How hormones affect the skin and the changes you can expect to see during your menstrual cycle.

Cyclical breakouts are caused by hormones. A woman’s hormone levels rise and fall over the course of her menstrual cycle, and these hormone shifts are normal and natural. When our hormones are imbalanced, we experience a host of unpleasant symptoms, including acne.

The good news? You can use homeopathy, food, lifestyle, and supplement strategies to balance your hormones and erase cyclical acne. Clinically, patients with hormone-related acne can be recognized by the concentration of lesions along the jaw line and chin.

How Fluctuating Hormones Affect Skin

Estrogen and progesterone levels affect the thickness of the skin differently in each phase of your cycle. During the follicular phase and especially during ovulation, high levels of estrogen boost collagen, make the skin thicker, and improve elasticity.

Testosterone levels rise during the second half of your cycle (luteal phase) which also keeps skin thick, but testosterone is a double-edged sword when it comes to skin. Testosterone converts to DHT (an androgen hormone – which causes hair loss as well as acne). So this is the crucial point in your cycle when you either become vulnerable to breakouts or go through the second half of your cycle with clear skin.

So what causes some women to break out and others to barely notice a blemish? The difference is in the body’s ability to efficiently process and eliminate the excess estrogen and testosterone in the system as levels rise.

If your body isn’t processing hormones properly during your luteal phase and eliminating them efficiently, excess estrogen and excess testosterone accumulate and fuel acne.

This happens in two ways: the excess estrogen causes estrogen dominance and skin inflammation, and the extra testosterone triggers the sebaceous glands to produce more oil.
For women with optimally functioning endocrine systems, these hormonal peaks don’t cause a lot of problems. But for women who can’t process hormones correctly, acne is the unwanted result.

When you break out in your menstrual cycle matters

So timing — that is, when you breakout — is a major sign that acne is hormonal.

🌱 If you break out during ovulation, the cause is high estrogen and you will need to support your body’s ability to break it down more quickly during this phase with cruciferous vegetables. *Refer to my previous post – Ovulatory Phase for the list of foods you can eat more of to help with estrogen excretion. I have also posted an Estrogen Detox Smoothie recipe which I would recommend if you tend to breakout around mid-cycle.

🌱 If you break out before your period, the cause is low progesterone and you can use food and lifestyle to support boosting progesterone. *Refer to my previous post – Luteal Phase for more info. Progesterone inhibits (stops) an enzyme called 5-Alpha Reductase (which converts testosterone to dihydrotestosterone (DHT – which is an androgen that is the main culprit in increase sebum (oil) production and acne). So the drop of progesterone can cause an increase in DHT resulting in more acne breakouts before your period.

🌱 If you break out all the time, the cause is inflammation, so incorporate inflammation-fighting foods into your diet like cruciferous vegetables and foods high in omega-3 fatty acids, like salmon. Try to incorporate more seeds into your diet, particularly flaxseeds which contain omega 3.

🌱 If you break out during stressful situations, the cause is high cortisol and dysregulated insulin. Focus on balancing blood sugar and limiting high-sugar foods. High levels of insulin also contribute to increased production of sebum (one of the reasons why PCOS sufferers experience more acne breakouts as they suffer from high insulin levels). Insulin also promotes more DHT production by the ovaries. I send most of my patients for a blood test to check their insulin levels – treating insulin is a vital part of the healing process.

Any long term fix for acne must go beyond skin care strategies. A holistic, sustainable fix for acne must include food, supplement and lifestyle strategies as well as homeopathic treatment.

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Article written by Dr Tharushka Naidoo