Bloating, cramps, backache, mood swings… There’s no escaping them when you get your period. To make bad matters worse, sometimes period acne will tag along too. Many women with reasonably clear skin complain about breakouts during their time of the month. Meanwhile, those who already have an acne problem will often notice a fresh set of blemishes and worsening skin texture.
What’s going on here? Can periods really cause acne? Time for a deep dive into the big, bad world of period pimples. Here is everything you need to know about the relationship between menstruation and acne.
Can periods cause acne?
Yes, they can! Hormonal fluctuations due to the menstrual cycle can throw your skin into a tizzy. But differentiating between period pimples and regular run-of-the-mill acne can be tricky. Rather than misdiagnose any blemishes, run through this five-point checklist to identify the acne type:
1. When does the acne appear?
Period-related acne generally shows up in the week leading up to the period and during menstruation.
2. When does the acne disappear?
Period pimples tend to clear up around the end of your period. (However, sometimes they will stubbornly stick around for longer.)
3. Where does the acne appear?
Hormonal acne—which is what period pimples are—tend to show up around the chin, lower lip, jawline, and upper neck.
4. What does the acne look like?
They usually appear as papules—red, inflamed, raised bumps that do not have a white or yellow head. These pus-free blemishes may not look like much in the mirror but can sometimes be painful.
5. Have you experienced this twice in a row?
If you notice acne flares around period time over two consecutive cycles, it could be linked to menstruation.
How hormonal changes affect your skin
Hormone levels remain in a constant state of flux throughout the menstrual cycle. As they rise and fall, you will notice impacts—both good and bad—on the condition of your skin. There are three main hormones to consider here: oestrogen, progesterone, and testosterone.
Oestrogen is the predominant hormone during the first half of your cycle, and it is great for the complexion. Your skin looks its radiant best and any acne begins to clear up now.
The first shift happens midway through the cycle when the levels of progesterone increase. Once progesterone becomes the dominant hormone, the sebaceous glands start producing more sebum—a thick and oily substance that lubricates the skin naturally. When too much sebum is secreted, it can clog the pores on your skin.
But your complexion faces another issue when progesterone levels are high. The hormone causes the skin to swell and, as a result, the pores get compressed. On the outside, your pores may look smaller than ever. Underneath, however, sebum and dead skin get trapped and they accumulate inside the compressed pores.
As your period due date nears, the oestrogen and progesterone levels decline sharply. The time has come for testosterone to hog the limelight as the predominant hormone. (Although testosterone is known as the ‘male hormone’, women have it too. While there is some fluctuation, the overall level remains fairly constant throughout the month.)
Like progesterone before it, testosterone fires up the sebaceous glands to produce more sebum. However, the extra sebum shows up differently in different women. Some lucky ladies pick up a radiant glow. Others are much less fortunate, for their skin gets greasy, pores get clogged, and the P. acnes bacterium finds an environment where it can prosper.
When P. acnes is happy, your skin is not. Pimples are just around the corner, and it all comes to a head around your period.
Your skin through the four phases of menstruation
The average menstrual cycle lasts around 28 days and is divided into four phases. Here is what each phase means for your body and complexion:
1. Follicular phase: The first day of your period marks the beginning of the follicular phase. Oestrogen levels are at their peak over the first week to 10 days. The hormone is busy preparing the uterine lining for ovulation. This is a great time for your skin: the pores are smaller, sebum levels are optimal, and blemishes clear up.
2. Ovulation phase: Ovulation lasts for around three to five days. Although this is a short phase, there is plenty of hormonal activity at this time to trigger the release of the egg.
Oestrogen, already on the rise during the follicular phase, continues its uptick throughout ovulation. But as ovulation begins, testosterone begins to climb as well. If you get zits during ovulation, the rising testosterone level may be to blame. That’s because testosterone binds with sebum receptors and triggers the release of excess sebum. This extra sebum, when combined with dead skin debris, creates the perfect environment for acne flare-ups.
But testosterone is not the only trigger for pimples during this time. Ovulation acne is also connected with rising progesterone levels. Progesterone starts to increase gradually during ovulation and continues to rise well into the luteal phase. Like testosterone, progesterone is also associated with heightened sebum production. The skin feels oiler than usual, which could leave you more prone to pimples during ovulation.
Hormonal acne tends to be more common during the luteal phase that follows, but some of us are acne-prone during ovulation as well. If that’s true for you, don’t panic. This is just your body reacting to the routine hormonal changes that occur throughout the menstrual cycle.
3. Luteal phase: If you are prone to hormonal acne, getting through the 10 to 14 days of the luteal phase can be a struggle. Your complexion may have to bear the brunt as hormones run riot behind the scenes.
When the luteal phase begins, progesterone levels increase and oestrogen levels fall. The body now has more testosterone than skin-friendly oestrogen. Quite the double-whammy! The elevated progesterone and testosterone levels push up oil production, leading to clogged pores, whiteheads, and inflammation.
The big villain during the first half is progesterone. Besides stimulating sebum secretion, it causes the skin to swell and therefore constricts the pores. Also significant is the slightly higher body temperature during this phase. Clogged pores, trapped sebum, and a warm body furnish acne bacteria with just the right conditions to proliferate.
