Period Acne: Why it Happens and What You Can Do

From cramps and bloating to fatigue, headaches and changes in your mood, periods are often accompanied by numerous unpleasant and annoying symptoms. 

One of these symptoms is acne. From small pimples to severe breakouts, it’s common to notice more pimples shortly before and during your period, even if you’re not normally prone to getting acne. 

In fact, one study published in the Journal of Clinical and Aesthetic Dermatology found that 65 percent of women aged 18 and up experienced worse acne during their period. Another study found that 44 percent of women aged 12 to 52 experience period-related acne flare ups.

While period acne can be annoying, it’s also very treatable. Below, we’ve explained why period acne develops, as well as the types of acne you may get during your period. We’ve also talked about how you can treat and prevent period acne to keep your skin clear and blemish-free. 

Why Period Acne Develops

Period acne usually develops as a result of hormonal changes that occur before and during your period. 

As we’ve explained in our guide to hormonal acne, acne is closely related to your production of certain hormones. When your hormone levels fluctuate, as they do during your period, it’s quite common to develop more acne than normal. 

Before we get into the ins and outs of how your hormones fluctuate during your period, let’s go over the basics of how hormones affect acne in the first place.

Acne forms when your hair follicles, or pores, become clogged. Two substances play the main roles in clogging your pores: dead skin cells and sebum.

Dead skin cells can accumulate on the surface of your skin as a byproduct of a process called skin cell turnover -- a natural process in which your body replaces old skin cells with new ones to keep your skin healthy and protected.

Sebum, on the other hand, is a type of oil that’s produced by your sebaceous glands to keep your skin hydrated and protected. Over time, your sebaceous glands may produce too much sebum, leaving you with skin that feels a little too oily.

When excess skin cells and sebum accumulate on the surface of your skin, they can become stuck inside your pores. These clogged pores can develop into different types of acne lesions, such as whiteheads, blackheads and red, inflamed pimples. 

You may be wondering how this process is related to your period. As we mentioned above, it’s all about how hormones affect your skin. 

Certain hormones are responsible for regulating your skin’s production of sebum. Specifically, androgen hormones such as testosterone are associated with overproduction of sebum in the skin -- a factor that’s directly related to the development of acne.

Put simply, more testosterone equals more sebum, which can increase your risk of developing clogged pores. 

Although testosterone and other androgens are often referred to as a male hormones, they’re also present in women. In fact, “male” hormones play essential roles in many aspects of your health, from managing your mood and energy levels to promoting healthy bones.

Before and during your period, your body’s production of certain hormones can fluctuate by a significant amount. 

During the preovulatory phase (the period immediately before you start ovulating), your body’s production of estrone and estradiol -- two different types of estrogen hormone -- increases, as does your production of testosterone.

This sudden increase in testosterone may cause your skin to secrete more sebum, resulting in pre-period acne breakouts.

Period acne is common. In fact, according to dermatologist Dr. Anjali Mahto, around two thirds of all women who have a genetic predisposition for acne will experience worse acne just before their period begins.

Types of Acne

The acne you develop before and during your period can vary in type and severity. For some, period acne is mild and only lasts for a few days. For others, period acne can be long-lasting, severe and even painful. 

If you’re only mildly prone to acne, you may notice a few whiteheads and blackheads forming around your face shortly before or during your period. 

If you get severe acne before and during your period, you may develop red, painful acne. This develops when bacteria gets trapped inside the pore, causing the acne lesion to become firm, inflamed and painful. 

Sometimes, severe acne can develop deep below the surface of your skin. Often referred to as cystic acne, this type of acne can be very painful and often leaves behind acne scars long after it goes away.

How to Treat Period Acne

Although period acne can be annoying, it’s almost always treatable. A variety of treatments are available to improve and prevent hormonal acne that flares up during your period, from topical medications to several prescription treatments.

There are also several habits and lifestyle changes that you can implement to reduce your risk of acne breakouts before and during your period. We’ve covered all of these treatments below, with information on how each option works, its availability and more.

Hormonal Birth Control

Certain forms of hormonal birth control, including some birth control pills, can help to regulate your hormone levels and may prevent period-related acne.

Healthcare providers have been prescribing the birth control pill for acne for decades. Although it isn’t totally effective for everyone, many women notice that their acne begins to clears up after using birth control for several months. 

Currently, there are three FDA-approved birth control pills for treating acne: Yaz®, Estrostep® and Ortho Tri-Cyclen®. All of these are combination birth control pills that contain a mix of progestins and estrogen hormones.

You can learn more about using the birth control pill to treat and manage acne in our full guide to hormonal birth control as an acne treatment. 

Topical Retinoids

Topical retinoids such as tretinoin are a mainstay of treating acne, including the hormonal acne that can flare up before and during your period.

Retinoids work by speeding up your body’s production of new skin cells through a process that’s referred to as skin cell turnover. By producing new skin cells at a faster pace, it becomes harder for old, dead skin cells to build up on your skin’s surface and clog your pores.

Tretinoin, one of the most popular topical retinoids, is a topical medication that you apply directly to acne-prone skin. It’s available with a prescription and is one of several ingredients used in our customized acne cream. 

Like most acne treatments, the results from tretinoin aren’t instant. However, most people don’t need to wait for long to see improvements. According to most studies, people who use tretinoin generally experience significant improvements after about 12 weeks. 

You can learn more about using tretinoin to treat acne before and during your period in our full guide to tretinoin for hormonal acne.

Isotretinoin 

If you have severe acne that gets worse during your period and doesn’t seem to improve with other treatments, your healthcare provider may suggest using a medication called isotretinoin..

Isotretinoin is a powerful medication. It’s usually prescribed for cases of acne (including period acne) that don’t improve with medications like tretinoin or the birth control pill. Research shows that it’s the most effective treatment available for severe acne. 

