How does hormonal imbalance lead to acne?

Acne usually begins when the body starts to produce the male hormone androgen. Androgens stimulate the sebaceous glands to enlarge and secrete more sebum. The sebum builds up in the follicle and moves up the hair shaft to the outside part of the skin. As the sebum moves up, it mixes with bacteria, and the hair follicle gets blocked. The blocked follicle becomes a breeding area for bacteria, resulting in acne. Since teenage boys produce more of the male hormone, they tend to suffer from acne more than girls. However, many women also get acne; some may start getting acne in their mid 20s or 30s, experiencing breakouts the week before their period during the time of hormonal flux.