Why Does Acne Get Worse Before Period Starts

INTRODUCTION

Acne that suddenly flares right before a period is so common that it has its own name: **perimenstrual acne**. For many people, it can feel predictable and frustrating—your skin is finally calming down, and then a week before bleeding starts, new, often painful spots appear along the chin, jawline, or cheeks.[1][7] This pattern can affect confidence, mood, and how you plan social or professional events.

Understanding *why* this happens is the first step to getting back some control. Period-related breakouts are not random; they are closely tied to hormonal changes that influence oil (sebum) production, inflammation, and how pores behave throughout the menstrual cycle.[2][5] Once you understand the timing and mechanisms, you can adjust your routine, start treatments at the right moment, and reduce the severity of those predictable flares.

In this article, you’ll learn what exactly is going on with your hormones before your period, why acne tends to peak in the late luteal phase (the week before bleeding), how long flares usually last, and which skincare ingredients and lifestyle strategies can help. You’ll also find step‑by‑step guidance on how to prepare your skin each cycle, plus answers to frequently asked questions about hormonal and period acne.

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Why Does Acne Get Worse Right Before Your Period?

Research shows that **about 63–65% of acne‑prone women notice their acne worsening around their period**.[1][6][8] These flares usually start about **7–10 days before bleeding** and tend to settle as the period begins or within about a week after it ends.[1][6]

The key driver is **hormonal fluctuation**, not “dirty skin” or poor hygiene. During the menstrual cycle:

• Just before your period, **estrogen and progesterone levels drop**.[2][4]
• Compared with these falling hormones, **androgens (like testosterone) are relatively higher**, even though their absolute level may not change very much.[6][7]
• This hormonal balance leads to **more sebum production**, more clogged pores, and higher inflammation—ideal conditions for acne to worsen.[2][5][7]

In other words, your skin is reacting to a predictable internal pattern, which is why the breakouts tend to recur at roughly the same time each month.

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What Happens to Your Hormones Before Your Period?

To understand pre‑period acne, it helps to see the menstrual cycle in two broad halves:

• **Follicular phase (period to ovulation)**
• Estrogen gradually rises.
• Progesterone is relatively low.[4][7]
• Skin often feels more balanced; some people notice fewer breakouts.
• **Luteal phase (ovulation to next period)**
• Progesterone rises and peaks mid‑luteal, then falls.[4][7]
• Estrogen is lower toward the end of this phase.
• Right before your period, both estrogen and progesterone are low, while testosterone is relatively more dominant.[5][6][7]

These shifts matter for skin because:

• **Progesterone** can **increase sebum production** and cause mild skin swelling, which can compress pores.[3][6][7]
• **Androgens (like testosterone)** further **stimulate sebaceous glands**, pushing them to produce more oil.[4][6]
• Falling **estrogen** means less of its “balancing” effect on skin hydration and barrier function.[3][4]

The combination of **more oil, compressed pores, and heightened inflammatory response** creates the perfect conditions for a breakout just before bleeding begins.

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How Exactly Do Hormones Trigger Breakouts?

Several mechanisms come together in the days before your period:

• **Increased sebum (oil) production**
• Progesterone and androgens drive sebaceous glands to produce **more sebum**.[3][4][5]
• Excess sebum mixes with dead skin cells and debris, clogging pores.
• **Pore narrowing and congestion**
• Rising progesterone mid‑cycle can cause **skin swelling**, which can compress pores.[6]
• This “tourniquet effect” traps sebum beneath the surface, creating ideal conditions for comedones (whiteheads and blackheads).[6]
• **Inflammation and bacteria**
• Hormonal changes can **increase inflammation** in the skin and support overgrowth of acne‑associated bacteria like *Cutibacterium acnes*.[2]
• Clogged, inflamed pores become red, tender papules or deeper, painful nodules.
• **Relative testosterone dominance**
• While testosterone may stay relatively stable, it becomes **more influential when estrogen and progesterone drop** just before your period.[6][7]
• This relative dominance contributes to oilier skin and deeper, often cyst‑like breakouts along the chin and jawline—typical for hormonal acne.[3][7][8]

This is why acne can feel “worse” before a period even if your routine hasn’t changed at all.

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Where and What Does Period-Related Acne Look Like?

Perimenstrual acne has some common patterns:

• **Location**
• Often clustered along the **chin, jawline, and lower cheeks**, which are classic hormonal zones.[3][8]
• Can also appear on the **neck, back, or chest** in some people.
• **Type of lesions**
• **Deep, tender bumps** (nodules or cysts) that may not come to a head quickly.
• **Red inflammatory papules or pustules**.
• Worsening of existing **clogged pores and blackheads**.
• **Timing**
• Typically peaks **7–10 days before your period**.[1][6][8]
• Many people notice that **breakouts improve once bleeding starts** and clear within about **a week after the period ends**.[1][2][6]

If you see this pattern repeating for several cycles, you are likely dealing with hormonally driven, period‑related acne rather than random breakouts.