How to avoid pimples during periods naturally
There isn’t much you can do to keep fluctuating hormones in check, so bring the focus to what you can actually control. Period-related pimples can be hard to eliminate once they show up on your face or neck. But the right skincare tools and techniques can speed up healing, and maybe even keep future period zits away.
- Choose your tools
Although the battle against acne is never-ending, a clear complexion is within your reach. But to win any battle, you have to arm yourself with the right weapons. Take your first steps by choosing from this basic shopping list of skincare must-haves:
Cleanser: This is your primary defence against acne, whether hormonal or otherwise. Go for a gentle, non-soap cleanser that suits your skin type. Cleanse your skin twice a day (once in the morning and again at night). Preferably wash with lukewarm water as this loosens any oil and dirt build-up.
(Need help making a choice? Read our guides on salicylic acid face wash and cleansers for oily skin.)
Toner: A toner does a world of good for oily, acne-prone skin. Soak a cotton ball in your favourite toner and wipe gently all over the face and neck. Some toners can be sprayed on to refresh the skin. Toning restores the skin’s pH balance even as it clears away any remaining oil and residue.
Acne control: Invest in a powerful acne-control formula to apply post cleansing and toning. A gentle product like Clearica Anti-Acne Cream not only soothes inflamed skin but also attacks acne bacteria, curbs the spread of infection, and promotes cell turnover. It could be your secret weapon against period pimples.
- Moisturiser: Moisturising is essential in acne care. Skip this and your skin will get dehydrated, pushing the oil glands to produce excess sebum, which is never good news for acne-prone skin. A good face cream also works as a barrier, protecting your skin from the elements and locking in the goodness of your acne-control cream.
- Exfoliant: Acne happens when dead skin cells, grime, and sebum block the pores. A gentle exfoliant, used a couple of times a week, will eliminate dead skin and stubborn impurities. Choose between a physical exfoliant that sloughs off dead skin cells and a chemical exfoliant that dissolves them away.
- Spot treatment: You could also explore the beauty aisle at the supermarket (or online store) for over-the-counter (OTC) products containing ingredients like benzoyl peroxide or tea tree oil. These are often handy for spot treating the occasional pimple.
- Red flags to avoid
Many everyday things can aggravate the skin and worsen your pimples. Show your skin some love and keep a safe distance from the following:
- Products that clog pores: Keep an eye on everything you use on the skin and hair. Greasy cosmetics and concealers, some hair oils and gels, and even heavy sunscreens could aggravate your acne. Sometimes, just cutting out the irritants and using non-comedogenic products could clear up your hormonal acne completely.
- Excessive friction: If you wear a helmet while riding a bike, check that it does not strap on too tight. That holds for other things like scarves and tight collars too. Friction could leave you sore and transfer bacteria on to the skin, leaving you at risk of acne.
- Not using sunscreen: The UV rays can be harsh on your acne-prone skin. If you avoid sunscreen because it feels heavy, here’s an easy fix: Invest in a lightweight moisturiser with SPF.
- Not washing when sweaty: This is a no-no! Always wash the perspiration off your skin after a sweat session. Otherwise, the sweat and the grime will settle on your skin and clog the pores.
- Not cleaning your smartphone: When you make a call, bacteria may get transferred from the cell phone to your jawline. So, make sure to wipe the phone clean at least once a day.
- Touching your skin: Checking on that pimple again and again won’t make it go away. Worse, you may end up spreading bacteria around.
- Looking for a miracle fix: There are no miracles. A good skincare routine will do most of the heavy lifting, so long as you stay patient. Jumping from one potential ‘magic cure’ to another will just irritate your skin and lead to more breakouts.
When to see a doctor
If your acne is mild and it disappears around the end of your period, then standard OTC products and a regular skincare routine should be sufficient. But if the flares are severe or show no improvement after a few months of skincare, then it is best to consult a doctor.
Doctors often usually prescribe topical or oral antibiotics to treat the underlying infection. Other common treatments include the following:
- Benzoyl peroxide: Prescription benzoyl peroxide can be quite effective against hormonal acne, especially if OTC versions are too mild to treat your breakouts.
- Topical retinoids: These Vitamin A derivatives promote skin cell production. The new cells push sebum and dead skin out of blocked pores, thus preventing blackheads and whiteheads.
- Birth control: Some oral contraceptive pills containing oestrogen and progesterone can ease hormonal acne. However, progesterone-only formulas tend to worsen the condition.
Sometimes, hormonal acne may be accompanied by other issues like irregular periods, excessive facial hair, weight gain, hair loss, or dark skin patches on the back of the neck. If you notice these symptoms, set up an appointment with your gynaecologist. They could be signs of polycystic ovary syndrome (PCOS), a common hormonal disorder.
Hormonal fluctuations are notorious for their effects on the skin. Zits happen at the most inopportune times, including around the time of your period. Although hormonal acne will never go away completely, you can learn to manage them better. The right skincare products and good skin hygiene could bring a swift turnaround, leading you away from acne and towards healthy, radiant skin.
Disclaimer: This page is for educational and informational purposes only. It is not intended as a recommendation or for diagnostic purposes. Please consult your dermatologist or doctor before acting on any of the information provided here.