Acne during ovulation? Why it happens & how to fix it

Hormones and acne — how are they related?

Acne is one of the most common skin conditions, and it affects as many as 80% of people at some point in their lives. [1] One major cause of acne is hormones, and more specifically hormonal changes. Acne often appears in people who are going through shifts in their hormone levels; that’s why it’s so common in teenagers. 

When it comes to adults, acne is more common in women compared to men. The fact that our hormone levels change during the menstrual cycle is likely at least partly responsible for these skin changes. As many as 85% of women with acne experience worse breakouts during the days leading up to their period. [2] Acne can also appear or worsen at other times when hormone levels change, like during pregnancy or menopause.

So, what’s the deal with hormones and acne? Acne has been linked to higher levels of a type of hormone called androgens (of which testosterone is perhaps the most well-known). These androgens cause the glands in the skin to produce an oily substance called sebum. Sebum is necessary for skin health (for example, by helping our skin retain its moisture). However, too much sebum can lead to acne since it may clog the pores and stimulate the growth of bacteria.

Can ovulation cause acne?

The short answer is yes, ovulation can cause acne. The menstrual cycle is regulated by our sex hormones, mainly estrogen and progesterone, and the biggest hormonal shifts happen around ovulation and menstruation. This is why you might notice acne appearing at these times. 

During the first part of the menstrual cycle (the follicular phase), estrogen levels are on the rise, while at the same time, progesterone levels are lower. Around ovulation, our hormone levels shift. There’s a peak in androgen levels (specifically testosterone). This stimulates the production of sebum, which can lead to acne breakouts. [3] After ovulation, estrogen levels drop while progesterone levels rise, and high progesterone in relation to estrogen can also trigger breakouts [4] In short, you may experience acne around ovulation due to the hormonal shifts that happen at this time.

Why do you get acne before your period?

The second phase of our cycles is called the luteal phase, and it’s characterized by higher levels of progesterone. Towards the end of the luteal phase, when we approach our period, progesterone levels start dropping, while estrogen levels are also low at this point in the cycle.

It’s common to experience breakouts before our period, and it’s thought that this is caused by the ratio of different hormones shifting. [2] It’s also likely that higher levels progesterone at this time in the cycle can lead to acne since progesterone can stimulate sebum production. [4]

What does hormonal acne look like?

Hormonal acne is a term that’s commonly mentioned online, but it’s actually not completely straightforward to differentiate between “hormonal acne” and “regular acne”, since all acne is related to hormones to some degree. However, adult acne (especially female adult acne) is often referred to as hormonal acne, likely because hormones play such a big role in this condition. [2] So, what are some things that indicate that acne is caused by hormones?

• Location: hormonal acne is traditionally described as being located around the jaw-line, although you may have acne on other parts of your face, back, and chest too.
• Cysts and nodules: acne that leads to cysts or nodules, which can be very painful and hard to treat, is often a result of too much androgens. [4]
• Timing: if you notice a pattern to your outbreaks, for example if you always have acne during ovulation, it’s likely a result of hormonal changes.
• Conditions like PCOS: PCOS (polycystic ovary syndrome) can lead to hormonal imbalances where the levels of testosterone or other androgens are higher than usual, which can lead to acne.

Common ways to treat ovulation acne

Acne can be a difficult condition to have, and some of us might feel that our confidence is affected by outbreaks. There are many ways of treating acne, so let’s walk through some common ones. It’s always good to discuss with your doctor before starting any treatment to make sure it’s the right fit for you. Acne treatments also take time to work, so you’ll need to give it a few weeks before you can expect to see results.

1. Hormonal treatments

Hormonal contraceptives like the combination birth control pill can be used to manage acne. It works by stopping ovulation, which means that the menstrual cycle is “on pause” and you won’t get the hormonal shifts that are associated with the different cycle phases. The combination pill also inhibits the androgen production that happens around ovulation, which can help reduce acne. [4]

However, if you decide to come off the hormones, the symptoms may return. It’s also common to experience acne as a result of stopping hormonal birth control even if you haven’t had acne before, although that should go away once the body gets back to its usual hormonal balance. Some hormonal birth control methods, like the hormonal IUD, have also been linked with acne, so if you’re thinking about birth control and are worried about skin changes, it’s good to bring it up with your healthcare provider. [5]

Oral contraceptives can be used alone or in combination with other therapies to treat acne in women. One example is Spironolactone, which works by reducing the androgens that trigger sebum production (oily buildup in the skin) and is especially effective for those with inflammatory acne. [6]

2. Retinoids

Retinoids are a type of chemical compounds that are derived from vitamin A. These come in many forms, (for example creams and gels), and they can be used to treat ongoing outbreaks and help prevent new ones. Retinoids have been shown to be effective for treating acne by helping to normalize the skin’s oil production, as well as treat bacteria and inflammation that lead to acne. [7]

3. Antibiotics

In some cases, your doctor may prescribe topical antibiotics (that you put on your skin) to treat acne, which works by killing the bacteria that can cause acne. Antibiotics are usually part of a bigger treatment plan that includes other medications as well. For example, you may also be prescribed a retinoid cream or benzoyl peroxide, another type of cream that reduces bacteria on the skin that cause acne, which is used to limit the risk of antibiotic resistance.

