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What to do about PMS & Pimples

By Amalah

First off, thanks for taking the time to read through this. Life’s busy though, so no real ass kissing here—just a big THANKS!
Anyways, on to the issue. I’m 24 and finishing up my master’s degree in the education this Spring. YAY! I went through a decent acne phase during adolescence and into high school. Since turning 20, however, I haven’t had much of an issue except for this one horrible zit. I have normal to oily skin and use the Purity wash in the mornings and evenings along with Hope in a Bottle cream (light amount in the evening) and Neutrogena Ultra Sheer Dry-Touch Sunblock during the day. For most of the month, this routine keeps my face looking wonderful (no dry skin, no peeling, no oil, no redness, no acne). During the week leading up to my period, however, I always (IT. NEVER. FAILS.) get a huge cyst-like zit on my chin (either under the left or right corner of my lips). It’s usually the size of a pencil eraser and is red and tender. It never becomes a white-head and takes almost a 7-10 days to go away. During this time I usually add the On a Clear Day serum into my routine, but it doesn’t seem to help.
Basically, I need to know if you have any tips? I try and keep my hands off my face as much as possible and wear nothing but mascara for makeup. I really am starting to get frustrated with this little sucker!
Thanks a million!

Well, bleh! That sucks. And of course, acne caused by hormones is One Whole Big Mess, and cystic acne is Another Whole Big Mess, and both of them together is just a tricky thing to solve.
I’ve never had cystic acne, although I’ve had friends who had chronic problems with it (problems which were usually solved through prescription medications or injections at the dermatologist’s office), but I have struggled with the PMS break-outs. While blemish treatments CAN shorten the life of the zit monster, I always found most of them supremely useless, and dear God, I cannot even begin to list all of the spot treatments I’ve tried. And isn’t the real point to try to prevent the zits in the first place? I know! We demand so much.
midol.jpgI would definitely advise AGAINST changing your skincare routine up — it’s working great most of the month and futzing with it to fight something that’s most likely hormonal will be futile and bad and may just cause your skin to head into a month-long revolt. I did this too — adding all kinds of astringents and masks in the week before my period to fight the breakouts, none of which worked. And then my skin was a red, peeling mess the rest of the month, OR I broke out MORE as my oil glands charged into hyperdrive to make up for what I’d stripped out.
Two things helped break my PMS-zit cycle: changing birth control pills and changing my diet. (I’m off the pill entirely now, and have been for years, but I was also on a lot of different brands for years too, and some definitely help with this sort of thing more than others.)
You don’t mention the Pill, but if you are on it, consider trying a new one. Sometimes a slightly different hormone make-up in a slightly different pill is all your body needs to calm itself pre-period.
If you aren’t on the Pill or feel strongly about messing with this (which I totally understand; it’s dang hard finding the right one, so sometimes it’s best to stop at “close enough”), take aim at your diet.
Cut back on saturated animal fats, including full-fat dairy. Ban hydrogenated and partially hydrogenated oils completely. Up your intake of lean meats and fish, whole grains, legumes, fruits and veggies. (Yes, rocket science, I know. “Eat good!” Brilliant advice.) Caffeine and salt are also big PMS no-nos (mostly for irritability and bloating), but it might really help you to swap that Diet Coke for a bottle of water in the week before your Big Zit of Misery is due.
For me, personally, knocking out the hydrogenated oils, eating more fish and nuts and making red meat, salty snacks and soda an occasional treat were enough to regulate my hormonal breakouts. I still drink my coffee and I know I eat too much dairy, but other women with more severe PMS symptoms might need to be more vigilant. (Of course, GET THIS, full-fat dairy is now supposed to improve your fertility, so…uh…that’s why I eat all that cheese.)
Again, I know nothing about your choices in birth control or diet, and you may be reading this and arguing with the computer screen that you are a vegetarian who buys everything at the health food co-op and hasn’t had a trans fat or sip of soda in years. Which in that case, I’d go to your GYN or dermatologist and see what they recommend. It could take some prescription fine-tuning.
I wish I had a solution as simple as a tube of blemish cream, but I just don’t. When Hope is Not Enough works for me, but I think it’s because I’ve already happened to address the big underlying causes of my PMS break-outs. (And mine, while not cystic, were BAD. My cycles are really irregular so I would get red spots and painful blind pimples all over the place.) (Can I mention those damn partially-hydrogenated oils ONE MORE TIME?)

Published February 8, 2008. Last updated February 8, 2008.
About the Author

Amy Corbett Storch


Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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  • DrMaureen

    February 8, 2008 at 2:40 pm

    Just my two cents: I once had an extremely painful pimple that kept coming back in the same spot just under my nose. I never noticed whether it was timed to my cycle or not, but I happened to mention it in passing at the dermatologist’s office when there on something unrelated, and they gave me a cortisone shot and it never came back! So you could ask your dermatologist.

  • laura in LA

    February 8, 2008 at 2:43 pm

    Another suggestion…Mario Badescu makes a product just for cystic acne. Maybe check out their website, they will even send you free samples if you give them a call.

  • AnninVA

    February 8, 2008 at 3:56 pm

    Origins makes a product called Spot Remover that I keep on hand for similar flare-ups. You use it at the first sign of a zit. It doesn’t prevent it, but it usually shortens the life span and intensity. Plus, you use it only on the affected area, so you can use your regular skincare stuff as well too.

  • KatieMick

    February 8, 2008 at 3:57 pm

    Yeah, I would second the “get thee to a dermatologist” recommendation. Same place, every month, and cystic? They can cortizone it away. It doesn’t sound like you need anything other than that, so don’t let them steer you towards oral antibiotics (unnecessary and messes up your immune system), accutane (blood tests – ew) or retin-a (so so severely drying).

  • mahina

    February 8, 2008 at 3:59 pm

    Amy, do you not love the Philosophy “On A Clear Day” serum anymore, or does it just not work on cystic acne?

  • hebgvc

    February 8, 2008 at 6:00 pm

    I say go to a dermatologist and get a cortisone shot. It has worked wonders for me! I’ll occasionally get a large, painful cyst and it will heal up within a day! Its a miracle! lol

  • Mary

    February 9, 2008 at 2:14 am

    I agree with the diet recommendations. I am lucky enough to have pretty good skin, but I can always tell when I’ve been over-indulging in cheese or chocolate. I’m 46, and they can still make me break out. It is just not fair.

  • hrmorgan

    February 12, 2008 at 6:09 pm

    It does sound like a job for the skin doctor, but I know for me changing toothpaste and lip balm really helped to get rid of the ones around my mouth. Also, my dermo told me that the blemishes caused by stress and/or hormones occurred mostly on jaw/jawline or neck right around ears. And clean your office/home/cell phones often if you touch your face with them. Really does help!