So, You Have Luteal Acne—How to Stop the Breakout Cycle

The luteal phase needs new PR. Thanks to the boom in wellness tech, like Ora rings and Flo apps, we’ve become a little obsessive about cycle tracking. On TikTok, users are commiserating about a phenomena known as the “luteal uglies”—a very relatable name for the bloating, hormonal acne, and feelings of overall ugliness and low self esteem that flood the body during the luteal phase of the menstrual cycle, which happens right before you start your period. Despite the cutesy name, dermatologists and OBGYNs confirm it’s a real thing.

“During the luteal phase (after ovulation and before your period), your body makes more progesterone and then sees a drop in estrogen and progesterone right before your period,” explains Tracy Bennet, MD., an OBGYN and the Chief Medical Officer of NellaSpec. According to Bennett, it’s actually not during your period but in the luteal phase when you’ll experience classic PMS symptoms. “You might notice a slight increase in body temperature, breast tenderness, bloating, mood changes (like feeling more emotional or irritable), changes in appetite or food cravings, and your cervical mucus may become sticky or dry up,” explains Bennett. 

One of the biggest other signs you’re in your luteal phase? Your skin freaks out. “Progesterone increases oil production, which can clog your pores and lead to breakouts,” explains Bennett. “Estrogen, which normally helps keep your skin clear and calm, drops. The hormonal shifts can make your skin more prone to redness, swelling, and painful acne—especially around the chin and jawline.”

Ahead, we dive deeper into the luteal phase and guide you through the most effective ways to cycle-sync your skincare routine to prevent breakouts and the dreaded “luteal uglies” next month.

What Is the Luteal Phase?

The luteal phase is the part of your menstrual cycle that begins after ovulation (when your ovary releases an egg) and lasts until your period starts. During the luteal phase, your body experiences a significant shift in hormones. “Progesterone levels rise significantly to prepare the body for a potential pregnancy, while estrogen remains at a moderate level before declining,” explains Dr. Ashley Magovern, MD, board-certified dermatologist and Dermstore Medical Advisory Board member. The length of the luteal phase varies from person to person, but “is usually about 12 to 14 days,” says Bennett.

How Do You Know You Have Luteal Acne?

Luteal-phase acne is usually diagnosed based on timing and pattern. Bennett says, generally, tests are not needed. Instead, a clinician or OBGYN will look for specific indicators including: consistent breakouts that start one to two weeks before your period and clear once it begins, acne that shows up around the chin, jawline, or neck, and pimples that are deep, red, and tender. If your periods are irregular and acne is severe, your doctor might run hormone tests to check for conditions like PCOS, adds Bennett.

Does Birth Control Affect Luteal Acne?

While certain types of oral birth control pills containing estrogen can help improve hormonal acne by suppressing ovulation, inhibiting progesterone, and reducing the body’s natural sebum production, doctors are becoming more wary of prescribing them for skin care. “Oral contraceptives don’t address the root causes of hormonal imbalance,” explains Magovern.

The relationship between hormonal IUDs and acne is complicated, with results varying from person to person. “Hormonal IUDs release hormones in the uterus and can help some people [experience fewer breakouts],” says Bennett. However, Magovern notes that “hormonal IUDs may worsen acne in certain individuals.” It’s always best to work with your doctor and your derm to determine what’s best for you.

How to Treat Luteal Acne

First, consult a medical professional—your dermatologist or OBGYN—who can diagnose your symptoms and help create a prescription or treatment plan. Depending on the severity of your acne, Bennett says that a provider will commonly prescribe Spironolactone, an oral medication that lowers oil production in the skin by blocking certain oil-producing hormones. In conjunction, she says, topical treatments, like retinoids, benzoyl peroxide, or salicylic acid, may be prescribed to help unclog pores and reduce bacteria on the skin. Finally, “cycle tracking can help you spot patterns and manage flare-ups early,” Bennett says.

How to Prevent Luteal Acne Before Your Next Cycle

If you’re not tracking your cycle, this would be a good place to start, so you know exactly when you’re approaching your luteal phase and can shift your skincare accordingly. “I encourage patients to use period-tracking apps to monitor ovulation and anticipate their luteal phase,” says Magovern. Consider Period Tracker Period Calendar (great for first-timers) or MyFlo (helpful if you have irregular periods). 

From there, you can sync your skincare routine to your cycle. “Skin definitely behaves differently throughout the cycle,” explains Magovern. “For example, in the follicular phase, estrogen is higher and skin tends to be more balanced—this is a great time for active ingredients like retinoids or exfoliants. In the luteal phase, when inflammation and oil production ramp up, it’s smart to shift toward calming, clarifying, and oil-controlling products.”

For example, when you’re in your luteal phase, you can mitigate breakouts by switching to a calming and purifying face wash that removes excess oil—we love the Dr. Loretta Gentle Hydrating Cleanser—and an oil-free moistuizer like Paula’s Choice Oil-Free Moisturizer. “While more research is needed, many patients see a noticeable difference when syncing their skincare this way,” says Magovern.

It may also be helpful to use a gentle detoxifying mask once a week during your luteal phase. Magovern recommends a sulfur or salicylic-acid mask. We like The Outset Blue Clay Mask because it has salicylic acid and blue clay to target excess sebum.

Beyond topical skincare, prescription medications and in-office treatments may be effective at treating luteal acne. “Oral medications like Spironolactone can be very effective,” adds Magovern. “In-office procedures like chemical peels, LED therapy, and laser treatments may also help regulate flare-ups.”

Remember, hormonal acne is very common and nothing to be ashamed of. “It’s caused by natural hormone changes,” explains Bennett. Treatment takes time, sometimes weeks or months of consistent hormonal or topical intervention, to see skin improvements. However, it may be helpful to know that in many cases, luteal acne resolves over time. “Luteal-phase breakouts often improve with age, especially after your 20s or once your hormones stabilize,” says Bennett. “Many people find they get fewer breakouts after starting treatments like medications that balance hormones. With the right care, these breakouts don’t usually last forever.”