Hormonal changes can trigger cystic acne by increasing androgen hormones, which stimulate excess oil production and clog pores, leading to deep, painful, inflamed cysts, especially around the jawline, chin, and lower face. Common hormonal treatments include birth control pills that regulate hormone levels, spironolactone which blocks androgen effects, and sometimes other prescription medications alongside topical acne treatments. Improvement usually takes 6–12 weeks or longer, since hormonal balance and skin healing happen gradually. A dermatologist should be consulted if acne is severe, painful, causing scarring, recurring frequently, or not improving with basic treatments, as stronger prescription therapy may be needed.