Struggle with premenstrual acne?

My Hormonology

Struggle with premenstrual acne?



  • Premenstrual acne is common in women of all ages who have menstrual cycles. Here are 4 reasons why your breakouts are more common in the days leading up to your period.


UPDATED May 27, 2022 (originally published July 23, 2014)—Do you have a menstrual cycle and notice more acne flare-ups on the days before your period? You’re not alone. Research shows that premenstrual pimples are fairly common.

Indeed, one 2021 study in the Journal of Cosmetic Dermatology found that in women who get acne, nearly 62% experience more breakouts before menstruation.1

A 2004 study in the Archives of Dermatology even pinpointed just how much more acne you tend to get in your premenstrual phase: 25%.2

If you assumed (or at least hoped) that premenstrual acne lessens as you get further from your teens and early 20s, well, there’s a bit of bad news. A 2001 study in the Journal of the American Academy of Dermatology found that women 34 and older had worse premenstrual break-outs than those who were aged 20 to 33.3

The acne/hormone connection

So, what’s causing this increase in pimples on the days leading up to your period? Researchers have a couple of theories4:

      1. A spike in testosterone mid-cycle at ovulation triggers pore-clogging oil. Throughout most of your menstrual cycle, you produce a steady low amount of testosterone. But, once ovulation rolls around, your body churns out a slightly higher amount of this hormone for three days. Though the increase in this hormone is small, it’s enough to produce more oil in your skin. So, it may be that this excess oil clogs pores mid-cycle, but you don’t see the ensuing pimples until about a week later after they’ve had time to stew and finally erupt.
      2. Elevated progesterone during the second half of your cycle causes inflammation that squeezes pores. Throughout the second half of your cycle (the luteal phase), progesterone is higher than it is during the first half (follicular phase). One side effect of a greater amount of this hormone is that it spurs fluid retention in your body. This excess fluid then causes inflammation in your skin that shrinks pores, which traps in dirt and oil that trigger premenstrual breakouts.


While pre-period acne can be a direct result of hormone changes in your body, they could also indirectly make you more prone to eruptions, too. For example, skin changes can happen due to…

  1. Premenstrual food cravings. Throughout the second half of your menstrual cycle, you have more food cravings compared to the first half. This is partly due to two drops in estrogen (the first for about three days right after ovulation, and the second during the six days before your period). When estrogen drops like this, it can drag down levels of serotonin in the brain, which causes cravings for comforting foods, which tend to be those high in fat and calories. Food cravings are also partly due to elevated progesterone, which spurs a longing for salty, fatty and sweet treats. As a result, it may be difficult for you to resist caving to temptation for these foods–which just happen to be the kinds that are more likely to cause pimples.
  2. Abandoning your skincare routine. In the first half of your cycle, rising estrogen is making your skin glow. Your face is clearer and brighter without you having to do much work to get it looking so healthy. While this is good news, it could also mean that you feel like you can slide on your usual skincare regimen. For example, you may forget to wash off your makeup before bed or just do a quick rinse. So, by the time you make it to the second half of your cycle, all that dirt and oil that you didn’t take care of could be turning your once healthy skin into a pimple party.


What can you do to reduce pre-period breakouts?

Since your acne could be caused by your hormones producing more oil or clogging pores in the second half of your cycle, it’s even more vital to cleanse your skin extra-diligently from ovulation to your period.

You may also want to step up your face-cleansing game by adding more products to your regimen that help keep skin clear, such as a gentle astringent.

Another option: Try a treatment that specifically targets acne. One option: topical niacinamide, which is made from vitamin B3. Numerous studies have shown this natural compound works just as well at combatting acne as the prescription topical treatment clindamycin, which is given out by dermatologists.5 You can find topical niacinamide at Amazon.

An added bonus: Topical niacinamide also reduces the appearance of fine lines and age spots and improves skin tone and color, research shows.6 (As with any skincare product, try a test patch first to see how your skin responds.)

If you’re on top of your skincare routine and acne treatments, but are still getting breakouts, then you may need to make changes to your premenstrual eating habits. Try cutting back on sugary, fatty and salty foods, as well as foods you know may be a pimple trigger for you (for example, chocolate or dairy).

If you’re not sure which foods are causing your breakouts, keep a journal tracking the foods you eat and your skin appearance to find a link. If you can pinpoint the eruption-causing culprit, you can cut back on it or eliminate it to keep your skin clear and smooth.

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(1) Nidhi Shah, et al., “Prevalence of acne vulgaris and its clinico-epidemiological pattern in adult patients: Results of a prospective, observational study”, Journal of Cosmetic Dermatology, (2021): 3672-3678
(2) Anne W. Lucky, “Quantitative documentation of a premenstrual flare of facial acne in adult women”, Archives of Dermatology, 140 (2004): 423-424
(3) Shelley Stoll, et al., “The effect of the menstrual cycle on acne”, Journal of the American Academy of Dermatology, 45 (2001): 957-960
(4) Katerina Steventon, “Expert opinion and review article: The timing of comedone extraction in the treatment of premenstrual acne–a proposed therapeutic approach”, International Journal of Cosmetic Science, 33 (2011): 99-104
M. Williams, W. J. Cunliffe, “Explanation for premenstrual acne”, Lancet, 10 (1973): 1055-1057
(5) Effat Khodaeiani, et al., “Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgaris”, International Journal of Dermatology, 52 (2013): 999-1004
Pierfrancesco Morganti, et al., “Topical clindamycin 1% vs. linoleic acid-rich phosphatidylcholine and nicotinamide 4% in the treatment of acne: a multicentre-randomized trial”, International Journal of Cosmetic Science, 33 (2011): 467-476
Alan R. Shalita, et al., “Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris”, International Journal of Dermatology, 34 (1995): 434-437
(6) Akira Kawada, et al., “Evaluation of anti-wrinkle effects of a novel cosmetic containing niacinamide”, The Journal of Dermatology, 35 (2008): 637-642
Donald L Bissett, John E Oblong, Cynthia A Berge, “Niacinamide: A B vitamin that improves aging facial skin appearance”, Dermatolgic Surgery, 31 (2005): 860-865
Donald L. Bissett, et al., “Topical niacinamide reduces yellowing, wrinkling, red blotchiness, and hyperpigmented spots in aging facial skin”, International Journal of Cosmetic Science, 26 (2004): 231-238

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