You can probably relate to this scenario: Just when you think you’ve gotten your complexion under control, you wake up with a hasty breakout. And of course, this skin inconvenience (or skinconvenience, if you will) just so happens to coincide with your monthly cycle. What gives? Weren’t breakouts supposed to stay in our teenage years?
Of course, it turns out your period can do a number on your complexion, causing everything from adult acne to increased sensitivity. Here, dermatologists explain what’s going on—and how to clear things up.
Hormones are usually to blame.
“Women’s hormones cyclically fluctuate during the menstrual cycle,” explains Joshua Zeichner, MD, dermatologist in New York City. “A surge of hormones mid-cycle causes ovulation but at the same time stimulates oil glands in the skin.” (Estrogen and progesterone are the hormones that surge mid-cycle.)
What that means for you: You may experience oilier skin and more acne breakouts during the second half of your cycle and around the time you get your period, he says. A study published in the journal Dermatologica even found that women with naturally oily skin produce even more oil the week before menstruating.
Another study, published in Clinical and Experimental Dermatology, found that a peak in progesterone, which happens mid-cycle, could exacerbate the symptoms of inflammatory conditions such as acne, eczema, psoriasis, and dermatitis.
Tsippora Shainhouse, MD, Beverly Hills-based dermatologist, notes that the acne you get as an adult is much different than the acne you deal with as a teen. This adult acne, caused by hormonal changes during your cycle, presents as tender, painful, inflammatory bumps and deep cysts under the skin, she says.
These bumps “often do not reach the skin surface and can be difficult to manage with topical treatment,” adds Shainhouse, noting that you’ll usually see this kind of acne on the lower “U” of the face—sideburns, lateral cheeks, chin, and neck.
According to the American Academy of Dermatology (AAD), women can experience adult acne well into their 50s, with the most common culprit being hormonal fluctuations—although other causes include stress, genetics, and use of pore-clogging products. (While you can’t change your genes, you can limit stress and switch to non-comedogenic skin care, hair, and makeup products.)
Excess oiliness and an increase in pimples aren’t the only skin changes that your cycle can cause. You may also notice an increase in pain sensitivity too, says Emmanuel Loucas, MD, founder of Loucas Dermatology and Laser Center in New York City.
“When your period starts, you have an increase in a hormone called prostaglandin,” Loucas explains. “It’s responsible for causing uterine contractions but is also responsible for an increase in pain sensitivity.” That’s why your skin may be more tender and irritated when you’re on your period.
There is good news to be had though, though: “After you get your period, during the beginning of the cycle, hormone levels are relatively low,” says Zeichner. “The skin is recovering from any breakouts that developed and the skin usually looks its best.”
Certain conditions can exacerbate your skin even more.
It’s important to note that certain women’s health conditions such as Polycystic Ovarian Syndrome (PCOS) can cause more severe skin—and health—issues. People with PCOS have excess hormones (estrogen and testosterone) circulating, which can trigger cystic, inflammatory acne as well as hirsutism (excess facial and body hair), says Shainhouse. “Acne is usually manageable with specific birth control pills and spironolactone.”
If you suspect you have PCOS, it’s extremely important to get a diagnosis as soon as possible, since you’re at an increased risk for insulin resistance and type 2 diabetes as well as high cholesterol and fertility issues, says Shainhouse. If your period symptoms and skin problems seem far worse than those around you, it may be time to go to a doctor.
Yes, it’s possible to prevent these pesky period breakouts.
Luckily, there are some easy steps you can take to put the kibosh on period-related skin issues like oiliness and acne. “I commonly recommend switching your cleanser to a salicylic acid-based product during the second half of the cycle to better remove oil,” says Zeichner.Salicylic acid is a gold-star acne-fighting ingredient. As a study in the Journal of Clinical and Aesthetic Dermatology notes, salicylic acid exfoliates skin, promoting smoother texture and smaller pore size.
“A topical acne product that contains either salicylic acid or benzoyl peroxide may be used at the beginning of your period to prevent and treat any breakouts,” adds Zeichner. Benzoyl peroxide works by killing acne-causing bacteria, and also boasts anti-inflammatory properties, according to the study in the Journal of Clinical and Aesthetic Dermatology. Keep in mind, the AAD states, that products with salicylic acid and benzoyl peroxide won’t clear acne overnight—but they still might be worth introducing into your skincare routine.
For those with increased eczema or dermatitis symptoms during your cycle, the National Eczema Association recommends soaking in a warm bath, then moisturizing immediately afterward to protect your skin barrier and keep irritants out.
Beyond topical products, The Pill can help with hormone-related skin issues—so ask your doc if this is a good option for you. “Birth control pills can keep estrogen and progesterone levels more steady by preventing ovulation,” says Shainhouse. “This will help reduce hormonal flares for many women.” Talk to your doc to see if it’s right for you—it could be just what you need to smooth out your period-skin problems long-term.