Menstrual cycle and skincare routine: influences on hormonal acne

It’s hard to talk about a “pattern” for skin, because skin is anything but static. It’s not like a painting on the wall: it’s more like a dynamic, colorful aquarium. Inside it and on its surface, we may not suspect it, but a thousand processes are always happening. Not even when we sleep does this frenetic movement of its substances, its bacterial flora, its amazing processes, ever stop.

Additionally, especially when we talk about facial skin, it transforms as the clock ticks—and we’re not really talking about aging. Skin goes through several life phases with us. In puberty, it’s one way. In adulthood, it’s another. And not only that: climate, health conditions, our emotions and feelings also influence it.

Another powerful force responsible for changing our skin is hormones. Hormones are responsible for sending messages from one part of the body to another, communicating things that help regulate our physical processes and behavior.

We usually think of hormones in isolation. We might worry if they’re “balanced” or not, for example, but the fact is that skin is constantly dialoguing with hormones, communicating with them, and reacting—they play a huge role when it comes to skin.

In this system, let’s say the menstrual cycle is a key determining factor, because the skin changes in response to the hormonal variations that are so present during it. You can notice these fluctuations in the skin’s hydration levels, the appearance of pimples, shine, elasticity, and even healing capacity—all of these elements go through different phases at this time.

So, by monitoring changes in your skin, you can spot any recurring patterns during the month. This allows us to create an action plan or method to minimize unwanted effects and enhance others that might actually be good for us.

If you want to know in detail what happens to your skin as your hormones rise and fall—so you can anticipate changes to your routine, synchronize, and adapt your skincare to match your unique cycle—just follow us to the end of this article.

1. What is cycle-based skincare synchronization?
2. A close relationship: sex hormones and sebaceous glands
3. Sex hormones and the cycle
4. What is hormonal acne?
5. Synchronizing your cycle

What is cycle-based skincare synchronization?

Basically, the starting point for cycle synchronization is accepting that hormone levels change throughout the cycle, and skincare needs must follow that journey. This way, the skin’s changes will be met in the best possible way.

As the French philosopher Michel Foucault (1926-1984) would say, “knowledge is power.” Have you ever imagined that investigating your cycle and your skin could do wonders for your routine?

Experts on the subject point out that this technique is best for people whose skin changes noticeably throughout the month and for those who experience these changes on a recurring basis.

How can we do this? The idea is to adapt the skin care products already in your routine—cleansers, toners, exfoliants, moisturizers—to your menstrual cycle. The main purpose is to improve the skin’s function and appearance and reduce (or prevent) those dreaded breakouts that affect so many women during this time (we’ll discuss hormonal acne in more detail below).

If you already pay attention to your skin, especially your face, you’ve probably noticed that as this happens, your skin needs change dramatically. One day, your skin might be much drier; a short time later, it may be “bursting with oil.” Why does this happen?

In short, before, during, and after menstruation, women go through a whirlwind of hormonal changes that usually cause quite characteristic symptoms in mood, body, and skin. This might show up as cramps, irritability or sadness, and a crazy desire to eat sweets (in other words, skin changes are just one more sign in the real “combo” that hormones bring).

For instance, before menstruation is usually when acne makes its appearance. However, shortly after the period ends, it seems like you have your best skin—balanced, without excess oil. These fluctuations don’t happen by chance and are not a coincidence.

The upside is that we gradually get used to this natural cycle and it starts to feel predictable, so even if we can’t control our own skin, we can at least ease the symptoms of its worst days by optimizing our routines—in other words, working with the changes in our bodies, not against them.
To handle such a flexible scenario, it’s important to understand when they happen, or exactly when your skincare routine should be adjusted.

A close relationship: sex hormones and sebaceous glands

Hormones act as the body’s chemical messengers. In practice, they are secreted into the bloodstream and travel a long way to specific tissues and organs in order to help them do their job. Every day, hormones coordinate and perform distinct functions in the body.

On the other hand, many of the changes we see in the skin’s appearance—both in puberty and throughout life—are due to the work of small glands called sebaceous glands. These glands secrete an oily substance called “sebum,” and how much they produce can vary over the course of the menstrual cycle.

