If you have endometriosis and have suddenly started dealing with breakouts, you may be wondering: can endometriosis cause acne? It is a reasonable question, especially when your skin seems to change around the same time as your menstrual cycle or after starting treatment.

But the medical answer is a little more nuanced.

Endometriosis is not currently established as a direct cause of acne. However, acne can occur in someone who has endometriosis, and there may be indirect links involving hormonal fluctuations, certain endometriosis treatments, or another condition such as polycystic ovary syndrome (PCOS). Acne can also change throughout the menstrual cycle because hormones influence the skin’s oil production and inflammation.

So, rather than assuming every breakout is caused by endometriosis, it helps to look at the bigger picture.

Can Endometriosis Cause Acne? 

Endometriosis does not appear to directly cause acne.

Endometriosis is a chronic gynecological condition in which tissue similar to the lining of the uterus grows outside the uterus. It is associated with inflammation, pelvic pain, painful periods and, in some women, fertility problems. Acne, on the other hand, develops when hair follicles become clogged and inflammation and hormonal activity contribute to breakouts. The American Academy of Dermatology notes that hormones can play an important role in acne, particularly because androgens stimulate the skin’s oil glands.

That distinction matters.

Endometriosis, meanwhile, is a condition in which tissue similar to the uterine lining grows outside the uterus. The lesions are influenced by hormonal cycles and can contribute to inflammation, adhesions, pain, and fertility problems.

That difference matters.

Having both conditions does not necessarily mean one caused the other. Think of them as two problems that may sometimes appear on the same hormonal “calendar.” The timing can overlap even when the underlying mechanisms are not identical.

Is Acne a Symptom of Endometriosis?

Acne is not generally listed among the classic symptoms doctors use to identify endometriosis.

Typical symptoms can include severe period pain, chronic pelvic pain, pain during or after sex, pain associated with bowel movements or urination, and difficulty becoming pregnant. NICE recommends considering endometriosis in people with these kinds of symptoms and supports specialist assessment when the condition is suspected or confirmed.

So if you have acne, that does not automatically point toward endometriosis.

What Recent Research Says About Acne and Endometriosis?

A particularly useful 2025 study looked directly at skin conditions in women with endometriosis. Researchers compared 835 adults with endometriosis with 309 women without the disease.

Acne was reported in 50.5% of the endometriosis group and 47.2% of the comparison group. Although acne was common in both groups, the difference was not statistically significant (P=.337). In other words, this study does not provide evidence that endometriosis itself directly causes acne.

The researchers did find higher rates of some other inflammatory skin diseases in women with endometriosis, including chronic urticaria, alopecia areata and psoriasis. They also noted that more research is needed to understand how inflammatory and hormonal processes may overlap between endometriosis and skin conditions.

That is an important distinction: an association between two conditions is not automatically proof that one causes the other.

Why Hormones Matter When You Have Acne?

Hormones are still highly relevant.

According to the American Academy of Dermatology, acne develops when pores become clogged, and hormones can influence the process. Androgens can increase the activity of the skin’s oil glands, leading to more sebum and a greater tendency for pores to become blocked.

This helps explain why some people notice acne around their periods or develop adult acne after years of relatively clear skin.

But hormonal acne does not automatically mean you have endometriosis.

It can be linked to normal menstrual hormone fluctuations, certain medications, PCOS and other factors. In that sense, saying that endometriosis causes “hormonal acne” without explaining the underlying issue can be misleading.

Can Endometriosis Treatment Cause Acne?

This is where the connection becomes more convincing.

Many people with endometriosis receive hormonal treatment to reduce pain and suppress endometriosis-related symptoms. NICE recommends hormonal options such as combined hormonal contraception or progestogens for people with suspected, confirmed or recurrent endometriosis.

Some of these treatments can affect the skin.

Progestins and Acne

Progestin-based medicines can help control endometriosis symptoms, but acne is a recognized possible side effect.

The NCBI’s InformedHealth resource specifically lists acne among possible side effects of progestins used for endometriosis. It also notes that side effects can vary from person to person.

This creates an important situation.

Imagine that you begin hormonal treatment for endometriosis and, several weeks later, notice more breakouts along your chin, jaw or cheeks. It may be reasonable to ask whether the medication is contributing to the change. That does not mean the treatment is wrong for you. It means the benefits and side effects should be reviewed together.

Hormonal IUDs and Skin Changes

A levonorgestrel-releasing intrauterine system, often called a hormonal IUD, can also be used in some people with endometriosis.

The NCBI resource notes that this type of device can cause side effects including spotting, breast tenderness and acne.

If your acne appears after starting a hormonal IUD, timing becomes clinically useful information. Keep track of when the breakouts began, whether they follow a cycle, and whether they improved or worsened over time.

Should You Stop Your Endometriosis Medication If Acne Appears?

No—not on your own.

If you suspect that an endometriosis medicine is causing acne, speak with the clinician who prescribed it. The American Academy of Dermatology similarly advises people who suspect a medication is triggering acne to discuss it with the prescribing doctor rather than simply stopping treatment.

Your doctor may decide that the medication remains the best option, adjust the treatment, change the hormonal approach, or recommend separate acne treatment.

The goal is not to choose between “healthy skin” and “controlled endometriosis.” The goal is to manage both as safely as possible.

Could PCOS Be Causing Your Acne Instead?

This is one of the most important questions to consider when acne and menstrual symptoms appear together.

Polycystic ovary syndrome (PCOS) is a common hormonal disorder associated with irregular periods and higher androgen levels. ACOG lists severe acne, oily skin, excess facial or body hair and irregular menstrual periods among common signs and symptoms of PCOS. It also explains that increased androgen levels can contribute to acne.

