Acne and Periods: Things All Women Should Know
Acne before periods is almost as synonymous with menstruation as is cramps, moodiness, bloating and cramps. It’s almost like your body conspires against your entire skincare regimen to fuel flareups just before the least convenient time of the month as if you didn't have enough problems as it is! However, getting acne before period is not exactly an excuse for slacking and being compulsive in the dermatological department. With the application and adoption of the right products coupled with a rigorous regime, you can control premenstrual acne before it rears its ugly head. But first, you have to understand how breakout before period comes about and why it is such a common phenomenon.
How Does the Menstrual Cycle Influences Acne?
The average menstrual cycle, which lasts approximately 28 days (give or take a day), is usually under the influence and control of a collection of specific hormones. These fluctuating hormones are essentially the genesis of acne during periods or period bumps occurring just before them. You see, while oestrogen rises progressively in the first half of your menstrual cycle, the level of progesterone will typically hit the roof in the 2nd half of one's cycle. But does progesterone cause acne? It is not as simple as that and you are just about to see why.
Here's the thing, the bodily changes that you normally experience during the first half of your periodic cycle are mostly under the control of estrogen. On the other hand, the changes experienced during the 2nd half of one's menstrual cycle are predominantly influenced by the 'pregnancy hormone' aka progesterone. The only way you can be sure that you are experiencing a breakout before period is if the flareups coincide with your menstruation pattern.
It is worth noting that just before your period, the levels of both oestrogen and progesterone fall while your baseline testosterone levels basically stay the same. This, therefore, implies that there are a few days just before your periods when your testosterone activity is significantly higher than that of progesterone and estrogen. This kind of bizarre hormonal shifts typically result in all manner of dermatological changes, ranging from mild period zits to really devastating nodules acne and anything else in between.
Experts believe that progesterone acne (the one that comes about a week before menstruation) is the aftermath of the sporadic rise in this hormone at the height of the luteal phase. Apparently, the 'pregnancy hormone' stimulates an unprecedented secretion of oil by the sebaceous glands, which when not taken care of using a water-tight skincare regimen can block or plug out your skin pores. What's more, sebum (as you probably already know) is a thick and oily substance whose purpose is to lubricate the moisturize the skin. Nonetheless, its oversecretion in the luteal phase as a result of the ensuing hormonal interaction can trigger a swelling of the pores which later on compresses your pores.
In other words, this may result in sebum building up cumulatively under your skin's surface and the result becomes the infamous acne during periods phenomenon that we all love to hate. This, in addition to the higher testosterone levels just before and during menstruation, can rile up the sebaceous glands more resulting in the secretion of even more sebum, which translates to angrier pimples.
Having said that, the higher amount of sebum is not necessarily a bad thing (dermatologically) for all women. Those with naturally dry skin, for example, will outrightly get a healthy glow just before and during their periods. For others, nonetheless, the extra sebum can trigger a nasty case of premenstrual acne as their pores tend to become more easily clogged with a blend of dead skin cells, debris, grime and dirt. Besides, the extra sebum often creates a healthy breeding ground for a myriad of acne-causing bacteria strains to thrive. Your immune system, on the other hand, might inadvertently fuel this brewing hormonal acne by triggering an inflammation that then makes the pimples angrier in the long run.
Notable Symptoms of Premenstrual Acne that You Ought to be on the Lookout For
While spironolactone acne can take different forms, there are certain common occurrences that are visible in a majority of women. They include whiteheads and blackheads. In this case, blackheads are also known as open comedones as they are typically open right at the skin's surface which explains their black pigmentation which is the result of oxidation due to exposure to air. Whiteheads, on the other side of the spectrum, are closed comedones since they are usually sealed under the skin's surface.
Apart from whiteheads and blackheads, other types of period bumps that may accost you during this time of the month include;
- Pustules: They are itchy red and have small pimples often with a yellowish or white pus-filled middle.
- Papules: Small raised bumps that are caused by inflammation and infection of hair follicles.
- Nodules: They are painful and solid lumps occurring underneath one's skin.
- Cysts: They are pus-filled lumps that occur underneath the skin and are quite painful compared to ordinary pimples.
Compared to ordinary non-hormonal flareups, acne during periods tend to occur mostly in the lower half of your face i.e the cheeks, chin, neck and jawline. What's more, they are a bit more inflamed and red but rarely develop into full-blown pustules i.e papules filled with pus.
Speaking of which, watch out for acne lesions that occur during and around your periods. They are tender bumps that form just underneath the skin on hormone-dependent areas such as the jawline or the cheeks. They can be very frustrating and itchy but it is in your best interest to avoid squeezing or scratching them as this can drive the inflammation and subsequent infection deeper into your skin.
Is Menopausal Acne a Form of Hormonal Acne?
In its most basic definition, hormonal acne is any breakout or flareup that is predominantly caused by changes in one's hormonal profile. Some women are, therefore, often surprised to discover that acne is one of the tell-tale signs of approaching perimenopause. But ironically, there's a striking similarity between the two despite the highly contrasting prevailing circumstances.
You see, the same changes in the sex hormones that trigger acne during your periods are responsible for the flareups experienced just before you get your final period. The term 'perimenopause' in this case, refers to the final 7 to 14 years of your fertility phase that precedes menopause. It is at this stage that your estrogen levels take a hit and trigger hot flashes, mood swings, sleeping difficulties and skin changes including acne.
