Some women have acne related to their menstrual cycle, manifesting as acne growth or aggravation in the pre-menstrual period, mainly on the forehead, between the eyebrows or on one cheek. This is mainly related to high androgen levels in the pre-menstrual period leading to increased activity of the sebaceous glands and increased secretion of sebum. The excessive secretion of sebum provides nutrients for Propionibacterium acnes, and the reproductive infection of Propionibacterium acnes leads to hyperkeratosis of the sebaceous gland openings of the hair follicles and the formation of acne This leads to hyperkeratosis of the sebaceous opening of the hair follicle and the formation of acne.
At the same time Propionibacterium acnes produces substances that promote varying degrees of inflammatory reaction around the hair follicle, leading to the appearance of pimples and even cystic acne.