How to keep PMS from sabotaging your skin

The best part about PMS—and there is one—is that you now have a great excuse for canceling plans in favor of staying in with your sweatpants, the couch, and a new, binge-worthy show. The downside? Period breakouts. You know the ones: those sometimes-deep, always-stubborn pimples that tend to flare around your chin and jawline. Blame them on rollercoaster hormones, which fluctuate wildly throughout your menstrual cycle and create acne-causing inflammation deep within skin. Since your usual breakout-busting ingredients might not cut it, we consulted a trio of experts to clear things up about what really works.

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The Dermatologist Says

One hormone in particular takes center stage during PMS: testosterone. “When you have either an excess of a certain type of testosterone, or your skin cells are more sensitive to changing testosterone levels, it creates more inflammation,” explains Melissa Levin, MD, a dermatologist in New York City. The usual acne-fighting ingredients, like salicylic acid and benzoyl peroxide, just won’t be as effective against this inflammatory acne. (And they may be too drying for adult skin, anyway.)

Instead, try retinoids, as some can actually quell inflammation. “They normalize how your skin cells turn over so you don’t get clogging, and they remodel collagen, which helps skin tone and texture,” she says. Levin recommends Differin, which contains adapalene, a type of over-the-counter retinoid that’s better tolerated than other kinds and offers anti-inflammatory properties. Start using it every other night after moisturizer, and then nightly after two weeks.

The usual acne-fighting ingredients may be too drying.

If you’ve used a retinoid for two or three months and don’t notice an improvement, or you have any sort of scarring, make an appointment with a derm, as you may need a prescription oral medication like birth control or spironolactone. The latter is what Dr. Levin prescribes most often to her patients, since the side effects—signs of dehydration, such as dry mouth or headache, as it’s a diuretic—are very mild. “It limits the conversion of one type of testosterone to another, so you basically make less of a type of testosterone that’s really active on skin cells,” she explains. You should expect to be on it for at least six months, says Dr. Levin. It’s so well tolerated and effective, though, that it’s often worth it.

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The Naturopath Says

Testosterone isn’t entirely dependent on your hormonal cycle, though. Your diet can also mess with it, wreaking havoc on your skin before your period rolls around. “Unsteady blood sugar levels impact testosterone,” says Nigma Talib, ND, a naturopathic doctor based in Los Angeles and London. “And testosterone increases oil production, since it’s an androgen.” She suggests eating a diet rich in protein and cruciferous vegetables like brussels sprouts and broccoli, as they can keep your blood sugar—and, therefore, your insulin levels—in check. And, as sugar, dairy, and alcohol have the opposite effect, limit how much of those you eat the week before you expect to get your period, says Dr. Talib.

Then, consider bringing in back-up bacteria. “If your gut health isn’t optimal and your bad bacteria are out of whack, they interfere with hormonal changes in the body,” explains Dr. Talib, who created her own probiotic supplement called Dr Nigma Talib Healthy Flora. Those bad bacteria may directly contribute to acne, too. “Bad bacteria in the gut causes acne, and the insulin imbalance causes acne,” she says. “So if you take a probiotic, you’ll be killing two birds with one stone.”

"Since acne is inflammatory, you’ll want to be very gentle with your skin."

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The Esthetician Says

If your skin is sporting a breakout, you’re starting from behind. That’s why Austin, TX-based esthetician Renée Rouleau recommends adjusting your beauty routine four to seven days before you expect to get your period. “The idea here is to start creating an environment in your skin where breakouts are less likely to occur,” she explains.

Start with your cleanser. Rouleau suggests avoiding any harsh ingredients or exfoliation methods, including sonic cleansing brushes. “Since acne is an inflammatory disease of the skin, you’ll want to be very gentle with your skin,” she says. “You want to keep the skin in a calm state, so set the brush aside leading up to your period.” You still need to exfoliate, though. Rouleau recommends adding glycolic and lactic acids to your routine to boost cell turnover and keep pores clear. Try Drunk Elephant T.L.C. Framboos Glycolic Night Serum, which offers both but prevents irritation with soothing plant extracts.

Rouleau’s final ingredient for preventing PMS breakouts is lichochalcone, a compound found in licorice root extract and a star in the Rapid Response Detox Masque from her eponymous skincare line. “It can help starve the bacteria, so it can’t breed, while also helping to control oil production,” she explains. “And it hydrates the skin.” Use the mask every night after cleansing throughout the week before your period, advises Rouleau.

Period breakouts may seem inevitable, but with the right ingredients—and some foresight—it’s surprisingly easy to outsmart them. And who knows? With your skin this clear, you might not want to opt for a night in after all. —Deanna Pai. Collages by Labyrinth of Collages.

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  1. isabella

    THANK YOU! I loved this tip. I am using benzoyl peroxide to improve my acne skin, but I feel, that the acnes always come back when I am PMS. As Melissa says retinoids can be more effective because of anti inflammatory property, I think I’ll try “adapalene”. I am much happier to know that it is much cheaper than benzoyl peroxide. Of course, I’m going to the pharmacy to buy it now. Even more that it sells without prescription. xx

  2. Catherine

    I love this article! Thank you so much for all the different perspectives. I’m definitely going to try these tips, so fingers crossed!

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