4. Isotretinoin

Isotretinoin is a prescription medication used to treat severe acne, the kind that causes painful cysts or nodules. This treatment may be used when other treatments haven’t worked and should always be prescribed by a doctor.

How to treat ovulation acne naturally

There are also some natural remedies that may help reduce breakouts. We’re all different and while these may work for some, they may not be right for others. It’s always good to check with a healthcare professional before starting any treatment plan.

1. Tea tree oil

Tea tree oil is an essential oil that has both anti-inflammatory and antibacterial properties, and it’s commonly used as a natural acne remedy. Research into the use of tea tree oil in acne treatment has shown some promising results and it does seem to reduce outbreaks. However, more studies are needed to understand more about how to safely use it and how effective it is. [8]

2. Alpha-hydroxy acids

Alpha-hydroxy acids (AHAs) is a group of acids derived from different animal and plant sources. AHAs are used in many different skincare products, like creams or serums, and are perhaps most widely known for their use in anti-aging creams. However, products with AHAs can also be used to treat acne since they exfoliate the skin, which prevents the pores from becoming clogged and help reduce inflammation. [9] 

3. Green tea

Tea might not be the first thing that comes to mind when thinking about acne or even skincare in general, but there is actually some research suggesting that green tea may have some positive effect on the skin, both in the form of tea lotion and when ingested. Green tea contains polyphenols (antioxidants) that may help reduce inflammation and acne outbreaks. [10] However, the studies done so far have been small and more research is needed.

4. A healthy diet

There are a lot of myths about acne and what causes it, and some of those relate to food. For example, chocolate and snacks that are high in fat are often mentioned as things to avoid if you have acne. 

It’s difficult to point out specific foods that are connected to acne, but there is some evidence that suggests the glycemic index (GI) in our diet does have some impact. In short, GI refers to how much a food item raises blood sugar. One review article concluded that a diet with a high glycemic index (GI) could potentially make acne worse, while a low-GI diet may improve it. [11] Food items that fall into the high-GI category tend to contain a lot of refined carbs or sugar. Low-GI foods are typically high in protein, fat, and fiber, and in this category, you’ll find foods like fish, vegetables, and seeds.

Dairy is another type of food that’s often mentioned when talking about acne. Research has found that dairy may worsen acne in younger people who also eat a Western diet (food that’s typically consumed in the US, Europe, and Australia), which likely means that there’s more to it than just the dairy itself. [11]

When it comes to diet, it’s important to remember that we’re all different, so some of us might notice breakouts after eating certain foods while others don’t. Keeping a generally healthy diet with a good balance of carbs, proteins and fibers is good for our overall health, but if you want to try a specific diet, it’s good to talk to a dietitian or other healthcare professional first.

How your cycle can influence your skincare routine

So far, we’ve covered how hormonal fluctuations during the menstrual cycle can affect acne, and some different acne treatment options. Luckily, we can also use what we know about hormone levels during the menstrual cycle to our advantage and incorporate this into our skincare routine. Here are some of our best tips for skincare at different points in your cycle!

Skincare during your period

Your cycle starts at the beginning of your period. At this point, skin tends to be dry, as levels of both of the sex hormones, progesterone and estrogen, are low. This is a good time for self-care, so use gentle products on the skin and creamier moisturizers will help plump and rehydrate dry skin.

Skincare during your follicular phase (before ovulation)

As your period ends, your body starts producing estrogen again. This plumps the skin and promotes collagen production, making the skin appear strong and healthy. We’re usually less sensitive to pain during this stage in our cycle, so it’s a good time to carry out hair removal if it’s part of your routine. Speaking of hair, did you know that there’s some evidence to suggest that hair growth and quality can be affected by our hormones too?

Skincare around ovulation

You may feel on top form during the fertile window. As well as feeling great, your skin is likely to appear stronger and healthier as collagen levels remain high. While some of us may glow, others may get some pimples at this point as skin is prone to becoming a little oilier. Enjoy the natural glow, and keep your face cleansed to avoid early breakouts. 

Skincare during your luteal phase

After ovulation, higher levels of progesterone increase the production of sebum, which makes the skin more oily and can make us more prone to breakouts during the luteal phase leading up to your period. Cleanse regularly and soak up any excess oil on the skin with your favorite face mask. 

Retaining water in the lead-up to your period is fairly common. For many of us, our skin looks puffier during this time. The cravings that come with PMS can also mean we tend to indulge in less healthy options, which in turn can have an impact on our complexion. Be kind to yourself and drink plenty of water during this time to help keep skin clear. 

When should I consult a doctor about hormonal acne?

Over-the-counter treatments are often a first step if you have mild acne, but it can still be good to consult a professional (like a pharmacist or skin-care professional) to make sure you find a treatment that works for your skin.

There are also several medical treatment options if you have acne, and you should reach out to your doctor or dermatologist if:

• You have moderate or severe acne
• You develop cysts or nodules
• You have tried to treat your acne without results
• The acne affects your wellbeing 

Keep track of acne and more hormonal changes with Natural Cycles

Here at Natural Cycles, we feel it’s important that you have all the information you need to make informed decisions about your health. Whether you’re looking for a hormone-free birth control option or want to plan a pregnancy, Natural Cycles helps you learn more about your unique cycle. In the NC° app, you can keep track of symptoms like acne to understand how your cycle affects your skin and spot patterns over time. Why not see if Natural Cycles is the right option for you?