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Is It Only About Hormones? Other Factors That Make Flares Worse

Hormones are the main driver, but several additional factors can amplify pre‑period acne:

• **Stress and PMS**
• PMS is often associated with higher stress, irritability, and sleep disruption.[2][3]
• Stress can raise cortisol, which can further aggravate oil production and inflammation.
• **Diet and cravings**
• Many people crave sugary or high‑glycemic foods before their period. These can **temporarily worsen insulin levels**, which may influence androgen activity and sebum production in some individuals (this link is supported by acne research more broadly, not just period acne).
• **Skin‑care changes**
• Using heavier, comedogenic products to combat PMS‑related dryness or sensitivity can **clog pores** at the worst time.
• Over‑exfoliating or using too many actives when skin is already more reactive can **damage the barrier**, triggering more inflammation.
• **Picking and squeezing**
• Hormonal breakouts are often deeper and more painful, tempting people to pick. This increases the risk of **post‑inflammatory hyperpigmentation (PIH)** and scarring, especially on darker skin tones.[3]

Recognizing these triggers allows you to adjust habits in the week or two leading up to your period.

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Which Ingredients Help With Pre-Period Acne (and When to Use Them)?

Targeting the **right step at the right time** in your cycle is more effective than reacting after a breakout has already erupted. Evidence‑based, acne‑friendly ingredients include:

**1. To prevent clogged pores and excess oil**

• **Salicylic acid (BHA) 0.5–2%**
• Oil‑soluble; penetrates into pores to dissolve sebum and dead cells.
• Use as a cleanser or leave‑on exfoliant **starting 7–10 days before your period** if your skin tolerates it.
• **Topical retinoids** (adapalene 0.1%, over‑the‑counter in many regions; tretinoin by prescription)
• Normalize cell turnover and help prevent microcomedones (early clogged pores).
• Best used consistently **throughout the month**, not just before your period.

**2. To reduce inflammation and active breakouts**

• **Benzoyl peroxide 2.5–5%**
• Kills acne‑associated bacteria and reduces inflammation.
• Use as a spot treatment or thin layer over acne‑prone zones, particularly in the **late luteal phase**.
• **Niacinamide 4–5%**
• Anti‑inflammatory, helps regulate sebum, supports barrier function.
• Gentle enough for daily use; helpful when skin feels more reactive before a period.

**3. To support the skin barrier**

• **Ceramide‑rich moisturizers**
• Help maintain barrier integrity when using actives like BHA, benzoyl peroxide, or retinoids.
• **Non‑comedogenic, gel‑cream textures**
• Provide hydration without heavy occlusion, reducing the risk of added congestion.

**4. For persistent or severe hormonal acne**

• **Combined oral contraceptive pills** and **anti‑androgen therapies** (e.g., spironolactone, in regions where it is used for acne) can reduce sebum production and hormonal flares over time.[1]
• These require assessment and prescription by a healthcare professional and usually take **3–6 months** to show full benefit.

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How Long Does Pre-Period Acne Last?

Patterns differ from person to person, but research offers a general timeline:

• In one study, **91% of women with perimenstrual acne noted that breakouts began within seven days before their period**.[1]
• About **77% reported that their acne disappeared within one week after their period ended**.[1]
• Other data suggest that flares **typically start 7–10 days before bleeding and improve once menstruation begins**.[6]

So, for many people, the most intense phase of period‑related acne lasts roughly **2–3 weeks** out of the cycle—building during the late luteal phase and fading in the early follicular phase. Because this pattern repeats, using a **cycle‑based routine** can significantly reduce severity over time.

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HOW TO PREPARE YOUR SKIN EACH CYCLE (STEP-BY-STEP)

This step‑by‑step plan assumes a roughly 28‑day cycle; if yours is longer or shorter, adjust the timing to your own pattern. The key is to **start prevention before you normally break out**.

Step 1: Track Your Cycle and Breakouts (Month 1–2)

Use a calendar or app to mark:

• Day 1 of your period (first day of bleeding).
• Days when new pimples appear or existing ones worsen.

2. After 2–3 cycles, identify:

• The typical **start of your flare window** (e.g., Day 20–24).
• Which areas of your face are most affected (chin, jawline, cheeks).

Step 2: Establish a Gentle Baseline Routine (All Month)

Morning:

• Cleanser:
• Gentle, non‑stripping gel or cream cleanser.
• Treatment (optional if skin is sensitive):
• 2–5% **niacinamide** serum for oil and inflammation control.
• Moisturizer:
• Lightweight, **non‑comedogenic** moisturizer with ceramides or glycerin.
• Sunscreen:
• Broad‑spectrum **SPF 30 or higher** every day.

Evening:

• Cleanser: same gentle cleanser.
• Treatment:
• **Topical retinoid** (e.g., adapalene 0.1% gel) 2–3 nights per week, increasing as tolerated.
• Moisturizer:
• Reapply lightweight moisturizer; consider a slightly richer version if using retinoids.

