Ever notice the odd pimple or even a full-fledged breakout in the middle of your cycle? You may be experiencing ovulation acne. The good news is that you’re not alone, with this condition affecting nearly 54% of the female population.
Ovulation acne all comes down to hormonal fluctuations, and not everyone experiences these breakouts in the same way. It’s no mystery, though. Your hormones follow a predictable path during your cycle, and anyone who’s been a teenager knows all too well how hormones can wreak havoc on your skin.
In this post, we’ll look into why ovulation acne occurs and what you can do about it. We’ll discuss some of the common treatments available, as well as natural methods used to treat it. We’ll then wrap it all up with some commonly asked questions about acne during ovulation.
Can Ovulation Cause Acne?
In a word – yes. But don’t panic, that doesn’t mean everyone who ovulates will experience ovulation acne, and it certainly isn’t a death sentence for your skin. For some women, the hormonal fluctuations that occur during their cycle can also cause acne flare-ups. Specifically, as the levels of estrogen, progesterone, and testosterone change relative to one another, the breeding grounds are ripe for a breakout.
Why Are You Breaking Out During Ovulation?
Your skin is your largest organ, and aside from providing a protective barrier and regulating your temperature, it allows your body to eliminate certain fluids like sweat and oils. The skin changes in response to hormones, so as your body goes through the different phases of the menstrual cycle, your skin can also change.
The first half of your cycle is dominated by estrogen. But by mid-cycle, estrogen levels start to fall and progesterone prevails. As progesterone levels rise during the second half of your cycle, it encourages the production of sebum. Sebum is the oily substance produced by sebaceous glands on the skin, which helps to lubricate and protect it.
Sebaceous glands are influenced by sex hormones, and these glands are especially affected by testosterone. Although testosterone remains fairly constant through your cycle, it becomes higher in relation to other hormonal fluctuations, and your skin produces more sebum, leading to noticeably oilier skin.
Excess sebum and dead skin cells create the perfect environment to allow the bacteria, Propionibacterium acnes (often abbreviated as P. acnes), to multiply and cause breakouts. Bacteria are a normal part of the skin flora, but when your hormonal balance changes, it can influence skin health.
Hormonal fluctuations during ovulation can contribute to acne and overall skin appearance. Period-related breakouts are very common, and many women report acne related to their menstrual cycle.
Even though we can see and feel the effects of hormonal fluctuations with acne, understanding how these fluctuations play a role in your health can be made easier by checking your hormones regularly. Monitoring your hormones at home is possible with the Mira Monitor and our wands, which can measure numeric hormone levels in urine. Together with the free Mira App, you can track these fluctuations to support your skin’s health and gain insights into your cycle.
What Does Hormonal Acne Look Like?
Hormonal acne can present in many different ways. Breakouts often pop up along the lower half of the face, especially the chin and jawline, and show up at regular intervals. The whiteheads and blackheads that form with hormonal acne are also the perfect breeding ground for bacteria like P. acnes, the bacteria involved in inflammatory acne lesions or zits. If you’re dealing with painful cysts or deeper bumps you just can’t get to, you are almost always dealing with hormonal acne.
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Spotting Hormonal Acne |
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What to Watch For |
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Location |
Breakouts typically appear on the chin, jawline, lower face, and sometimes between the brows. |
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Timing |
Typically flares up before menstruation; can occur monthly. |
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Appearance |
Can range from small whiteheads and blackheads to larger, deeper cysts and inflamed bumps. |
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Severity |
Ranges from mild to severe. In more severe cases, breakouts may last throughout the menstrual cycle. |
Hormonal acne tends to present on the lower part of your face, but may also show up between the brows. For some, these breakouts are mild and occur closer to menstruation, but for others, acne can be severe and persist throughout the month. If you’re noticing breakouts that happen along the lower third of your face and they get worse before your period, you can be fairly certain you’re dealing with hormonal acne. Painful cysts or deeper bumps may need the help of a dermatologist since they are cystic and inflammatory in nature and may require a more clinical approach than over-the-counter remedies can provide.
