Of the two certainties in life—death and taxes—for me, I can add a third: a hormonal breakout right around the end of the month.
It is such a part of my life that I scheduled my wedding–almost 20 years ago–well away from that treacherous week before my period, for that very reason.
This other unpleasant monthly visitor is usually painful and angry, glaring at me from my chin or jaw, and it’s as predictable as the sun.
Never mind that I’m well into middle-age and all that teenage acne crap should be well behind me.
Should be. Isn’t.
Hormonal adult acne can be tricky to treat because it doesn’t always respond well to traditional acne treatments like benzoyl peroxide and salicylic acid patches.
Yes, birth control and Spironolactone are definitely effective for some people, but they are not without some significant risks.
However, there are several specific things you can do, both internally and externally, that are effective for that time of the month, no Rx required.
What is hormonal acne, exactly?
Well, first, acne is formed by four factors, primarily:
- clogged pores
- excess oil production and thickening skin
- bacterial infection
Other things can trigger acne, such as stress, lack of sleep, genetics, allergic reactions, etc, but one or more of the four factors above are involved in the formation of acne.
Hormonal acne, which includes teenage acne, as well as breakouts during pregnancy, menopause and your monthly cycle, is generally caused by shifts in the normal balance of hormones.
This hormonal imbalance can bring about any or all of the four causes of acne.
These hormones can trigger excess oil production and cause skin cells to become sticky, leading to clogged pores and breakouts.
How do changing hormones cause acne?
Dr. Anjali Mahto, dermatologist and author explains to Refinery 29: “About two-thirds of acne-prone women will note worsening of their acne typically occurring anywhere from a week to a few days before the start of their period,” says Dr. Mahto. “This is because female hormones are at their lowest, and male hormones (androgens) are higher at these points.”
A rise in testosterone levels in women can mean oilier, thicker skin, and in turn, Dr. Whitney Bowe, a NY dermatologist, states, “…these hormones can trigger excess oil production and cause skin cells to become sticky, leading to clogged pores and breakouts.”
And while hormonal acne can occur anywhere, it does have a distinctive pattern: “In hormonal acne, we classically see it on the chin and jawline, and occasionally the sides of the cheek and down your neck,” says Dr. Gary Goldfaden, a FL dermatologist, to Well + Good. “These are typically nodular, tender, deep, and painful types of pimples that occur around the same time each month.”
So if you struggle with hormonal acne, here’s what you can do:
7 Effective Treatments for Hormonal Acne
First, to state the obvious, be particularly scrupulous about keeping your face clean the week or so before your cycle. No sleeping in makeup, and cleanse your face right after a workout, if possible.
Things that touch your face–pillowcases, towels, washcloths, sleep masks, makeup brushes and sponges, cell phones–should all be washed or otherwise disinfected regularly.
A study of dermatology practices showed that most dermatologists considered retinol a core component of an effective acne treatment plan.
Why? Because retinol unclogs pores, keeps skin cells from sticking together to block pores, is anti-inflammatory, and clears away existing acne.
For mild to moderate hormonal acne, this should be one of your first considerations.
It’s that good.
There is a risk of skin irritation, redness, and flaking, so you’ll want to start low and slow with this.
Try fan-favorite Drunk Elephant A-Passioni™ Retinol Cream with 1% retinol.
2. Vitamin C serum
Like retinol, vitamin C serum works hard to do many things at once; primarily, it neutralizes free radicals, stimulates collagen production, protects against sun damage, fades hyperpigmentation (and acne scars) and calms inflammation.
That last point is the key to vitamin C’s effectiveness against acne. When you take away the redness, irritation and inflammation of pimples, the acne is greatly reduced. Vitamin C really excels here.
3. Detoxifying and clarifying masks
How could this list be complete without a good detox mask?
If you haven’t tried them, these masks are heavy-hitters when it comes to drying up active breakouts and killing those below the surface.
They also smooth out the texture of your skin. Most masks of this type tend to be of clay or charcoal, and you can often see results after just one use.
A clay or charcoal mask is super-easy and quick to DIY (check out the recipe card below for the 2-ingredient mask that I use that WORKS!) or you can pick up some excellent, clean choices like Yes to Tomatoes Detoxifying Charcoal Mud Mask and Tata Harper Clarifying Mask. And you can find the super-popular Aztec Secret Healing Bentonite Clay here.
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If you want clear, smooth, uncongested skin that’s soft, you need to exfoliate regularly.
And for those us who are middle-aged and older, it’s a must. As we age, that cell-turnover action doesn’t happen quite as quickly as when we were younger.
So dead skin cells pile up on the surface of the skin, making it look dull, textured, and rough to the touch. Skin like this does not absorb well, so the moisturizers, serums and other nutrients that you apply don’t sink in like they should.
There are chemical exfoliants, like alpha hydroxy acids (ie., glycolic and mandelic acids—better for drier skin) and beta hydroxy acids (i.e. salicylic acid—better for acne-prone and oily skin); and there are physical exfoliants, like sugar, baking soda, salt, rice powder, pumice, etc.
Despite their name, acids can actually be very gentle, and may be a better exfoliating option for irritated, active breakouts. I love Biologique Recherche LOTION P50 PIGM 400, a liquid exfoliant for hyperpigmentation.
But the one thing that has made the biggest change in my skin and really reduced any type of breakout for me is Paula’s Choice 8% AHA Gel Exfoliant. It’s fairly gentle, it improved my skin’s texture after 1 use, and it has reduced my breakouts by at least 80%. Definitely check this out.
Related: 5 Amazing Ways Hyaluronic Acid Benefits Your Skin (#3 is must-know info if you’re concerned about signs of aging in your skin!).
5. Essential Oils
Here is another see-results-overnight acne option, along with clay masks, vitamin C and even retinol, sometimes. Certain essential oils are fantastic at killing bacteria and/or shrinking inflamed blemishes.
I like this super-simple rollerball acne recipe.
Using probiotics is an indirect but potentially very effective way of reducing acne by soothing inflammation in your gut.
When you lower your inflammation, you kill a main source of acne.
Probiotics is good bacteria that help tilt the scales in your favor, gut-health-wise.
When bad bacteria proliferate in your GI system, inflammation results and often reflects in the quality of your skin.
Dr. Whitney Bowe of Mt. Sinai Medical Center in New York explains, “Stress alone or in combination with processed comfort foods that lack fiber can slow digestion. This, in turn, changes the type and number of bacteria that live in the gut to unhealthy bacteria. Eventually the gut lining becomes leaky and toxins are released into the bloodstream causing inflammation throughout the body. People who are predisposed to acne or rosacea can experience flares as a result of this shift in gut bacteria and subsequent inflammation.” Try Klaire Labs Ther-Biotic Complete.
7. Dietary changes
While more studies need to be done on the subject, research does seem to point to certain dietary triggers in some people when it comes to hormonal acne.
In a nutshell, researchers believe that a hormone called insulin-like growth factor-1 (IG-1) is linked to more oil production and other acne-precursors. Certain foods are known to increase IG-1.
High-glycemic foods like white carbs and other simple sugars, and low- or non-fat milk are culprits. This article gives a nice rundown of the anti-inflammatory diet.
Hormonal acne is caused by shifting hormonal levels, with rising testosterone being a main culprit for oilier, breakout-prone skin about a week before your monthly cycle.
Taking heavy-duty meds like birth control and Spironolactone for the off-label use of acne control has some risks.
So before you go the prescription-med route, consider these at-home treatments, some of which produce overnight results:
2. Vitamin C serum
3. Detoxifying masks
5. Essential oils
7. Dietary changes
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