Why Does Your Acne Get Worse Before Your Period? Here’s Why

Getting clear on the pattern of when your acne shows up is going to be the first step in finding out the root cause. I know you’re busy juggling a social life, meetings and deadlines at work, and trying to stay healthy. The last thing you need is an acne flare-up right before your period. Yet, like clockwork, you notice notice your skin acting up a few days before your cycle begins. “This again?!”

Acne popping up right before your period is pretty common, but that doesn’t mean it’s normal! There’s a clear hormonal reason behind it. The good news? Understanding why it happens can direct your next steps to reducing these breakouts.

As a naturopathic doctor who specializes in acne, I’ve worked with many women in their 20s and 30s who experience this same struggle. Let’s dive into why your skin seems to rebel before your period and what you can do to support your body through these changes.


Disclosure: this post may contain affiliate links, meaning I get a commission if you decide to make a purchase through my links.

The Menstrual Cycle and Your Skin

Your skin is the largest organ of your body and it doesn’t just work on it’s own, it’s deeply connected to your body’s internal rhythms, even your menstrual cycle. The fluctuations in hormones throughout your cycle can have a significant impact on your skin’s behavior.

The Four Phases of Your Cycle

Your menstrual cycle is divided into four main phases:

Menstrual Phase: Day 1 to about Day 8 (depending on the days you're bleeding), count from the first day of heavy bleeding. Your uterine lining is shedding at this time.



Follicular Phase: about day 8 to day 14, this is the time when your energy is higher and your body is preparing for ovulation. Estrogen levels rise, promoting skin health and a natural glow.



Ovulation: halfway through your cycle (around day 14, 15, or 16). Your estrogen peaks at this time giving you lots of energy and high sex drive. This is typically when your skin looks its best.



Luteal Phase: the last part of your cycle where energy is usually lower, about day 16 to 28 (depending on the length of your cycle). After ovulation, progesterone levels rise while estrogen drops. It’s during this phase that premenstrual symptoms, including acne, tend to appear.



How do hormones impact the skin?

The luteal phase is the prime time for acne breakouts. Let’s dive into it. During this phase, your estrogen levels drop, while both progesterone and androgens (like testosterone) rise. These hormonal fluctuations can lead to increased oil production, clogged pores, and inflammation, contributing to those dreaded breakouts.


Why Acne Worsens Before Your Period

Let’s explore the specific hormones that wreak havoc on your skin right before your period.

The Progesterone Spike

In the second half of your cycle, your body increases the production of progesterone. While this hormone plays an essential role in preparing your body for a potential pregnancy, it also increases sebum (oil) production in your skin. More oil means a higher likelihood of clogged pores, which can result in deep, cystic acne, especially around the jawline, chin, and lower cheeks—areas known for hormonal breakouts.

The Androgen Effect

Androgens, particularly testosterone, also rise during the luteal phase. These hormones further stimulate the skin’s oil glands. The more oil your skin produces, the more prone it becomes to acne-causing bacteria. Androgens can also trigger inflammation, leading to those large, painful pimples that feel impossible to get rid of.

Androgens are often the hormones I see responsible for hormonal breakouts because of their close connection to blood sugar balance.

Inflammation and Water Retention

During this time, you may also notice that your skin feels puffy or swollen. This is because hormonal fluctuations can lead to water retention, which can exacerbate inflammation and make existing acne look and feel worse. If you’re dealing with low progesterone levels, you may experience more water retention because progesterone acts as a diuretic. A diuretic helps to get rid of extra fluid in the body,like a water pill many older people take for high blood pressure.




How Stress and Lifestyle Habits Intensify Hormonal Acne

Cortisol's Role

If you’re managing a demanding job, stress is likely a regular part of your life. Unfortunately, stress and acne are closely linked, particularly when it comes to hormonal breakouts. When you're stressed, your body releases cortisol, the stress hormone. Elevated cortisol levels disrupt your hormone balance by taking away the building blocks to hormones like estrogen and progesterone, this exacerbates hormonal acne by increasing oil production and inflammation.

Skipping the Basics - Sleep and Food

Busy work periods often come with late nights, skipped meals, and irregular sleep patterns. These habits can further disrupt your hormones. Lack of sleep leads to higher cortisol levels, which then increase androgen production and worsen acne. Poor nutrition, especially relying on quick processed foods, can lead to blood sugar imbalances that spike insulin, another hormone that can trigger breakouts.



Managing Your Hormonal Acne with Naturopathic Approaches

The key to reducing hormonal acne requires balancing your hormones and supporting your body’s natural detoxification processes. Here are some naturopathic strategies that can help.

Balance Hormones Naturally

One of the most effective ways to support hormonal balance is by providing the nutrients your hormones need. The best way to do this is through diet, incorporating more B vitamins, vitamin C, magnesium, zinc, and protein. Working on supporting your response to stress is going to be vital as well because we can’t completely remove stress from our lives. Deep breathing exercises, hot girl walks, and engaging in your hobbies is a great way to do this.

