How the Menstrual Cycle Affects Acne

It seems to happen every month, like clockwork. Your skin seems to be cleaning up nicely when it suddenly flares up again, right around the time of your period. Can you imagine, or is premenstrual acne a real phenomenon?

Premenstrual Acne Symptoms

Premenstrual acne is a real phenomenon. Premenstrual acne, commonly referred to as “PMS acne,” is acne that persists or worsens each month, coinciding with the menstrual cycle.

Some people find that their existing acne gets worse before their period. Others have relatively clear skin for the rest of the month, only breaking out a week or so before menstruation.

These PMS breakthroughs are different from your “typical” breakthroughs. They tend to be red and inflamed papules with rarely whiteheads. These pimples appear mainly on the lower half of the face – the cheeks, chin, chin and neck.

According to various studies, premenstrual acne affects 50% to 80% of the menstruating population.

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Causes of Premenstrual Acne

Your menstrual cycle directly affects your skin, and hormones are the culprit. Just like hormones trigger acne during puberty, hormones also play a role in acne before your monthly cycle.

Hormones are also responsible for acne that worsens during pregnancy and menopause.Specifically, we’re looking at testosterone.

While we think of testosterone as a “male” hormone, women also produce this hormone, just at lower levels than men. Testosterone is thought to be a factor in the development of acne because it triggers your sebaceous glands to produce more sebum (or oil).

For most people, breakouts occur about a week to 10 days before menstruation begins. This is when estrogen is at its lowest. Testosterone levels remain fairly constant throughout the month, so as estrogen drops, testosterone is relatively high.

The hormone progesterone also plays a role in premenstrual acne. Progesterone levels rise during the second half of the cycle. It can make your skin more oily and cause pores to swell and close, trapping dirt and oil.

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This creates the perfect storm for a breakout: Your skin is oilier, and it’s easier for oil to get trapped in swollen pores. There may be other factors at play, and more research is ongoing on how the menstrual cycle affects acne and skin in general.

What exactly is progesterone?


You don’t have to simply live with these monthly breakouts. There are treatments that can help control them.

  • Birth control pills: Oral contraceptives have long been used to reduce acne breakouts, presumably because they help regulate hormonal fluctuations.
  • Benzoyl peroxide: This common acne medication also works for hormonal breakouts. If you have mild acne, you may only need OTC benzoyl peroxide. If you need a stronger drug, prescription benzoyl peroxide is an option.
  • Topical retinoids: This is another prescription medication that works well for acne in adults. They help keep pores clear and can also reduce fine lines and wrinkles.
  • Spironolactone: If you can’t control your acne, this hormone modifier may be the way to go. Spironolactone is a prescription drug you can take by mouth.
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Don’t curse your skin this month. Instead, see your dermatologist and look forward to clear, healthy skin all month.

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