Hormonal acne / Before your period
Hormonal acne before period
Hormonal acne before period is a flare that comes back in the days before your cycle starts, often as deeper, tender spots on the chin and jawline, as hormone levels change in the second half of the menstrual cycle. It often eases once the period starts, and steady treatment through the whole month, not just the bad week, is what calms it.
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Why hormonal acne before period happens
The NHS lists changes in hormone levels during periods among the causes of acne, and the American Academy of Dermatology names fluctuating hormones around periods as one reason adults break out. Androgens, a type of hormone, stimulate the oil glands and hair follicles, the AAD explains. Extra oil and dead skin plug the pores, bacteria grow in the plug, and inflammation turns it into a spot.
Spots are part of the premenstrual picture for many people: the NHS lists spotty skin and greasy hair among the most common symptoms of premenstrual syndrome (PMS), which may come from changing hormone levels during the cycle.
When hormonal acne before period shows up
MedlinePlus says PMS symptoms start one to two weeks before a period and go away once it starts. Acne follows a similar clock. In a survey of adult women with acne seen at a New York dermatology clinic, 65% said their acne got worse around their period. Of those, 56% noticed it in the week before, 17% during the period and only 3% after it, while 24% said it was worse throughout the cycle.
Where it shows and how it looks
Hormonal breakouts tend to sit on the lower face: the chin, the jawline and the sides of the mouth, sometimes running down onto the neck. The AAD names stubborn acne on the lower face, including the chin and jawline, and breaking out predictably around your period as signs of hormonal acne. The spots are often deeper and more tender than ordinary whiteheads, and they come back in the same places.
How to check the pattern
Note the date of each new flare for two or three months, next to the first day of each period. If the flares cluster in the week before, hormones are very likely part of the picture. Each trigger that can add to it, from starting or stopping the pill to stress, is covered in our sister guide on what causes hormonal acne, including how to tell a cycle pattern from a one-off flare.
Treating hormonal acne before period
Treatment starts on the skin and runs all month. A retinoid such as adapalene and benzoyl peroxide are the usual first pair, and azelaic acid is another option. The AAD advises spreading a thin layer over the whole area that breaks out, so you treat the spots that are still forming, and expects fewer breakouts in 4 to 8 weeks and clearing at about 16 weeks. Dabbing a spot treatment on only during the bad week treats the spots you can see but does not prevent the next ones.
When breakouts clearly follow the cycle, a doctor may add a hormonal option. For women, a combined birth control pill and spironolactone are the two the AAD names, and the pill takes 2 to 3 months to show results. Clascoterone cream treats the hormonal causes of acne in anyone 12 or older. The step-by-step version, with what to try first and what comes next, is on how to treat hormonal acne.
Getting through the week before
Keep the routine plain: wash up to twice a day and after sweating with a mild cleanser, keep hands off your face, and don't pick, since squeezing pushes the contents deeper and makes the spot more noticeable. Ice can ease a painful lump. For an occasional large, painful lump, a dermatologist can inject a corticosteroid; the AAD says this is kept for a few severe breakouts rather than used every month.
When to see a doctor first
Book an appointment if your periods are irregular or missing, or you notice extra hair on your face or body. MedlinePlus lists these as signs of polycystic ovary syndrome (PCOS), which raises androgens and needs its own care. See a dermatologist too if spots are deep, painful or leaving marks, or if hormonal acne before period hasn't improved after a few months of treatment.