Acne prevention: Why do I get only spots when I’m on my period?

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Everyone gets a spot every now and then, even as adults. There’s a long list of reasons why your skin is breaking out when you least expect it, but the main culprit is normally hormonal changes. Women’s hormones fluctuate throughout the menstrual cycle, and many women experience acne when they are on their periods. chatted to INTIMINA’s gynaecologist Dr Shree Datta to find out why your skin breaks out during that time of the month.

Acne isn’t simple and it can happen for many different reasons including sebum production, genetics, bacteria, diet and medication.

Your hormones wreak havoc on your sebaceous glands and can cause your skin to produce more sebum during your period, making your skin spottier.

It’s difficult to control your hormones, but there are a few ways to ward off spots around your period.

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Why do I get only spots when I’m on my period?

The concentration of hormones change throughout the month, because the body is preparing for ovulation and pregnancy.

Dr Datta explained: “The menstrual cycle consists of the follicular phase, ovulation and luteal phase.

“The follicular phase begins with the first day of menstruation and lasts up to ovulation. In the first few days, the concentrations of oestrogen and progesterone are low.

“Then, the oestrogen levels start to rise, and oestrogen reaches its peak value right around ovulation – that’s when an egg cell leaves the ovary and starts travelling towards the uterus.

“That’s usually the time when you feel the prettiest; you may find your skin is glowing and your body’s plump and feminine.”

After ovulation, oestrogen levels suddenly drop and progesterone levels start to rise. The luteal phase starts and your body prepares for pregnancy.

If you don’t get pregnant, your progesterone levels drop and you start your period. This is when your skin starts to see problems.
Dr Datta explained: “There is another reason you feel your prettiest during ovulation – it’s because oestrogen reduces sebum formation. That’s why your skin is in its best condition mid-cycle.

“The sudden drop of oestrogen after ovulation causes those premenstrual flares of acne to occur.

“At this time, androgens such as testosterone come into the picture. Androgens are male hormones, but every woman has them in her body and their concentration also changes during the cycle.

“The sebaceous glands (the glands which produce sebum) have many androgen receptors and when androgens (testosterone) give the signal to the glands, more sebum is produced.”

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Oestrogen and testosterone are total opposites: oestrogen reduces the production of sebum, while testosterone boosts the glands to make more of it.

When you’re ovulating, the concentrations of testosterone and oestrogen are high.

After ovulation, oestrogen level suddenly drops and their ratio changes. Studies have suggested that premenstrual flares of acne could be explained by this testosterone-oestrogen ratio in the luteal phase.

Cortisol and several other hormones affect the sebaceous glands and the production of sebum and your skin condition.

How to get hormonal acne under control

There’s little you can do to control your hormones unless you fancy going on hormone therapy, such as the contraceptive pill.

Dr Datta said: “If there isn’t an underlying health issue such as Polycystic Ovary Syndrome and you’re still struggling with your skin, your doctor may suggest a therapy in the form of the contraceptive pill.

“It will lower the concentration of androgens and stabilise oestrogen and progesterone concentration – this usually results in clearer skin.

“If you think that this would be the best option for you, make sure to talk it through with your gynaecologist and consider all the pros and cons of taking the pill.”

If you’d rather not start taking the pill, you can make a few lifestyle changes to help the problem.

Dr Datta recommends avoiding greasy and overly salty or sweet food, dairy products, refined sugar and simple carbohydrates.

She explained: “All these foods make your blood sugar spike quickly and lead to an increase in inflammatory agents in the body – and this affects your skin, too.

“While you’re at it, get your body moving – regular exercise has its benefits for the skin – it increases the blood flow, which delivers fresh oxygen to the skin and rids your skin and body of toxins,”

Getting enough sleep will help to reduce stress hormone (cortisol) levels in your body and prevent spots.

Dr Datta added: “When you don’t get enough sleep, your skin will look dull, won’t be plump and fresh and, what’s more, cortisol plays a role in sebum production – so you will be more prone to skin flare-ups. So put on your PJs and go to bed; your skin will be grateful in the morning.”

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