Hormonal acne is triggered by fluctuations in androgens — specifically testosterone — which stimulate the sebaceous glands to produce more oil. In women, these fluctuations happen around the menstrual cycle, during perimenopause, with PCOS, after stopping birth control, and during periods of high stress (which elevates cortisol, which in turn affects androgen levels).

  You've been getting facials. Maybe monthly, maybe every few months. And your skin looks okay right after — that post-facial glow is real. But a week later you're back to square one. The congestion returns. The texture is still there. The acne comes back. Sound familiar? Here's what's actually going on.