Around puberty, these glands begin to enlarge. It’s estimated that most sebum is produced between the ages of 15 and 35.

Sebaceous glands, like many other parts of the skin, have receptors influenced by sex hormones. These receptors allow interaction: thanks to them, hormones send their messages. Especially androgens (male sex hormones like testosterone, present in both men and women) have a strong effect on sebaceous glands.

The thing is, these androgens increase sebum production during puberty. It’s simple math: the more androgens are binding to sebaceous gland receptors, the more sebum is produced. This context can clearly lead to increased skin oiliness, making it easier for acne to develop.

In newborns, due to the action of maternal androgens, the sebaceous glands are moderately developed. Once the influence of maternal androgens passes, the sebaceous glands regress, then redevelop at puberty, triggered by androgens from the testes, ovaries, and adrenal glands.

The largest sebaceous glands are found in areas where there’s less hair growth—like the nose and forehead. They consist of a delicate mesh network filled with fats.

In a study conducted with women with oily skin, increases in sebum production occurred during the week before menstruation and also during menstruation. The week with the lowest amount of sebum produced was the second week of the menstrual cycle. In women with non-oily skin, no significant changes were noticed in this process. Since hormone levels were not measured in this study, researchers could not confirm whether these changes in skin oiliness were actually due to changes in hormone levels.

Many other factors influence sebum levels and can affect skin oiliness, such as:

• Excessive sun exposure;
• Excessive or improper use of skincare products;
• Genetics;
• The seasons of the year.

Interestingly, science still does not fully know the true physiological significance of sebum. However, functions have been attributed to it—beyond its importance in keeping the human body balanced—such as serving as a protective barrier, and having antimicrobial, antibacterial, and antifungal activity.

Sex hormones and the cycle

Although there are many different types of hormones involved in the menstrual cycle, estrogen, progesterone, and testosterone play the most important roles when it comes to synchronizing your skincare routine to your cycle:

• Testosterone – Studies suggest that people with acne may produce more testosterone. Higher testosterone levels can lead to excessive sebum production, which in turn clogs follicles and causes inflammation of the sebaceous glands. This can trigger an acne outbreak and make hair feel oily, too.

Although testosterone levels vary throughout life (puberty, for example, is a peak phase), during the menstrual cycle itself, it changes only slightly.

• Estrogen – This hormone can be a real relief for the skin, helping to keep it acne-free and suppressing sebum production. In addition, studies show that estrogen also has many anti-aging effects, increasing collagen production, helping to improve thickness and elasticity, and boosting healing. It also plays a crucial role in maintaining a healthy lipid barrier, which prevents skin dryness.

Even though it’s still not clear how much this hormone affects sebaceous glands, estrogen has been shown to reduce sebum production and gland activity, especially at high doses. On the other hand, when out of balance, it can also cause skin problems. High estrogen levels, also called “estrogen dominance,” are associated with hyperpigmentation and melasma;

• Progesterone – Healthy progesterone levels can also positively influence skin, helping fight testosterone-related acne and promoting pimple-free skin. On the other hand, after ovulation in the menstrual cycle, progesterone rises and as a result, body temperature also increases. This leads to higher sweat rates, meaning that indirectly, it can make the skin environment more prone to acne.

It’s worth noting that progesterone levels drop in the presence of chronic stress, and when this happens symptoms like high testosterone, estrogen dominance, and PMS may arise. In other words: bad mood, oily skin, and skin prone to blemishing.

Consider, overall, when your breakouts appear on your face during the month. If you pay attention, you might notice it happens around the third week, during the so-called luteal phase, when progesterone makes the skin swell. This ends up making pores tighter and, finally, oil production increases as well—a dangerous double whammy that can lead to inflammation.

These are just clues, but to get more precise information and synchronize your cycle effectively, specific apps can be great allies. There are many available online today that provide support so you can track your cycle and its signals.

The idea is to monitor things for at least two to three months to spot patterns in your cycle. A recommendation here is Paula, which was created by Famivita for women to better understand their bodies. The app is a free, AI-powered menstrual and ovulation calendar.