Unlike tretinoin, isotretinoin isn’t a topical medication. Instead, it comes in capsule form for use either one or two times per day. 

Although it’s highly effective for treating acne, isotretinoin can cause more severe side effects than other acne medications. As such, you’ll need to closely follow your healthcare provider’s instructions if you’re prescribed this medication. 

Topical Antibiotics

If the acne you get before and during your period is inflamed and infected, you may also benefit from using a topical antibiotic.

Topical antibiotics work by killing the bacteria that can get inside clogged pores, causing them to become inflamed and painful. Antibiotics are often prescribed alongside other acne medications to target acne breakouts from multiple directions. 

One topical antibiotic that’s commonly used to treat acne is clindamycin. Used at the same time as medications such as tretinoin or isotretinoin, clindamycin is highly effective at removing acne lesions and clearing acne-prone skin.

You can learn more about how topical antibiotics such as clindamycin work in our full guide to using clindamycin to treat acne. 

Anti-Androgens

Sometimes, hormonal acne can be treated using anti-androgens -- medications that reduce the amount of androgen hormones produced by your body.

If you have persistent or severe period acne that hasn’t gotten better with other treatments, your healthcare provider may prescribe an anti-androgen such as spironolactone to lower your levels of acne-causing hormones.

Spironolactone is generally effective. According to studies, around one third of women who use it experience a complete removal of all acne, with another third developing noticeably less acne after treatment. Most people experience a 50 to 100 percent reduction in acne.

Because spironolactone isn’t safe for use in pregnant women, you’ll need to use birth control at the same time as you take it. We’ve explained more about this and other side effects in our full guide to spironolactone for acne. 

Over-the-Counter Acne Treatments

Several products that can treat acne are available over the counter. These products can vary in effectiveness, but some may be enough to get rid of mild acne breakouts that develop before or during your period. Ingredients to look for include:

• Cleansers. If you get mild acne before and during your period, try washinging your face with a gentle cleanser. This can help to remove dead skin cells and excess oil from your skin, all without drying out your face or causing irritation.
  
  When it comes to cleansers, it’s best to stick with mild products that don’t contain harsh chemicals. Our deep sea cleanser is formulated specifically for acne and is designed to prevent breakouts while keeping your skin smooth, hydrated and healthy.

• Benzoyl peroxide. A topical antiseptic, benzoyl peroxide works by getting rid of bacteria that live on your skin and contribute to inflamed, painful acne breakouts.
  
  Although benzoyl peroxide won’t necessarily stop period acne from developing, it can be helpful if you often get papules, pustules, cysts and other forms of infected acne that are caused by bacteria.

• Salicylic acid. Salicylic acid is a type of topical exfoliant. It works by removing dead skin cells from your skin, preventing them from becoming stuck inside pores and contributing to acne lesions.

Lifestyle Changes and Habits to Prevent Period Acne

Although making changes to your lifestyle usually isn’t enough to treat severe acne, it may help you to reduce the severity of your breakouts and deal with period acne easier. Try the following lifestyle changes and habits if you’re prone to acne before and during your period:

• Avoid popping pimples. No matter how tempting it might feel, it’s best to avoid popping pimples once they develop. This is because popping pimples with your fingers can easily transfer bacteria onto your skin, increasing your risk of developing an infection.
  
  If you have severe acne, the best approach is to talk to a dermatologist. They can safely get rid of certain forms of acne using sterile extraction equipment and, for some types of acne, medications such as corticosteroids.

• Use a cold compress to deal with acne-related pain. If your acne is inflamed, painful and swollen, you can gently apply a cold compress to your face to reduce swelling and provide relief from the discomfort.

• Limit your use of makeup. Although makeup can help to cover up acne breakouts, it’s generally best to avoid wearing makeup while you’re experiencing acne. This is because certain types of makeup may clog your pores and worsen your acne breakouts.
  
  If you can’t go without makeup, make sure to only use makeup products that are labeled as non-comedogenic. These products are formulated using fewer oils and are less likely to clog your pores and contribute to acne.

• Wash your face twice a day. Washing your face is essential for removing oil, sweat and other substances that can clog pores and contribute to acne breakouts, especially if your skin gets noticeably more oily before and during your period.
  
  Avoid scrubbing your skin, as this can cause your skin to become irritated. Instead, try to wash your face as gently as possible using your fingers and an irritant-free cleanser after you wake up and before you go to bed for the night.

• If you have inflamed acne during your period, drink a cup or two of green or black tea every day. While green tea and black tea won’t cure acne, research shows that they have anti-inflammatory effects that could help with inflamed, painful acne.

• Avoid eating high-GI foods. While eating oily food won’t worsen your acne (a common misconception), some research has found that eating lots of high-GI carbohydrates may cause acne breakouts to worsen.

In Conclusion

Acne breakouts are a common occurrence before and during your period. With your hormones fluctuating, it’s normal to experience everything from a few blackheads or whiteheads to a large breakout of inflamed, painful acne. 

Luckily, period acne is treatable. For mild acne, an over-the-counter treatment may be enough to keep your skin clear during your period. For severe acne, you may need to use prescription medication such as tretinoin or a type of birth control pill that helps to prevent acne. 

Treating period acne can take several weeks, but it’s worth the wait. Find the right treatment for you and use it consistently and you’ll be able to enjoy acne-free skin every day of the month. 

Learn More About Treating Acne

Tired of dealing with acne? Treating and preventing acne is much easier once you understand how acne develops and what you can do halt it in its tracks.

Our guide to science-backed acne treatments goes into more detail about the factors that can cause acne breakouts and the proven treatments that are available to help you keep your skin in top condition.