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wikiHow to Prevent Premenstrual Acne

Three Parts:Using MedicationsMaking Diet and Lifestyle ModificationsUnderstanding the Causes of Premenstrual AcneCommunity Q&A

Before and during menstruation, a woman's hormonal levels fluctuate. This means that the level of some hormones rise while the level of others drop. Imbalances in these hormonal levels can lead to the development of premenstrual acne and pimples. Luckily, there are some things that can be done to prevent this from happening.

Part 1
Using Medications

  1. 1
    Talk to your doctor about taking oral contraceptives. Progesterone-only oral contraceptives are not effective in reducing acne and pimples, so combined oral contraceptives that contain both estrogen and progesterone are used. They work by reducing androgen production by the ovaries.
    • Combined oral contraceptives are available in 21-day and 28-day packs. Start on the first day of menstruation and take one each day for 21 days.
    • Then, take a one week (7 days) break or take placebo tablets for a week if it is a 28-day pack[1]
  2. 2
    Take spironolactone. This is a potassium-sparing diuretic medication used for liver disease, heart failure and high blood pressure. However, it is also useful for treating hirsutism (excessive hair growth), acne and seborrhoea (excessive secretion of oil in the skin) due to its anti-androgenic properties.
    • Spironolactone works by blocking androgen receptors, thereby reducing the production of this hormone.
    • The dose of spironolactone is slowly increased from 25 to 200 mg per day, taken throughout the day.
  3. 3
    Get a prescription for cyproterone acetate. This medication works by preventing the production and blocking the effects of testosterone, which is one of the male hormones or androgens. The daily doses ranges from 25 to 200 mg.[2]

Part 2
Making Diet and Lifestyle Modifications

  1. 1
    Understand the focus of these modifications. Preventing premenstrual acne and pimples through diet and lifestyle modifications focuses on reducing the levels of male hormones (androgens) such as testosterone, as they are mainly responsible for overstimulation of the sebaceous glands.
  2. 2
    Avoid sugar and refined carbohydrates. These substances can cause elevated blood sugar levels, which in turn leads to higher levels of insulin.
    • Higher levels of insulin can stimulate a woman’s ovaries to produce more androgens or male hormones such as testosterone. An increase in male hormones can stimulate an overreaction of the sebaceous gland , causing it to produce excessive oil that can cause acne and pimples.[3]
    • Avoid foods that are high in sugar such as granulated sugars, instant sweetened teas, candies, dried fruit, cookies, cake, jam, spreads, cereals, ice cream, yogurts and shakes. Also, avoid foods high in refined carbohydrates such as white bread, pasta, carbonated drinks, corn starch and grains.
  3. 3
    Minimize your protein intake. According to studies, protein increases the level of androgens such as testosterone in the body by allowing greater uptake of testosterone from the blood.[4]
    • Minimize your intake of protein-rich foods such as turkey breast, fish, cheese, pork loin, tofu, lean beef, beans, eggs, yogurt, dairy products and nuts.
  4. 4
    Minimize Vitamin A-rich foods. Vitamin A has been shown to increase testosterone levels by suppressing estrogen levels. High estrogen levels cause a decrease in the production of testosterone.[5]
    • Cut down on your intake of foods rich in vitamin A such as apricots, broccoli, carrots, mango, melon, spinach, sweet potatoes and winter squash.
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    Minimize your intake of Vitamin D-rich foods. Vitamin D enhances the sensitivity of receptors in the androgen glands’ cells that release testosterone.
    • Minimize the intake of foods rich in vitamin D such as cod liver oil, fish, oysters, soy milk, fortified cereals, caviar, tofu, salami, dairy products, ham, sausages, eggs and mushrooms.
  6. 6
    Eat more tofu. According to studies, tofu reduces testosterone levels by increasing sex-hormone binding globulin (SHBG) level. This SHBG is a protein that controls testosterone levels by transporting it throughout the body.[6]
    • The recommended daily intake of tofu is 56 grams for men and 46 grams for women.[7]
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    Increase your fiber intake. Higher levels of insulin can stimulate a woman’s ovaries to produce more androgens or male hormones such as testosterone.
    • Fiber reduces insulin in the body by displacing some of the carbohydrates that are absorbed by the small intestine or by moving the carbohydrates to a place in the lower intestinal tract where there is less effect on insulin secretion.[8]
    • Fiber rich-foods include apples, figs, kiwi, legumes, beans, berries, peas, plums, mangoes, oats, peaches and sweet potatoes. The ideal daily intake is 21 grams.[9]
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    Try to lose weight. Obesity causes stress in a system of cellular membranes called the endoplasmic reticulum (ER). This in turn causes the endoplasmic reticulum to suppress the signals of the insulin receptors, which then leads to insulin resistance.[10]
    • When the body has insulin resistance, it is unable to respond normally to the effects of insulin, therefore resulting in high levels of insulin.
    • Higher levels of insulin can stimulate a woman’s ovaries to produce more androgens or male hormones, thereby overstimulating the sebaceous glands to produce more oil or sebum, resulting in the development of acne and pimples.
  9. 9
    Eat foods rich in Omega-3 fats. A higher intake of omega-3 fatty acids can reduce insulin resistance, which is a condition whereby the body is able to produce insulin but it cannot be used effectively.
    • Our body’s cells are composed of a double fat layer and these fats will dictate the efficiency of the metabolism. If healthy omega-3 fats are deposited in the cell layers, insulin will easily attach to them and this allows for improved energy utilization and increased fat burning.
    • In this way, insulin does not build up and will stay at normal levels. This can aid in preventing premenstrual acne and pimples because the insulin level is not too high.
    • Keep in mind that higher levels of insulin can stimulate a woman’s ovaries to produce more androgens or male hormones that can lead to acne and pimples.
    • Foods rich in omega-3 fatty acids are sardines, salmon, soybeans, flax seeds, walnuts, tofu, brussels sprouts, cauliflower, shrimp and winter squash. The recommended dose of omega-3 fatty acids is not more than 3 grams daily.[11]
  10. 10
    Switch to mild soaps. Using harsh soaps when washing your face can irritate the hair follicles of the skin which can lead to acne or pimples. Use only mild soaps. These soaps has a pH near 7.

