I started getting adult acne (and melasma). I got my hormones checked after the results showed an imbalance. I received a prescription for natural progesterone, and a couple of other supplements from a naturopath, then a compound pharmacist formulated it. Because the hormonal acne and some hyperpigmentation happened to me due to this imbalance (especially during specific times of the month), bio identical hormone replacement therapy was the only thing that cleared up both after trying every topical & antibiotics, rx & otc, on the market with either temporary or no change at all. It also helped my sleep patterns and energy level.