

Investing In a Skincare Routine

While balancing your hormones through diet and lifestyle changes or the introduction of hormonal medication will work internally, nourishing your skin from the outside can also help improve the symptoms of acne and reduce the severity of the condition.

Therefore, investing in a skincare routine that consists of gentle face wash, an exfoliating solution to manually clear the pores from accumulated debris, a moisturizer to keep your skin hydrated and healthy, and sunscreen to protect it from the damaging effects of the UV rays, can also be beneficial for soothing external inflammation, and reducing the risk of permanent scarring.

Best Ways to Treat Bacterial Acne

If the issue is a more superficial one than hormonal imbalances that have led to acne, tackling bacterial acne is considerably easier and can be done with the following methods:

Good Hygiene

Regularly washing your face with a gentle cleanser will help minimize the accumulation of dirt, debris, and excess oil on the skin that could play a role in the formation of acne.

Therefore, cleansing your face and other areas where acne is prevalent twice a day is important, as this practice can help reduce the severity of the condition and maintain clear skin.

Skincare Treatments

Investing in a skincare routine that addresses the components responsible for causing this condition is essential when dealing with bacterial acne.

Therefore, having a complete routine that consists of a gentle face wash, an exfoliating solution, a moisturizer, and sunscreen to keep the skin barrier healthy and hydrated will help minimize inflammation and improve the condition of your skin.

In addition, acne treatments such as retinoids can help prevent buildup inside the pores by increasing cellular turnover and helping the dead skin cells shed more efficiently instead of remaining stuck inside the follicles.


If bacterial acne becomes severe and topical products don’t seem to help reduce the inflammation, oral antibiotics might be another option to quickly reduce the severity of the condition, as they work to eliminate the bacteria responsible for causing breakouts.

A few popular antibiotics used to reduce acne include clindamycin, erythromycin, and doxycycline, usually prescribed in courses of a minimum of 6-8 weeks to see improvement.

The Difference Between Hormonal vs. Fungal Acne

The most significant difference between hormonal and fungal acne is the trigger causing the conditions along with their symptoms and appearance.

Fungal acne is an inflammatory skin condition caused by the overgrowth of yeast on the skin and usually appears in oily areas of the face, such as the forehead, manifesting itself as clusters of red or white bumps accompanied by itching.

Another difference between the two conditions is that different treatment approaches are required for each issue, as fungal acne doesn’t usually respond to typical acne treatments and involves the use of antifungal lotions or creams, such as ketoconazole, to subside.

The Difference Between Bacterial vs. Fungal Acne

Similarly to hormonal acne, the difference between bacterial and fungal acne is the trigger that has caused the conditions as well as the appearance of the lesions.

Bacterial acne is usually caused by the overgrowth of the C. acnes bacteria that already reside on our skin and is generally not problematic until it encounters the perfect environment to proliferate, while fungal acne is caused by the overgrowth of yeast on the skin due to taking certain medications, the use of cosmetics, poor hygiene, etc.

Another difference between the two conditions is their appearance, as bacterial acne can be non-inflammatory in the form of open and closed comedones and inflammatory in the form of papules, pustules, and cysts, while fungal acne is almost always inflamed bumps that appear in clusters and are followed by itching.

Finally, fungal acne rarely responds to common treatments for bacterial acne, such as benzoyl peroxide, and usually requires antifungal creams or lotions to alleviate the symptoms.

Frequently Asked Questions

What Does Hormonal Acne Look Like?

Hormonal acne is usually inflammatory and appears on the skin in the form of papules and pustules, but most frequently, it goes even deeper than that, presenting itself as discolored or purple cysts along the jawline.

What Does Bacterial Acne Look Like?

Bacterial acne can be non-inflammatory and look like whiteheads and blackheads, or inflammatory, appearing as papules or “blind” discolored or red pimples, and pustules, or a spot with a white tip.

What Kills Bacterial Acne?

Components known as antibiotics, which can fight infections caused by bacteria by either killing the bacteria or making it difficult for the microorganism to proliferate, can reduce the appearance of bacterial acne.

Originally Published: May 15, 2023

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Analyzed by Simone Sydel

Hi, I’m Simone Sydel, a licensed esthetician and acne expert dedicated to helping others solve their skin issues including acne, eczema, and UV damage. I specialize in testing and reviewing the latest acne treatments and beauty products, offering honest, practical advice for skincare. I’ve helped hundreds of clients clear their skin and my skincare product reviews have been read by several hundred thousand people. Thanks for visiting!

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