Not All Acne Is the Same
It’s important to remember that not all acne is caused by hormonal fluctuations. Bacterial acne is caused by an overgrowth of bacteria that can then clog pores, while fungal acne is caused by a type of fungus on the skin. The table below highlights the key differences between hormonal acne, bacterial acne, and fungal acne.
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Hormonal Acne vs. Bacterial Acne vs. Fungal Acne |
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Feature |
Hormonal Acne |
Bacterial Acne |
Fungal Acne |
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Cause |
Hormonal fluctuations (e.g., estrogen, progesterone, testosterone) |
Overgrowth of Cutibacterium acnes bacteria |
Overgrowth of Malassezia yeast (fungus) |
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Common Triggers |
Menstrual cycle, PCOS, puberty, pregnancy, perimenopause |
Poor hygiene, oily skin, clogged pores |
Humidity, sweat, antibiotics, occlusive skincare |
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Typical Location |
Chin, jawline, lower face, sometimes between brows |
Forehead, nose, cheeks, back |
Forehead, chest, back, shoulders |
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Appearance |
Deep, painful cysts or nodules; sometimes comedones |
Whiteheads, blackheads, pus-filled pimples |
Small, uniform red bumps (pustules), often itchy |
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Pattern |
Cyclical, worsens around ovulation or menstruation |
Random or persistent based on hygiene/lifestyle |
Appears in clusters, often symmetrical |
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Treatment Approach |
Hormonal therapy (e.g., birth control, spironolactone), retinoids |
Topical or oral antibiotics, benzoyl peroxide |
Antifungal treatments (e.g., ketoconazole), oil-free skincare |
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Response to Antibiotics |
May not respond to antibiotics alone |
Often responsive to antibiotics |
Not responsive; antibiotics can worsen it |
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Special Note |
Linked with internal hormone imbalance |
Surface-level infection |
Often misdiagnosed as bacterial acne |
Can Acne Increase During Ovulation?
The hormonal changes that occur around the time of ovulation can lead to an increase in acne during this time. As testosterone spikes, it increases sebum production, which provides a ripe environment for clogged pores and bacterial growth. While some women experience a glow with the increased oil production during ovulation, others experience pimples and breakouts thanks to the excess oil and clogged pores.
Causes of Increased Acne During Ovulation
Acne during ovulation is usually a result of increased sebum production in your pores. Testosterone and its metabolites begin to climb and bind to receptors on sebaceous glands in the skin. This results in more sebum being produced and secreted, which then combines with dead skin cells to block the pore and trap the sebum. This leaves the skin primed for potential breakouts and often manifests as acne. Rising progesterone can also increase sebum production, leading to the same result.
When to See a Doctor About Ovulation Acne
Acne is a common experience that many people go through, so it can be hard to know when it requires more intervention.
You should see a doctor if:
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Your acne is painful or severe
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Over-the-counter treatments aren’t working
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Breakouts clear but always come back
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You have deep, painful acne cysts or nodules
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Your acne is affecting your quality of life
If you have additional symptoms, like excessive facial or body hair, weight gain, or irregular periods, you should definitely consult a doctor. This can be a sign of something more serious, such as polycystic ovarian syndrome, which is a sign of an underlying hormone imbalance.
Depending on your fertility goals, treatment for PCOS often involves a mix of lifestyle changes and medication. There are also certain PCOS supplements that can help your skin as part of a comprehensive hormonal care approach. Mira’s own PCOS supplements may help alleviate many of the symptoms of PCOS, including acne. Mira’s formulation, created by experts and fertility doctors, helps nourish your body’s natural rhythm while supporting your hormonal fluctuations and promoting good skin health.
How to Stop Acne During Ovulation?
