Don't you wish you could tell when you were most likely to get a zit, and prep your skin to prevent it so it doesn't crop up on the day of an important party? Turns out, you can—sort of. If you are suffering from hormonal acne (typically, the breakouts on your jawline and chin before it's that time of the month), it follows a predictable cycle that you can try to get ahead of. We spoke to dermatologist Dr Harshna Bijlani about hormonal acne, and what you can to help your skin in every phase.
Predicting your next acne breakout based on your menstrual cycle
“A woman's menstrual cycle is one of nature's most complicated and intricately designed cycles connecting your brain, uterus or womb, ovaries and hormones,” explains celebrity skin expert Dr Harshna Bijlani, medical head, The AgeLess Clinic. Here, she decodes the four stages of menstruation to help you understand your body better.
Menstrual phase: This phase lasts three to seven days and is the time when you are actively bleeding. “Here, the egg from the previous cycle hasn't been fertilised and hence levels of oestrogen and progesterone drop and your uterus starts shedding the extra lining,” says Dr Bijlani. During this phase, hormone levels are the lowest they are in the cycle, so skin is likely to have calmed down. It might be healing from the breakouts of the luteal phase, so it's best to use gentle exfoliators like retinol and AHA/BHA masks at this time. If you have dark marks from a healing pimple, a serum with lactic acid, Vitamin C or hydroquinone may help to brighten skin and even tone.
Follicular phase: This phase lasts eight to 10 days and sees oestrogen secreted in its highest level, as it readies the uterine lining for implantation. This oestrogen causes a stimulation in collagen and elastin as well as an increase in hydration levels. “Enjoy this phase, because it is the best one,” says Dr Bijlani. This is a good time to use antioxidant-heavy serums and lightweight lotions, and go makeup-free for a few days to let pores get their rest.
Ovulation phase: During this phase, skin can get a little sensitive and irritated. There is a rise of the follicle stimulating hormone (FSH), which causes a rise of the luteinising hormone. Oestrogen and testosterone levels climb in this phase. It is a good idea to be committed to a cleansing routine during this time to prevent the clogging of pores. “The hormones are at their peak during this phase, and while some women may face ovulatory acne, it is not very common,” says Dr Bijlani.
Luteal phase: During the luteal phase, the progesterone first peaks, and should you not be pregnant, drops to prepare for the shedding of your uterine lining and re-enter the menstrual phase. This hormone makes skin swell and increases sebum production, which can plug pores and result in inflamed acne. Testosterone levels are pretty high during this time, which can make the skin look and feel oilier. Some dermatologists suggest that you use a retinol like Differin more frequently during this phase, and reduce it for the other three phases.
A primer on hormonal acne
Whether it's male or female hormones, a combination of both is what affects our menstrual cycle, and in turn, our skin. “Oestrogen and progesterone are the main female hormones. The first half of your cycle is dominated by oestrogen and the latter, by your progesterone production. There are various types of testosterone, which are the male hormones. An excess of these usually aggravates oil production, making skin more prone to acne,” explains Dr Bijlani. And what makes things worse is cortisol, the stress hormone released by our body that impacts acne and leads to skin dullness. “The relationship between our hormone system, brain, uterus and skin is one of the most complex ones to understand,” says Dr Bijlani. It's difficult to understand this balance, but one can learn more about how their skin behaves in different phases and be ready for it. “Individuals suffering from PCOD generally have an imbalance of male and female hormones, which is why PCOD is generally accompanied by characteristics like an increase in acne and hair growth, both caused by hormones.”
While there is no definitive cure to menstrual acne, a holistic approach and change in your lifestyle can help you combat it. “I would strongly advise everyone to not pick on acne, burst it or try pricking it at home. This could result in acne scars, marks and other skin issues,” warns Dr Bijlani. “For existing, active acne, you can use a medicated face wash with ingredients like benzoyl peroxide, salicylic acid and tea tree oil, or try creams containing benzoyl peroxide or clindamycin (among other acne combating ingredients). Regular facials, peels and clean-ups also help to reduce acne, so opt for different kinds of laser treatments that are great for spot treatment to painlessly reduce your active acne and prevent re-occurrence. While topical skincare has been proven to be helpful, those with medium to chronic hormonal acne are also prescribed Spironolactone, an anti-androgen drug that reduces testosterone levels and oil production. When treating hormonal acne, it's best to treat it as soon as possible with the help of your doctor. Medical tests can determine the exact imbalance in your hormones, and regularising those, combined with topical treatments, is the right way to treat hormonal acne,” she concludes.
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