Welcome to Bo-Talks, our feature series where we talk with industry professionals about the treatments, tips, and tricks that can change your skin for the better.
If you menstruate, chances are you’re all too familiar with this scenario: you wake up one morning of the week before your period only to discover a huge, painful zit swelling beneath the surface of your skin. As if periods weren’t hard enough, we regularly have to deal with the skin-related side effects of our hormones shifting. Many people turn to oral birth control pills to try to manage breakouts, but that solution is not without side effects. Mood swings, weight changes, or nausea can make the whole thing not worth it. In light of that, we’re wondering—is birth control really the only option? We talked with FACILE dermatology + boutique provider Breana Wheeler, MSN, NP to get the lowdown on what really goes on with your skin during your period and how you can take care of hormonal breakouts, with or without the pill.
First, it’s important to understand the difference between hormonal acne and regular, everyday zits. Mostly, it’s timing that counts. “A few ways to know if hormones are the main contributing factor to acne is if it worsens before your period,” says Wheeler. “Usually hormonal breakouts occur during the luteal phase of your cycle, which is the last 10 days right before your period.”
We know what shows up on our chins during our periods, but what’s going on inside the body that causes hormonal breakouts? It all comes down to progesterone and androgens. “The rise in progesterone during a menstrual cycle causes increased sebum, or oil production,” says Wheeler, “and fluctuation or increase of androgens tends to be the main culprit behind hormonal acne.” Both of these hormones occur naturally in the body, but you might recognize progesterone if you take birth control—progestin, a form of progesterone, is a common ingredient in many of the pills on the market.
If you experience side effects from oral contraceptives, or you just plain don’t want to take them, don’t worry. Wheeler has some tips for managing breakouts without the aid of the pill. “There’s a prescription medication called Spironolactone that’s great. It’s not a hormone, but it can help women with hormonal acne,” says Wheeler. “It does require a prescription, so ask your provider if it would be right for you.” She also recommends upping your skincare game to round out your zit-busting treatment plan. “Lasers, medical-grade facials and peels and other skin treatments paired with the right skincare regimen can also help significantly to achieve and maintain clearer skin,” she says.
“Fluctuation of androgens tends to be the main culprit behind hormonal acne.”
Outside of treatments, there are also lifestyle adjustments you can make that might help clear up your skin. “Reducing sugar and dairy in your diet can help balance hormones, thus clearing your skin,” says Wheeler. Also tracking your breakouts on a calendar or a period app might take some of the surprise out of a zit appearing overnight. All in all, hormones are out of our control, and managing them requires some effort. But if it makes dealing with our periods just a little bit easier, in our opinion, it’s worth it.