There are a number of ways to treat ovulation acne, from topical solutions to oral medications and natural remedies. It’s not a one-size-fits-all approach, though, and what works for you may not work for someone else. Sometimes, hormonal acne can become treatment-resistant, and common solutions like isotretinoin may not work because they don’t address the hormonal imbalance causing the acne in the first place.
Oral Contraceptives and Treatments
Birth control pills are a common treatment option for acne during ovulation, especially for women who also need contraception. Combination pills that contain both estrogen and progesterone work by regulating hormonal activity and decreasing sebum production, which leads to clogged pores and acne. Many studies have found the pill to be an effective treatment for acne, and some pills have even been approved specifically for treating the condition.
Other oral treatment options include Spironolactone and Metformin. Spironolactone is a medication often prescribed to treat high blood pressure, fluid retention, and also acne and excess hair growth in women. It’s often prescribed when other treatments don’t work and is an effective option for deep-seated acne. A word of caution about this ovulation acne treatment, though: if there’s a chance you can get pregnant, it’s essential to use birth control while on Spironolactone, as it is known to cause serious birth defects.
Metformin is a common option for ovulation acne, especially for those with PCOS. Many women with PCOS also have heightened levels of insulin, which can lead to the production of too much testosterone, one of the androgens. Metformin aims to target the hormonal imbalance causing acne, leading to improvements in your skin, and is showing promise in those with and without PCOS.
Retinoids
Retinoids are a family of compounds that come from vitamin A and are considered the gold standard to treat acne. They can help with ovulation acne by exfoliating your skin and ridding it of excess dead skin cells, dirt, and oil. Spread on the skin, retinoids’ greatest benefit is that they effectively slough off dead skin cells to unclog pores and prevent future breakouts.
Retinoids are only available by prescription and can come in the form of topical treatments or oral capsules. Accutane is a well-known type of retinoid used to treat acne. Retinoids for acne work best when combined with other treatments like benzoyl peroxide. Benzoyl peroxide is a topical treatment sold in different concentrations that treats the bacteria on your skin, causing acne, as well as helping to shed dead skin cells and excess sebum. If you are taking retinoids and may become pregnant, it’s recommended to be on birth control.
Hormonal Treatment
Hormonal treatment for ovulation acne is any medication that acts on your hormones to treat the issue. Many are used to treat acne, whether that is their original intention or not. Our hormones are easily affected by normal parts of our life, like stress, sleep, and diet. Treating acne may involve more than taking medication, and introducing hormone-balancing habits into your life can help.
Everything from the foods we consume to how much sleep we get can influence our hormonal balance. But balancing hormones isn’t an easy fix, and although it can be done, it can take some time and effort. It can be helpful to talk to your doctor or a trusted professional like a hormone health coach. Mira’s own Hormone Health Clinic for Fertility is a great place to start with our empathetic fertility experts who can answer all your questions and offer personalized support to balance your hormones.
How to Treat Ovulation Acne Naturally
Tea Tree Oil
This essential oil, extracted from the leaves of the Melaleuca Alternifolia tree native to Australia, has natural antiseptic properties that can help fight acne. Specifically, tea tree oil kills C. acnes, one of the bacteria associated with acne. It’s also been shown to reduce inflammation, which can help with the redness around acne.
Green Tea
Green tea contains powerful antioxidants and also has anti-inflammatory and antimicrobial properties. Research has shown that for some women, it can improve oily skin and the lesions and redness associated with acne. It is especially rich in epigallocatechin gallate (EGCG), a plant-based compound that has anti-androgenic properties. This works to break the cycle of androgen hormones like testosterone, causing the sebaceous glands to produce more oil.
Teas that contain hormone-supportive herbs may also be a treatment option to help balance sebum production and reduce acne flare-ups. Mira Fertility Tea is designed to provide you with a mix of antioxidants, vitamins, and minerals to support your overall health.