Seed Cycling

Seed cycling is a gentle and natural way to balance estrogen and progesterone levels throughout your cycle. During the follicular phase (days 1-14), incorporating flaxseeds and pumpkin seeds into your diet can help support estrogen production. In the luteal phase (days 15-28), sunflower seeds and sesame seeds support progesterone levels. This simple addition can make a big difference in stabilizing your hormone levels and reducing acne flare-ups. If you’re interested in learning more about seed cycling, make sure to visit the in depth blog post I wrote on seed cycling.


Herbal Support

Certain herbs can be powerful in regulating hormones. Vitex (chaste tree) is particularly helpful for supporting progesterone levels and balancing the luteal phase. Other herbs I love to include in a clear skin routine include hibiscus, green tea, and turmeric.

I’ve had many patients who have seen a noticeable reduction in their hormonal acne after incorporating vitex into their daily routine. Make sure to check in with your doctor to see if herbs like vitex are right fore you! Disclaimer: this is not medical advice.

Support Liver Detoxification

Your liver plays a crucial role in processing and eliminating excess hormones. When your liver isn’t functioning optimally, hormones like estrogen and progesterone can become imbalanced, leading to acne flare-ups.

Incorporating foods rich in B vitamins, magnesium, and zinc can support liver detoxification and help regulate your hormones. Leafy greens, nuts, seeds, and whole grains are great sources of these essential nutrients. Cruciferous vegetables are a great addition to supporting your liver because they contain nutrients like sulforaphane that help to detox.


Long Island Holistic Doctor

Skincare Tips to Tackle Hormonal Acne

While internal balance is crucial, your skincare routine also plays a role in managing hormonal breakouts.

Switch to Gentle, Non-Comedogenic Products

Believe it or not, a lot of skin care contains pore cloggers! When something is comedogenic it means it clogs pores. Picking your skin care wisely if you’re acne prone is going to be vital on your acne journey. Opt for gentle cleansers that won’t strip your skin’s natural moisture barrier, and use non-comedogenic moisturizers to prevent clogged pores.

Hydration and Moisture Balance

Keeping your skin hydrated is essential, even when dealing with acne. Use moisturizers that are non-comedogenic and that maintain your skin’s moisture without contributing to excess oil. Drinking plenty of water also helps flush out toxins and supports overall skin health.

Cleansers I recommend:

  • Native Facial Cleanser

  • BYOMA Creamy Jelly Face Cleanser: this face was also contains ceramides that are helpful for barrier repair which is often helpful in acne

Moisturizers I recommend:

Spot Treatments for Breakouts

If you feel a pimple forming, act quickly with a natural spot treatment. Ingredients like tea tree oil and salicylic acid can help reduce inflammation and prevent the pimple from getting worse. I have a few go-to products I recommend with breakouts including this Acne Spot Treatment and Claritea Blemish Care by Saje. Of course you could just keep plain tea tree oil on hand!






Easy to Add Lifestyle Hacks to Prevent Hormonal Acne

Plan Your Meals

Nutrition plays a key role in hormone balance. Meal prepping hormone-balancing, anti-inflammatory meals at the beginning of the week can make a big difference in preventing hormonal acne. Focus on whole foods like vegetables, lean proteins, healthy fats, and fiber-rich grains. Avoid processed foods, refined sugars, and excessive caffeine, as these can trigger hormonal imbalances.

Manage Stress with Mini Breaks

In a busy work environment, stress is unavoidable, but how you manage the stress makes all the difference. Short stress-relief techniques can help prevent cortisol surges that worsen acne. Try taking a five-minute walk outside on your lunch break, practicing a few deep breaths on your drive home from work, or doing a quick meditation to reset your body and mind before bed.




Getting Your Beauty Sleep

Getting enough sleep is one of the best things you can do to support your whole body, especially your hormones. Aim for 7-8 hours of rest each night to allow your body to regulate cortisol, insulin, and other hormones that influence your skin. If you’re having trouble sleeping, trying some calming herbs like chamomile or lemon balm before bed can be helpful.


Hormonal acne is driven by the fluctuations of various hormones throughout the month, but it’s manageable with the right approach. By balancing your hormones, supporting your liver, and implementing a tailored skincare routine, you can reduce those pesky breakouts that appear before your period. No more feeling the dread of having to go to a meeting because you’re breaking out!

Remember, small, consistent changes can make a big impact over time. It’s time to take control of your cycle and enjoy clearer skin all month long!





As a naturopathic doctor focusing on acne, I specialize in understanding how your symptoms and lab results relate specifically to acne. Unlike other providers you may have seen, I dig deeper into the root causes, providing tailored solutions that address your skin from the inside out. If you're tired of generic approaches, it's time for a personalized strategy that delivers real results. Book my Acne Healing Package to get started on your clear skin journey.

Long Island Holistic Doctor




Talk Soon,

Dr. Alyssa

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Could Your Blood Sugar Spikes Be Causing Cystic Acne?