We ignore the menstrual cycle at our own peril because it matters.
Acne is common in postadolescent women, and an increase in lesions may be noted in the last 7-10 days of the menstrual cycle. Why?
Changing hormones across the menstrual cycle produces measurable variations in immune function and susceptibility to disease. The skin and scalp have estrogen and progesterone receptors in both the dermis and epidermis. Levels of estrogen and progesterone fluctuate during the cycle and influence numerous characteristics of the epidermis, including lipid secretion and sebum production, skin thickness, fat deposition, skin hydration, and barrier function. Dermal collagen content, which contributes to skin elasticity is also affected. Estrogen levels also influence skin pigmentation and sensitivity to UV, and even the skin’s microbial flora.
Figure: The progression of the menstrual cycle and some of the hormones contributing to it. By Isometrik – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=8703107
In males, the overall sebum output seems constant. In contrast to men. the sebum excretion in women exhibits a rhythm that is related to the phase of the menstrual cycle. There is a decline in sebum excretion in the estrogen phase followed by increases during the luteal phase. Fluid retention (what we call bloating) peaks on the first day of menstrual flow, is lowest during the mid-follicular period, and gradually increases over the days surrounding ovulation. Water retention may facilitate the rupture of follicles, extruding sebum and bacteria into the dermis and causing a pustule to form. Variations in the number of active sebaceous follicles and in the sebum output were prominent in women with oily and almost absent in women with dry skin.
Polyphenols, such as epigallocatechin-3-gallate in green tea and resveratrol in grapes and berries suppress sebaceous lipogenesis and diminish the manifestations of acne vulgaris. Curcuminoids are TORC1 inhibitors and may help control acne.
What to do? If there is no acne, nothing. But if your skin is predisposed to acne, control sebum secretion by using T-zone serum. The salicylic cleanser will also help. And be ready for an “explosion” with Zit ender, which should abbreviate the duration of any lesions.
Farage, M. A., Neill, S., & MacLean, A. B. (2009). Physiological Changes Associated with the Menstrual Cycle. Obstetrical & Gynecological Survey, 64(1), 58–72. doi:10.1097/ogx.0b013e3181932a37
Piérard-Franchimont, C., Piérard, G. E., & Kligman, A. M. (1991). Rhythm of Sebum Excretion during the Menstrual Cycle. Dermatology, 182(4), 211–213. doi:10.1159/000247796
White CP, Hitchcock CL, Vigna YM, Prior JC. ( 2011) Fluid Retention over the Menstrual Cycle: 1-Year Data from the Prospective Ovulation Cohort. Obstet Gynecol Int. 2011:138451. doi:10.1155/2011/138451
Melnik, B. C. (2018). Acne vulgaris: The metabolic syndrome of the pilosebaceous follicle. Clinics in Dermatology, 36(1), 29–40. doi:10.1016/j.clindermatol.2017.09.006
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