Yes hormonal imbalance is one of a major cause of acne. In men it can be due to low levels of testosterone levels. You should go to a doctor for a proper checkup so that he can tell you the real cause of your acne.Be positive and take care of your eating habbits, andbe clean. Use clean towels and change your pillow covers once or twice a week.There's so much bacteria on them you really should to prevent new acne. So I tried these disposable pillows covers from this website [Edited link out] These ones are actually disposable so super easy! They also have product in them that improves the condition of your skin whilst you sleep. So along with medication proper care is also important. Take care.