Alpha Hydroxy Acids (AHA)
AHAs work to exfoliate the skin and remove excess dead skin cells, and reduce inflammation. They do this by stripping the outermost layer of the skin of dead skin cells to reveal live epidermal tissue. These acids encourage cellular turnover, help inhibit excess sebum production, and clear your pores. There are different types of AHAs, and they are commonly used in many skincare products since they have so many benefits for your skin.
Manage Stress
It’s no secret that stress can be harmful to your overall health. When we are experiencing stress, our bodies release stress hormones in response, and this can have an effect on multiple systems throughout the body. Stress doesn’t cause acne, but its effects on the body can make existing acne worse. Chronic stress can cause your body to have a prolonged hormonal imbalance and can exacerbate the root causes of your ovulation acne. Managing your stress is foundational to any healing plan and balancing hormones.
Limit Sugar and Refined Carb Intake
Food and beverages high in sugar and refined carbs raise your blood sugar quickly and contribute to the inflammation-causing effects of insulin. Some foods actually promote inflammation, and we know that our diet can affect our hormones as well. When we eat high-fat and high-sugar foods, it can cause a rise in insulin (the hormone that regulates blood sugar). Insulin spikes can cause inflammation throughout your body and also an increase in sebum production. Foods that cause a rapid rise in blood sugar levels are known as “high glycemic foods” and can contribute to a number of health issues, including acne. Scientists believe that limiting high glycemic foods to reduce insulin spikes can help reduce inflammation, which may cause acne.
Limit Dairy
Dairy is known as a common trigger for acne, and although there are many hypotheses, more research is needed in the area. If you are struggling with hormonal acne, dairy alternatives like goat or soy milk might be worth trying.
Increase Soluble Fiber, Omega-3, and Antioxidants
Research shows that a high fiber diet can decrease blood testosterone (the androgen that triggers hormonal acne). Increasing soluble fiber helps optimize elimination pathways and keep the gut flora healthy to balance hormones and encourage a healthy metabolism.
Antioxidants can also help your skin health by offsetting the free radicals through the body, and limiting their negative impact on your skin. They’re a vital part of your skin and can help with ovulation acne by reducing inflammation and supporting healing processes.
While antioxidants work to reduce free radicals and the damage they can do to your skin, Omega-3s can enhance antioxidant defense and are known for their anti-inflammatory properties. Adding antioxidants and Omega-3s to your routine can help balance your hormones and may improve the look of your skin.
Cycle-Based Skincare: What to Do With Acne Before, During, and After Ovulation
So how can we take care of our skin alongside the ebb and flow of our hormonal fluctuations? Here’s an overview of how acne tends to behave during each phase of the menstrual cycle, and what you can do about it.
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Cycle-Based Skincare* |
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Cycle Phase |
Hormonal Changes |
Skin Behavior |
Suggested Care |
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Follicular Phase (Days 1-13) |
Rising estrogen levels |
Clearer, more balanced skin |
Exfoliate gently, hydrate |
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Ovulation (Days 13-15) |
Testosterone peak, estrogen peak |
Oilier, more breakout-prone |
Cleanse well, use oil-control products |
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Luteal Phase |
High progesterone, estrogen drops |
Inflammation, clogged pores |
Soothe, support barrier, spot treat |
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*Based on a 28-day cycle |
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Skincare During the Follicular Phase (Day 1–13)
The follicular phase marks the beginning of your cycle. It begins on the first day of your period and lasts until ovulation. During this time, estrogen levels gradually rise while progesterone levels remain low.
This is the ideal hormone balance for your skin. If you pay close attention to your cycle and skin, you’ll notice that your skin looks clearer, has a natural glow, and feels more resilient during this phase ahead of ovulation.
In terms of skincare, this is the time to focus on maintenance and gentle exfoliation. To keep your skin looking and feeling its best, incorporate mild exfoliants (such as glycolic acid, lactic acid, and/or fruit enzymes) to help remove dead skin cells and support skin cell turnover.