Let’s take a look below at the four phases of the menstrual cycle and how hormone levels fluctuate, depending on which phase you’re in:

• Phase 1 (Menstrual) – Begins on the first day of your period and can last three to six days. Hormone levels are low;
• Phase 2 (Follicular) – Starts after menstruation, usually ending around day 12. Estrogen starts to accumulate;
• Phase 3 (Ovulatory) – Occurs around days 13-16 of the cycle. Lasts three to four days and features estrogen peaks;
• Phase 4 (Luteal) – Runs from days 17-28. This is after ovulation and ends when a new period starts. Progesterone rises sharply, estrogen rises, and both fall again before menstruation.

Using this information about the cycle and hormones, you can synchronize your skincare. Without a doubt, with this knowledge plus careful observation of your skin’s surface, you can stay ahead of the curve, predict changes the skin will go through, and respond to these changes to prevent and treat acne in a more conscious and, therefore, more effective way.

What is hormonal acne

Of course it’s not news, but when it comes to the cycle, one of the most reported skin conditions is acne. In this scenario, the appearance of hormone-related pimples connected to menstruation is very common in what’s called the perimenstrual phase, which covers the 10 days before menstruation plus the days of bleeding. Basicallly, the process goes like this:

1. High androgen levels create excess sebum production;
2. This sebum can mix with dead skin cells inside the pores, causing a blockage;
3. Pores full of sebum create an ideal environment for bacteria, giving them a chance to grow and worsening the condition, resulting in inflammatory acne.

Although the reasons for the development of hormonal acne aren’t fully understood, there are several hypotheses that try to explain them, two of which are:

• Before menstruation starts, there’s not enough estrogen to create its “anti-sebum” effect. So, with low estrogen, androgens ramp up sebum production, resulting in more clogged pores and a favorable environment for acne;
• Hormonal acne may result from a deficiency or imbalance in progesterone or estrogen levels.

It is already known, however, that women who have cycles with higher levels of androgens—such as those with polycystic ovary syndrome (PCOS)—are more likely to have acne. That’s why some of them notice a clear decrease in breakouts when they take hormonal birth control.

The explanation is that combined birth control pills contain synthetic estrogen at doses that suppress ovulation. When ovulation doesn’t happen, ovarian androgens aren’t produced. Not all acne, however, is related to the menstrual cycle or hormones.

While acne is common in adolescence, various authors point out that the number of cases in adult women is rising, whether in those who started in adolescence and continued, or in those with late-onset disease. In adults, a major focus has been on hyperandrogenism (increased androgen biological activity) as an important factor.

In women, most androgen production occurs in the adrenal gland and ovaries.

So, how does hormonal acne show up in adult women? In general, it’s characterized by mainly mild forms of acne, most frequently located around the mouth (perioral area), on the jawline and neck—quite different from adolescence, when lesions appear more in the cheekbones (the upper cheek area) and the forehead (between the eyebrows and the hairline).

The association between hormones and acne has been studied for many years. For example, as far back as 1969, increased testosterone levels were linked to acne. In another study, increased androgens were associated with acne, hirsutism (excess hair on a woman’s body in areas typical for men), and menstrual disorders.

In addition to the ones we’ve already mentioned, the main hormones involved in acne are:

• Luteinizing hormone (LH);
• Follicle stimulating hormone (FSH);
• Prolactin (P);
• Free testosterone (FT);
• Dehydroepiandrosterone sulfate (DHEA-S);
• Dehydroepiandrosterone (DHEA);
• Androstenedione (A).

Remember that chronic or severe acne at different points in your cycle can be a sign that something needs addressing.

Synchronizing your cycle

After gathering all this information about hormones and hormonal acne, and tracking the cycle in detail for a few months, it’s time to combine this knowledge with your skincare—putting synchronization into practice.

It’s important to stress that these are merely suggestions; knowing your own skin is essential to respecting its uniqueness, as some skin types simply don’t agree with certain cosmetics or ingredients.

