The red signals on women's faces should not be ignored! Why do "menstrual acne" recur?

Menstruation will accompany women for most of their lives. Before menstruation comes, many women will have red "signals" on their faces, which we commonly call "period acne". This type of acne recurs and troubles countless women. Today we will explore why acne appears crazily before menstruation?

01 Why does “ menstrual acne ” recur ?

What is the so-called "menstrual acne" and is there any scientific basis for it? The professional term for "menstrual acne" is premenstrual acne , a chronic inflammatory disease of the hair follicles and sebaceous glands. Studies have shown that up to 83% of women suffer from this symptom . At the same time, domestic and foreign scholars have found that this type of acne is cyclical and closely related to menstruation. Among them, 44% of female patients have worsening symptoms before menstruation, [2] and 63% of female patients will have an increase of 25% in the number of acne. "Menstrual acne" usually appears 7-10 days before menstruation . Once a menstrual cycle ends, the acne will gradually subside, but it will "come back" before the next menstruation.

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So what is the reason for the recurrence of "menstrual acne"? A very important factor is the change of hormones in the body . The change of hormones in the body is not static, but presents a cyclical change. The most obvious manifestation for women is menstruation . The change of hormones not only affects the menstrual cycle, but also affects the sensitivity of the skin and personal emotions, which often leads to the recurrence of "menstrual acne". In addition, in the early stage of menstruation, due to the different hormone conditions, skin sensitivity, and emotional state in each person's body, some people will develop "menstrual acne" while others will not.

02 How does “menstrual acne” form?

First of all, we need to understand what acne is. Acne, medically known as "acne", is caused by a complex of factors. Hormones play an important role in it . In addition, it is related to increased sebum production, hyperkeratosis of the epithelium at the mouth of the hair follicles, and the proliferation of Propionibacterium acnes in the hair follicles . In general, it is: oil secretion - pore blockage - skin irritation - bacterial growth - causing redness and swelling.

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"Age acne" is no exception. Its formation is deeply influenced by hormones such as estrogen, progesterone and androgen . Estrogen has a significant impact on the endocrine, cardiovascular, metabolic systems, skin, etc. Estrogen deficiency can lead to dull skin, and estrogen can inhibit the secretion of sebaceous glands. Acne before menstruation may also be an autoimmune reaction of the body to progesterone and its metabolites, and androgen has a consistent effect on acne .

We assume that the first day of menstruation is the first day of a menstrual cycle (it should be noted that the menstrual period is not the same as the menstrual cycle, which is generally about 28 days). After ovulation (around the 14th day), a corpus luteum will be produced, which is what we call the luteal phase (third and fourth weeks). If there is no conception, as the corpus luteum function declines, the estrogen and progesterone levels in the female body decrease rapidly, and menstruation is approaching. At this time, the ratio of androgen to estrogen (androgen/estrogen) increases, and the inhibitory effect of estrogen and progesterone on androgen and the anti-inflammatory effect decrease ; in addition, the decrease in estrogen levels before menstruation leads to a decrease in androgen binding globulin synthesized by the liver, and the level of free androgen also increases at this time . There are also studies that show that the aggravation of premenstrual acne may be related to luteal insufficiency and reduced estrogen secretion.

Hormone changes during the menstrual cycle Source: Zhihu/FACELABX Facebook Laboratory

The development of sebaceous glands is dominated by androgens. Before menstruation, the production of androgens increases, which enlarges the sebaceous glands and increases the secretion of sebum. Sebum is discharged to the surface of the skin through the hair follicles. When sebum stagnation occurs in the hair follicles, bacteria proliferate. Among them, the enzymes produced by Propionibacterium acnes can decompose sebum. The free fatty acids produced by them are an important reason for stimulating the hair follicles and causing inflammatory reactions. Moreover, before menstruation, the duct of the sebaceous glands of the hair follicles is in its smallest state at this time, which means that the passage of oil excretion becomes smaller, resulting in the obstruction of sebum excretion. After the sebum is mixed, it is blocked in the hair follicles to form acne, which is exposed at the top of the hair follicles, forming acne. After menstruation, with the increase of estrogen levels, acne gradually improves. Some women are prone to anxiety and irritability before menstruation (those who seriously affect their lives are also called premenstrual syndrome), which will also stimulate the adrenal glands to secrete more androgens. The final result is that more oil is secreted on the face. Under such an effect, the skin is more likely to have crazy acne to express "dissatisfaction".

03How to adjust and treat menstrual acne ?

First, we need to realize that "menstrual acne" is actually a normal physiological phenomenon, and generally there is no need to be overly nervous. Premenstrual anxiety, increased stress, poor sleep, etc. can all cause increased sebum secretion. Therefore, it is key to maintain emotional stability, relax, and develop good living habits. In addition, it is also necessary to properly control diet, avoid staying up late, quit smoking and drinking. Second, good skin cleaning can help alleviate the troubles of menstrual acne. It is recommended to clean the face with warm water and facial cleanser, which can open the pores and facilitate the cleaning of blockages. If you clean the face with cold water, it will aggravate the blockage of pores. In addition, it is best to keep the skin moisturized, because dryness can cause the epidermis to crack and become inflamed, leading to increased skin sensitivity, slow healing of skin lesions, and slow fading of pigmentation.

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Third, stay away from radiation and avoid strong sunlight. Long-term accumulation of electromagnetic radiation from computers and mobile phones will cause biological thermal effects, damage the skin barrier, and easily induce or aggravate "menstrual acne". Fourth, reduce high-sugar and greasy foods as much as possible, and avoid excessive consumption of dairy products. ** High glycemic load and excessive dairy products can easily increase the level of androgen in the body.

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Maintaining a good mood, healthy living habits, keeping your skin clean, and eating a healthy diet can all help alleviate the troubles of "menstrual acne". However, if it is still out of control and the symptoms are severe, it is also recommended to consult a doctor in time and receive necessary examinations and regular treatment. Finally, I wish you all a successful battle against "acne"!

References

[1] Steven Stolla, Alan R. Shalita, Guy F. Webster, et al. The effect of the menstrual cycle on acne[J]. Journal of the American Academy of Dermatology.2001,45(6).957-960.

[2] Anne W, Lucky.Quantitative documentation of a premenstrual flare of facial acne in adult women.[J].Archives of dermatology.2004.140423-4.

[3] Liu Chanke, Xie Ting, Yuan Juanna, et al. Analysis of Fan Ruiqiang's experience in treating female acne vulgaris with cyclical therapy[J]. Journal of Jiangsu Traditional Chinese Medicine, 2019, 51(1): 28-30. DOI: 10.3969/j.issn.1672-397X.2019.01.009.

Author: Wang Wei, Wang Qun, Department of Gynecology, Ruijin Hospital, Shanghai Jiao Tong University

Editor: One person

Acknowledgements: Li Jing, deputy chief physician of the Department of Gynecology, Ruijin Hospital, Shanghai Jiaotong University, provided scientific guidance for this article