You know the routine. You’ve got some gorgeous skin products you just love, and your skin is glowing. Then, out of nowhere, comes the redness, the inflammation, the jawline of a 15-year-old boy. And nothing. No. Thi. Ng. Can shift it. Until, that is, your period starts. Strap in ladies, today, we’re talking period acne. Or how you can look like a teenager from the nose down at 50.

What is period Acne?

The bad news is, it’s not uncommon to experience breakouts for the first time as an adult, or, if you’re super unlucky, right through from puberty to the end of menopause. And, as the name suggests, hormonal or period acne is intrinsically linked to your hormonal cycle. So what exactly is going one with our hormones that causes the inflamed skin known as period jaw to begin with? I’m glad you asked.

Round and Round the cycle goes

Now, we’re all, probably, aware of the 28-day (or thereabouts) hormonal cycle that results in periods. Roughly speaking, those 28 days are split into two halves. Estrogen dominates the first, while Progesterone takes over for the second. While those two halves are pretty well defined, the levels are constantly in flux. This next little factoid blew my mind, so prepare yourself. All that fluxing means that no two days are the same, hormonally speaking. So, if, like me, you sometimes wonder why you never feel the same two days in a row, it’s because you don’t. You actually don’t. Mind blown! Anyhoo, here’s why that matters in an acne sense.

Causes of period acne

Both of those hormones, that’s estrogen and progesterone, peak at different times during your cycle, and are at their lowest as your period starts. In contrast, your levels of testosterone remain fairly constant. So, relatively speaking, by the time the bleeding starts, testosterone is dominant. And these hormone switcheroos can play havoc with your skin. The spikes in both progesterone and testosterone increase the production of sebum in your skin. And just for fun, the former also causes swelling and pore-tightening, stopping the oil and dead skin cells that inhabit them from escaping, leading to clogged pores. Those conditions then increase the presence of the P. acnes bacterium that we all have. Result: Acne, in all its glorious forms. And they include everything from red inflamed patches to blackheads, whiteheads and everyone’s favorite mirror-spoiler – pus.

Living with Hormonal Acne

As I mentioned earlier, hormonal acne is mostly prevalent during puberty, periods and the menopause. But those aren’t the only things that can upset your hormones. Starting or stopping birth control, stress and obesity can all have an effect on our hormonal wellbeing. And that’s before you add in pregnancy, or endocrine conditions like Hashimoto’s or polycystic ovaries. Basically, a million things can trigger a hormonal breakout. But it’s not all bad news. Honest.

What can I do to improve period acne?

There are some things you can do to help combat period acne. Now, if yours is severe, you’re probably already under the care of a professional. But if you’re not, please see one as soon as possible. You don’t have to suffer. There are several medical solutions that can work wonders when all else has failed. Admittedly they mostly involve taking birth control pills that add extra estrogen to your body and help rebalance the oil production of your skin. They do, though, come with increased risk of blood clots, so a six-month course is generally the limit.

Then there are dermatologist-only therapies that can help lower the production of sebum but can lead to very dry skin. But before you get there, you may well be given oral antibiotics to help kill the bacteria that can cause inflamed skin. The good news is that many patients see an end to their acne around six months after starting treatment.

For the rest of us, who live with mild to moderate acne every few weeks, or if you feel a medical solution isn’t right for you, don’t worry – there are some practical things you can do to help make the whole thing more bearable. First and foremost is great skin hygiene. Pamper your skin a little more in the run-up to your period, choosing products that are non-comedogenic, which means they’re oil-free and won’t lead to clogged pores. And definitely no touching. And no picking. Seriously. Not only can it leave scars, but it’ll just spread the bacteria around, so really, no picking.

Define relax…

But here’s something that’s perhaps even more important. Try and relax. As I mentioned right at the beginning, stress can have a huge impact on your hormones. And given the last year or so, you’re probably about as stressed as you’ve ever been. Which means finding a way to relax is probably as important as it’s ever been. Have a long bath, take a walk, talk to your loved ones, binge RuPaul’s Drag Race on Netflix. Whatever works for you, do it. Because it’s not just your skin that will benefit from a little me-time.

On a very similar note, eating well and generally looking after yourself can have a fantastic knock-on effect on your skin. Add some fruit to your diet, up your fish consumption and take away a little sugar, and you might be pleasantly surprised. I might even suggest cutting down on the dairy, but I know how important coffee is to us all. And while this all sounds like general lifestyle advice, what you put in your body does have an effect on how feel and look. With a little patience, a small amount of work and an acceptance that hormones-r-us, your skin can look great every day of the month.

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