Adult acne affects many adults around the world, and the best way to treat it is to find the real cause behind it. It could be that your hormones are to blame!

Here are five signs you might be experiencing hormonal acne:

Your pimples are mostly around your jaw and chin area

One of the most significant signs of hormonal acne is where it’s located on your face. If you’re experiencing painful and inflamed cysts on your lower chin and jawline area, chances it’s hormonal acne. Dermatologists don’t exactly know why it’s such a common sign, especially amongst women, but your unbalanced hormones are causing the production of excess sebum and thus clogging up your pores.

“This is because these excess hormones in your body stimulate the oil glands, many of which are around your chin area,” Marina Peredo, M.D., a cosmetic and medical board-certified dermatologist and associate clinical professor of dermatology at Mount Sinai Hospital told SELF magazine. “These excess oil glands make your skin a prime spot for these types of breakouts.”

You break out once a month

Hormonal acne is typically cyclical, closely aligning with the menstrual cycle.

Hormonal pimples also have the habit of popping up in the same spots each month. This is usually due to particular pores being enlarged in size by a previous pimple, but that typically varies from person to person.

Youre stressed

The stress hormone (cortisol) affects all of your hormones too, which makes them go out of balance. Women’s hormonal shifts monthly also carry the risk of increased stress levels.

You have deep pimples (AKA cysts)

Your blackheads yield more oil and gunk then you would ever expect, which makes them become intense overtime. Your whiteheads are those tiny white dots that are caused by bacteria on your face. They are not the same as hormonal acne, which can come in the form of really painful cysts. Cystic acne are deep under the skin’s surface and typically need a cortisol shot to reduce in size. They cannot be manually extracted.

Your diet is making it worse

Adult acne can also worsen by what you eat. Dermatologists are now talking about the connection between food and acne. Some recent studies showed that there’s a connection between dairy, milk specifically, and adult acne. Other studies that there is a strong connection between foods that are high in sugar and fat and acne. Many dietitians also advise people suffering from hormonal acne to stay away from meat and poultry as they contain high levels of added hormones (to promote growth and milk production).