Just like what happens before receiving your period, the dropping estrogen levels usually pave way for testosterone levels to go through the roof. This shift in the hormonal balance combined with a notable decrease in the rate of skin cell regeneration usually culminates in plugged pores and nasty-looking pimples. If anything, it can lead to some women experiencing stubborn flareups for the first time in decades.
Having said that, if you are not yet in the typical age bracket that a majority of women enter perimenopause (i.e mid-40s) and you start experiencing a sudden and unexplained case of acne, you may want to get checked by your dermatologist as soon as possible. Chances are, while the acne could be a result of hormonal imbalance, it could be the backdrop of a rather serious health condition.
Cystic Acne During Period: How to Get on Top of Things
Cystic acne, unlike ordinary pimples, is a relatively more severe type of acne that mostly affects the back, chest and face. It is characterised by several badly inflamed lumps underneath the skin that later morph into cysts, nodules and scars when left untreated. As such, severe cystic acne as a result of the drastic hormonal changes that many women experience at the height of their menstrual cycle calls for a full suite of specialized treatments that may include;
- Hormonal therapy
- Oral antibiotics
- Intralesional steroids
- Systemic steroids
Otherwise, OTC treatments should be your first port of call before seeking further prescription-based assistance from your healthcare provider. One recommended OTC solution for cystic acne is AENO's Cystic Acne Treatment & Scar Remover. The topical treatment combines a number of completely organic skincare ingredients geared towards arresting worsening cases of cystic acne before they become frustratingly hard to clear.
Still, it is possible that the reason that you are struggling with cystic acne during period is that you are naturally predisposed to this form of acne courtesy of your genetic profile. In such cases, you may need a more aggressive form of treatment involving the application of prescription-strength isotretinoin. It's an oral form of retinol (vitamin A) that is considered to be among the most effective solutions for notoriously hard-to-treat cystic acne.
Isotretinoin, being an orally administered medication, works by targetting almost all possible sources of period cystic acne. This implies that apart from killing acne-causing bacteria, it also unclogs pores, drains excess oil and combats cellular inflammation from inside out. The treatment course, which pregnant women are strictly not allowed to take, typically takes around five to six months to complete and may have severe side effects too.
How To Prevent and Treat Acne Before Period?
We have good news if you are currently at a loss on how to prevent acne before period and stay flawless throughout the year. The first step is to implement a couple of easy-to-hack lifestyle changes that can go a long way in helping you stomp the brakes as far as menstrual acne goes. And this includes;
1. Practising Excellent Skin Hygiene
One of the triggers of premenstrual acne is pimple-causing bacteria. Therefore, it should go without saying that one of the fool-proof ways of how to prevent period acne has to involve keeping your face devoid of these acne-aggravating bacteria, especially around and during your periods. In addition to this, get into the habit of not frequently touching your face as this is one of the easier ways of transferring bacteria and grime from foreign surfaces to your sensitive epidermis. Sanitize/clean your phone often too, while at it.
2. Stop Smoking
Apart from causing irreparable harm to the structural integrity, smoking contributes to close to a dozen types of acne.
3. Maintain a Healthy Body Weight
Studies show that obesity can decrease the sensitivity and effectiveness of SHBG. This is an important sex hormone-binding globulin that combats period acne by soaking up excess testosterone from your bloodstream. Remember that one of the main causes of period zits is the drastic increase of free testosterone in a woman's system following the subsequent decrease in the progesterone and estrogen levels just before menstruation. Apparently, SHBG helps tone down this difference but won't work as properly if you are overweight.
4. Supplement Your Diet with the Right Profile of Minerals and Vitamins
Though it may sound a bit far-fetched, taking the right set of minerals and vitamins can go a long way in keeping premenstrual flareups at bay. Bear in mind, however, that the aim is to create a conducive ground for a healthy glow and not substitute your primary acne treatment regimen.
Speaking of which, here are some critical micronutrients to take if you have acne-prone skin.
- Zinc: Apart from improving your skin's natural healing abilities, zinc has also been observed to be critical in restricting the activity of acne-causing bacteria.
- Vitamin D: Vitamin D is primarily synthesized by your skin in the presence of sunlight. However, they are chances that you could be deficient in it if you have a habit of spending a lot of time indoors.
- Vitamin A and E: These two chiefly antioxidants and a deficiency in any or both of them has been shown to make acne a tad more severe.
- Vitamin C: Apart from being an important antioxidant, ascorbic acid also packs a host of anti-inflammatory properties that help make acne lesions less itchy and purulent.
That aside, if your acne persists, you may want to try one of the following topical treatments to rein control of the flareups. This is actually one of the most practical ways of how to prevent breakouts during period from worsening or scarring afterwards.
- AHA: Alpha hydroxy acids such as glycolic and lactic acid are tailored to improve the rate of skin cell turnover which then translates to lower incidences of blocked skin pores.
- Antibiotics: They prevent the proliferation and multiplication of acne-causing bacteria.
- Azelaic and salicylic acids: Apart from their legendary anti-inflammatory and antimicrobial properties, they act as dependable chemical exfoliators that can keep your pores open enough to stave off a nasty flareup before your periods.
- Benzoyl peroxide: It provokes oxygen production when applied topically on the skin which eventually kills off anaerobic acne-causing bacteria.
- Sulfur and zinc: Both contain notable anti-inflammatory and antimicrobial properties that come in handy in reducing the severity of acne symptoms before and during menstruation.
In Closing - The Takeaway
There's no scarcity of how to prevent acne during period just as there isn't a lack of treatment options to pursue when such a flareup threatens to get out of hand. The idea here, at the end of the day, is to make it as hard as possible for acne-triggering bacteria to thrive.