Step 3: Start “Pre-Period Prevention” 7–10 Days Before Your Period

About a week before your expected period (or whenever you typically start breaking out):

**Add or increase salicylic acid (BHA)**

• Use a **0.5–2% salicylic acid cleanser** once daily or a leave‑on BHA every other night, depending on sensitivity.
• Focus on acne‑prone areas (chin, jawline, T‑zone).

2. **Spot‑treat early lesions**

• Use **2.5–5% benzoyl peroxide** as a thin layer on areas where you historically flare, once daily at night.
• If irritation occurs, reduce to every other night and buffer with moisturizer (moisturizer first, then a thin layer of benzoyl peroxide).

3. **Keep moisturizer consistent**

• Don’t skip moisturizer, even if you feel oilier; choose a **light gel‑cream** to maintain barrier function and reduce the risk of irritation from active ingredients.

Step 4: Adjust During Your Period

Once bleeding starts:

• If skin feels **more sensitive or dry**:
• Reduce retinoid or BHA use to **2–3 nights per week**.
• Focus on hydrating ingredients (glycerin, hyaluronic acid, ceramides).
• If breakouts are still active:
• Continue **benzoyl peroxide spot treatment** once daily on active lesions.
• Avoid new strong actives or harsh scrubs.

Step 5: Avoid Common Mistakes

• Do **not**:
• Over‑wash (stick to cleansing **twice daily**).
• Use harsh physical scrubs, which can inflame already stressed skin.
• Pick, squeeze, or dig at deep hormonal cysts—this increases scarring risk.
• Do:
• Keep pillowcases and makeup brushes clean.
• Choose **non‑comedogenic, fragrance‑free** makeup and skincare where possible.
• Manage stress with realistic tools (sleep, light movement, relaxation practices).

Step 6: Reassess Every 3 Months

• Acne treatments, especially retinoids or hormonal medications, often need **8–12 weeks** to show clear improvement.
• If your pre‑period flares:
• Are severe, cystic, or painful.
• Cause scarring or significant dark marks.
• Do not improve after **3–4 months** of consistent topical care.
• Consider seeing a dermatologist to discuss prescription options, including hormonal treatments.

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NEXT STEPS: WHAT TO DO AFTER READING

• **Map your cycle and skin**
• For the next 2–3 months, track when breakouts worsen in relation to your period. Note locations, severity, and type of lesions.
• **Layer in one change at a time**
• If you are new to actives, start with **one**: for example, a salicylic acid cleanser before your period, or a nightly niacinamide serum.
• **Build a pre‑period plan**
• Decide exactly what you’ll do **7–10 days before bleeding** (e.g., add BHA and benzoyl peroxide spot treatment on your chin and jawline).
• **Monitor trends, not single breakouts**
• A single pimple is less important than the overall pattern. Look for fewer new lesions, milder flares, and faster healing over several cycles.
• **Know when to seek professional care**
• If you suspect conditions like **PCOS**, experience irregular periods, excessive hair growth, or very severe, persistent acne, speak with a healthcare provider.
• A dermatologist can discuss oral contraceptives, anti‑androgen medications, or stronger topical treatments tailored to hormonal acne.

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FAQ SECTION

1. How do I know if my acne is hormonal or just regular breakouts?

Hormonal, period‑related acne typically:

• Flares **cyclically**, often **7–10 days before your period**.[1][6][8]
• Appears mostly along the **chin, jawline, and lower cheeks**.[3][8]
• Includes **deeper, tender bumps** that may not come to a whitehead quickly.

“Regular” acne may:

• Be present **all month** without clear timing.
• Affect more areas randomly (forehead, nose, cheeks, back) with no clear cycle link.[8]

Tracking your cycle and breakouts for 2–3 months is the best way to see if there is a pattern. If lesions cluster consistently in the late luteal phase, they are likely hormonal.

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2. Is it normal for my acne to get worse before my period?

Yes. Studies suggest that **between about 63% and 65% of women with acne experience perimenstrual flares**.[1][6][8] For many, this is one of the most noticeable symptoms of PMS. While it is common, “normal” does not mean you have to live with severe flares. Topical treatments, cycle‑aware routines, and in some cases hormonal therapy can significantly reduce severity over time.

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3. How long will it take for a new routine to help my pre-period acne?

Acne treatments work on the **skin cycle**, which is typically around **4–6 weeks**, and deeper hormonal patterns can take longer to reflect in your skin. For most topical acne regimens:

• Expect initial changes in **6–8 weeks**.
• More reliable improvement in **8–12 weeks** of consistent use.
• With hormonal treatments (like oral contraceptives), dermatologists often reassess at around **3–6 months**.

It’s important to evaluate over several cycles, not just one. If you see no improvement after 3–4 months of consistent, appropriate care, consult a dermatologist.

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4. Can birth control help my acne that gets worse before my period?

Certain **combined oral contraceptives** (containing estrogen and a progestin) are commonly used to treat hormonally driven acne. They work by:

• **Reducing androgen activity**, which lowers sebum production.
• Smoothing out the **hormonal fluctuations** that trigger pre‑period flares.[1]

Not every pill improves acne, and some progestin‑only methods can worsen it for som