• Menstruation (Average days 1-6): Restorative, soothing, and hydrating actives

This phase is characterized by low levels of estrogen and progesterone (estrogen gives skin firmness and hydration; progesterone increases oiliness), which can leave skin dry, dull, or even looking tired. On the other hand, a rise in prostaglandin can make skin more sensitive and inflamed.

The levels of hormones produced by the pituitary gland also drop (like LH and FSH). So it’s a good idea at this time to avoid exfoliation and waxing and, if possible, get at least eight hours of regular sleep.

Also, you can go for light hydration with a rose water toner, for example, because oiliness control may still be an issue. Pimples are not uncommon during this phase.

This is also a time to cleanse pores, absorb toxins, and help cell renewal. A great ingredient for this phase is salicylic acid, as it is effective at reducing blackheads and pimples and helps dissolve the skin debris that clogs pores. It’s also anti-inflammatory and helps reduce redness.

• Follicular phase (Post-menstruation/ Average days 6-12): Actives that boost collagen and preserve glow

Let’s say this is the skin’s golden hour. Estrogen starts to rise, optimizing skin moisture retention, collagen levels climb, resulting in plumper, more elastic skin, and everything heals faster than usual. All of this gives it a natural glow.

On top of that, here’s a bonus: sebum production is under control. To extend this natural brightness, a good tip is to use a vitamin C serum or a hyaluronic acid serum (or alternate between the two).

It’s also a good moment to exfoliate with a gentle chemical peel (without grains—no need to irritate your skin), keeping pores clean and giving a boost to cell renewal. Glycolic acid is also a good option.

This phase is also perfect for focusing on antioxidant actives, like retinol, because it (like vitamin C) boosts collagen (already naturally stimulated during this phase) and brightening agents like tranexamic acid.

Sunscreen is especially essential here, because increased estrogen and sun exposure can lead to hyperpigmentation. Go for more fluid consistencies that won’t clog pores.

As a tip, if you have oily skin, nourishing day moisturizers can be used as night creams.

• Ovulation (Average days 13-16): Preventive actives

Estrogen and testosterone are elevated, and high luteinizing hormone levels trigger egg release. As we mentioned, the luteal phase (which comes next) means sebaceous glands will work even more. So it’s a good idea to prevent acne before oiliness sets in.

At this stage, you may already notice skin is changing, showing more oil and also being prone to spots. An essential item for this period is aloe vera gel, which is non-greasy, highly anti-inflammatory, and antibacterial. A serum with niacinamide may also be a good choice.

High testosterone levels also tend to encourage facial hair growth, so keep an eye on that here.

• Luteal phase (Average days 17-28): Actives that calm inflammation and control sebum

This is the most dreaded phase, because progesterone peaks make the skin swell and pores shrink. And as for testosterone, an imbalance can mean even more sebum, which gets trapped in pores, causing breakouts and inflammation. On the other hand, the level of “glorious” estrogen drops—the hormone that made skin so beautiful in the follicular phase. With all of this, facial swelling is common, but can be relieved by facial massage.

Also notable during this phase: skin tends to be oily yet dehydrated, because its water retention capacity is reduced. Collagen production drops, elasticity decreases, and problems like rosacea and psoriasis can worsen. But don’t worry; now that you know what’s happening, you can minimize the damage.

During this phase, finding skin balance is almost like winning at chess: you have to remove excess oil without setting off inflammation, since inflammation can trigger breakouts.

In this phase, it’s best to avoid “heavier” cosmetics, as they will almost certainly clog pores. Stick to serums only. Cleansing is crucial and should be done gently, preferably with a pH that matches facial skin (between 5 and 5.5). If needed, you can cleanse your face one extra time per day.

If you already have a well-established skincare routine that’s a bit lengthy (more than four products, for example), it may be best to pare it down—during this time, “less is more” definitely applies. The goal is not to irritate or overload your skin.

A key ingredient to help in this phase is ferulic acid and, if you don’t have sensitive or reactive skin, you can do spot treatments in areas likely to get acne (like the jawline, for example) with a gel containing benzoyl peroxide. Cosmetics containing soothing ingredients like tea tree are also very helpful.