Premenstrual Acne: Why Your Skin Breaks Out Every Month
Acne flare-ups are almost a monthly ritual for many people, often striking in the week before your period—known as the late luteal phase. This phenomenon, commonly called premenstrual acne, is a direct consequence of the dramatic hormonal rollercoaster your body rides during the second half of the menstrual cycle.
These breakouts are usually concentrated on the lower third of the face—think chin, jawline, and neck—and they tend to be deep, cystic, and painful.
The Hormonal Timeline Behind Premenstrual Acne
The menstrual cycle has two main halves, but it’s the second half—the luteal phase—that wreaks havoc on your skin.
1. The Luteal Phase (Post-Ovulation to Period)
This is when the hormonal imbalance sets the stage for breakouts.
| Hormone Shift | Effect on Skin | How It Causes Acne |
|---|---|---|
| Rising Progesterone | Peaks right after ovulation; can cause mild skin swelling or water retention, slightly compressing pores. | Swollen pores trap excess sebum and dead skin cells, forming clogs. |
| Relative Rise in Androgens | Testosterone and other androgens stay roughly constant, but as estrogen and progesterone drop, androgen activity becomes dominant. | Overstimulates sebaceous (oil) glands → excessive sebum production, fueling clogged pores and inflammation. |
Bottom line: Progesterone squeezes the pores, and relative androgen dominance cranks oil production to max—an ideal storm for acne.
2. The Premenstrual Flare-Up (Days Leading Up to Menses)
The combination of clogged pores and overactive oil glands creates the hallmark pre-period breakout:
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Clogged Pores + Excess Oil: Sebaceous glands are overstimulated, producing more sebum than usual, while slightly compressed pores trap oil and dead skin cells inside.
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Inflammation: The trapped environment allows acne-causing bacteria (P. acnes) to thrive. The immune response kicks in, turning the clogged follicle into red, painful, cystic blemishes.
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Stress Factor: Premenstrual stress (hello, PMS!) increases cortisol, which further stimulates oil production, intensifying breakouts.
The Science in Simple Terms
Think of it as a double whammy:
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Pores tighten (thanks to progesterone).
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Oil glands overproduce sebum (thanks to relative androgen dominance).
Together, these factors produce the deep, inflamed, lower-face acne so many experience each month.