Part 3
Understanding the Causes of Premenstrual Acne

  1. 1
    Know that premenstrual acne may be due to hormonal imbalances. Hormonal imbalances during menstruation may lead to the overproduction of oil (sebum), leading to acne or pimples.
    • During the menstrual cycle, hormonal imbalances occur and may stimulate the overproduction of a certain hormones called androgens which are found in both men and women.
    • This leads to the incidence of acne by overstimulating the sebaceous glands and altering the development of skin cells that covers the hair follicles.[12]
    • Hormonal imbalances can also lead to irregular shedding of dead skin cells. This results in irritation of the hair follicles of the skin. This irritation can lead to the development of acne and pimples.
  2. 2
    Understand that premenstrual acne may be caused by the build-up of bacteria. Acne develops following the blockage of hair follicles with dead skin cells and oil. These hair follicles are attached to the sebaceous glands, which are responsible for secreting sebum (an oily substance) that lubricates the skin and hair.
    • Normally, this oily substance moves along the hair shafts and into the opening of the hair follicles which leads to the skin surface. However, when there is an excess production of sebum as well as dead skin cells, these substances may accumulate in the hair follicles and together form a soft plug which provides the ideal environment for bacteria to grow.
    • The formation of this plug may stimulate the walls of the hair follicles to swell, thereby producing a whitehead. Alternatively, the plug may be exposed to the skin surface and become dark in color, resulting in a blackhead.
    • When these clogged hair follicles become infected with bacteria, pimples (raised red spots on the skin with a white center) appear. If blockage and swelling occurs deep within the hair follicles and produces lumps beneath the skin surface, cysts develop.

Community Q&A

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      • Pimples are defined as small lesions or swellings in the skin that develop when sebaceous glands that are found at the base of hair follicles become infected with bacteria. The affected area then starts to swell and is eventually filled with pus deposits. Pimples are also referred as spots or zits and are most common in areas such as the back, chest, face and shoulders.
      • Acne is defined as constant breakouts, where several painful, pus-filled pimples develop at the same time.. Most of the time, acne is associated with the hormonal changes occurring in the body which trigger an overactive sebaceous gland, leading to the excess discharge of oil. This oil then collects underneath the skin causing the blockage of pores. Acne commonly affects areas such as the back, chest, face, neck and shoulders.
      • Acne can cause a lot of stress as the healing process may take some time and when one lesion starts to resolve, others seem to build-up. In severe cases, acne can cause skin scarring and can even trigger low self-esteem and depression.

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