That means a woman may have painful periods and pelvic symptoms suggestive of endometriosis while also having acne related to PCOS—or she may have one condition, not both.

Acne, Irregular Periods and Androgen Excess

Acne becomes more interesting from a hormonal perspective when it is accompanied by other signs of androgen excess.

For example, talk with your doctor about a broader evaluation if you also have:

• irregular or widely spaced periods
• excessive facial or body hair
• scalp hair thinning
• persistent oily skin
• unexplained difficulty conceiving
• acne that began or became severe after adolescence

These features do not diagnose PCOS by themselves, but together they may justify further assessment. ACOG also emphasizes that PCOS can present differently from one person to another and that not everyone has every classic feature.

When It Makes Sense to Ask About PCOS

Consider asking about PCOS when acne is persistent and appears alongside menstrual irregularity or other signs of androgen excess.

This is particularly useful because PCOS and endometriosis involve different mechanisms and usually require different diagnostic approaches. A good medical evaluation looks at the entire picture rather than assuming every symptom comes from one diagnosis.

Does Having Acne Increase the Risk of Endometriosis?

Here is where the story gets especially interesting.

A large prospective study published in Human Reproduction followed data from 88,623 women in the Nurses’ Health Study II. Researchers reported that women with a history of severe teenage acne had a 20% higher risk of subsequently diagnosed endometriosis compared with women without severe teenage acne.

The study’s summary answer stated:

“Endometriosis is positively associated with severe teenage acne.”

But there is an important catch.

This does not mean acne causes endometriosis. It also does not mean that anyone with acne will develop endometriosis.

The study investigated an association between severe teenage acne and later endometriosis risk. The researchers also acknowledged limitations, including the study population and reliance on laparoscopically confirmed endometriosis cases.

So the finding is interesting, but it should be interpreted carefully.

In simple terms:

Severe teenage acne has been associated with later endometriosis in research.

That is different from saying:

Endometriosis causes acne.

Keeping those two statements separate is essential for medically accurate health information.

What Should You Do If You Have Endometriosis and Acne?

Start by looking at the bigger picture.

When did the acne begin? Did it start before or after your endometriosis symptoms? Did it appear after starting hormonal treatment? Is it worse around your period? Are your periods regular? Do you have excess facial hair or other signs of hormonal imbalance?

These details can tell your doctor much more than the word “acne” alone.

A dermatologist can evaluate the skin itself, while a gynecologist can assess menstrual, hormonal and pelvic symptoms. In some situations, coordinated care makes the most sense.

When to See a Dermatologist or Gynecologist

You should consider professional evaluation when acne is persistent, painful, scarring, suddenly severe or resistant to standard skincare.

A gynecological assessment becomes especially important when acne occurs alongside symptoms such as severe period pain, chronic pelvic pain, painful sex, bowel or bladder symptoms, or fertility difficulties.

And remember: acne should not be used as a standalone test for endometriosis.

A proper endometriosis evaluation may involve a detailed medical history, examination and appropriate imaging or specialist assessment depending on symptoms and suspected disease location. NICE recommends that people with suspected or confirmed endometriosis have access to clinicians with specialist knowledge of the condition.

Endometriosis Care With Dr. Lucas Minig in Valencia, Spain

For women whose main concern is endometriosis rather than acne alone, specialist gynecological assessment can be particularly valuable when symptoms are complex or treatment decisions involve fertility and surgery.

Dr. Lucas Minig’s practice in Valencia, Spain, provides individualized endometriosis care and describes medical treatment as well as minimally invasive laparoscopic and robotic approaches for selected patients. The practice also highlights fertility-focused planning and surgery for conditions such as endometriomas and deeper endometriotic disease.

That does not mean acne itself requires endometriosis surgery. It doesn’t.

Rather, if you have confirmed or suspected endometriosis together with a complex collection of pelvic, menstrual or fertility symptoms, a specialist can help determine which symptoms are related to endometriosis, which may have another cause, and which treatment options make sense for you.

That distinction can save you from chasing every symptom as though it has one explanation.

Conclusion

So, can endometriosis cause acne? Based on current evidence, endometriosis itself has not been established as a direct cause of acne. However, the two conditions can occur together, and several factors may explain the overlap.

Menstrual hormone fluctuations can trigger acne, some hormonal endometriosis treatments can cause or worsen breakouts, and conditions such as PCOS can produce acne alongside menstrual and fertility symptoms. Research has also identified an association between severe teenage acne and later endometriosis, but that finding should not be interpreted as proof that endometriosis causes acne.

The bigger picture matters. If you have acne plus significant pelvic pain, painful periods, bowel or bladder symptoms, or fertility concerns, it is worth discussing the complete pattern with a qualified gynecologist or endometriosis specialist rather than assuming the skin problem tells the whole story.

FAQs

Can endometriosis cause hormonal acne?

Endometriosis itself has not been proven to directly cause hormonal acne. Acne may instead be related to normal menstrual hormone fluctuations, medication effects, or another hormonal condition such as PCOS.

Can endometriosis medication cause acne?

Yes. Some hormonal treatments for endometriosis can cause acne in some patients. For example, clinical studies of dienogest have reported acne among treatment-related adverse effects.

Does acne mean I have endometriosis?

No. Acne is common and has many possible causes. A history of severe teenage acne has been associated with later endometriosis in research, but acne cannot diagnose endometriosis.

Can PCOS and endometriosis occur together?

Yes. PCOS and endometriosis are different conditions, but a person can have both. Acne, irregular periods and excess hair growth may suggest androgen-related PCOS and should be assessed in the wider clinical context.