This is also the time to focus on hydrating your skin. Look for ingredients like hyaluronic acid and glycerin in lightweight moisturizers to maintain your skin’s moisture, without clogging your pores.
Because your skin is much more resilient and less reactive, the follicular phase is also the optimum time to introduce new products or even tweak your regular skincare routine.
Skincare for Acne Around Ovulation (Day 13–15)
In the run-up to ovulation, hormonal shifts (particularly the surge in luteinizing hormone (LH) and peak in testosterone) can lead to increased sebum production. For some women, this can result in a mid-cycle glow. But others may experience more oiliness and breakout-prone skin, due to clogged pores.
To keep ovulation acne at bay, prioritize oil control and antibacterial care. To clear pores, look for products that contain salicylic acid. To balance oil production and soothe inflammation, look for products containing niacinamide. And to purify the skin, consider tea tree oil or clay-based masks.
Investing in a gentle, non-stripping cleanser is also essential during this time, as is avoiding comedogenic (i.e., pore-clogging) makeup and skincare routines. If you typically see a pattern of breakouts during ovulation, consider tracking your cycle and adjusting your skincare routine accordingly.
Skincare for Acne After Ovulation (Luteal Phase: Day 15–28)
After ovulation, progesterone levels rise while estrogen levels drop. This creates a hormonal environment that encourages the skin to retain more oil and thicken sebum, which can lead to clogged pores and inflammatory breakouts. The skin barrier may also become more reactive and prone to redness, sensitivity, and irritation during this time.
During this phase of your cycle, it’s important to focus on soothing and protecting your skin. Look for calming and barrier-repairing ingredients, such as ceramides, panthenol, and aloe vera. It’s also a good idea to use gentle cleansers that don’t strip the skin, and try to avoid strong actives, like AHAs or retinoids, when your skin feels more sensitive.
To manage breakouts, use targeted spot treatments with ingredients like sulfur or benzoyl peroxide. Calming clay masks can also help manage pesky breakouts.
The luteal phase is also the prime time for experiencing premenstrual cravings. However, it’s important to be mindful that dairy products and foods high in sugar can negatively impact your skin. Supporting your body with hormone-friendly foods (such as fruits, vegetables, whole grains, and lean proteins) and lots of water can go a long way towards protecting your skin during this hormonally tumultuous time.
Final Thoughts
Yes, it’s annoying to see breakouts appear like clockwork each cycle. But having an understanding of the underlying causes can empower you to take proactive, informed steps to protect your skin.
For further information on acne and cycle tracking, you may find the following articles helpful:
In short, tailoring your skincare routine to your cycle is officially in, and we’re here to help you get it all figured out!
Frequently Asked Questions
How long does hormonal acne last?
Hormonal acne is most common during big hormonal shifts like puberty, ovulation, pregnancy, and menopause. It can last for months or years, with symptoms coming and going as you go through hormonal fluctuations.
Why does acne keep coming back?
If you feel like you’ve tried everything and your acne is still coming back, it may be due to factors like a hormonal imbalance, lifestyle choices, and even genetics. A wide number of factors can influence acne, so it can be helpful to identify your triggers or work with a doctor to determine the root cause of your acne.
Does hormonal acne require hormone testing?
Yes. If hormonal acne is accompanied by other symptoms and signs of a hormone imbalance, it may be beneficial. For routine insight into your hormonal fluctuations, you can track your hormone levels at home with Mira’s Hormone Monitor. This will allow you to see your unique hormone patterns and fluctuations, and can be shared with your healthcare provider.
What’s the best diet for acne?
The best diet for acne focuses on low-glycemic and nutrient-rich foods that can support skin health and reduce inflammation. Include nutrients that support hormonal balance, like fruits, vegetables, lean meats, nuts, seeds, and whole grains, while avoiding processed foods and high sugar intake.
Can natural treatments replace medication?
Natural treatments vs medication depend on the type of acne you are experiencing and your overall health situation. Some natural remedies may help, but may not be as effective as medication to treat your acne.
