25 years to put
a name to the pain.
Irene has just been diagnosed with endometriosis at 39. For roughly 25 years, pain was part of her life without a definitive explanation. And her skin kept changing along the way.
ENDOMETRIOSIS AND SKIN · IN BRIEF
There is no single type of “endometriosis skin”, and the available evidence does not support saying that endometriosis causes acne. The diagnosis, the treatments and the current state of the skin are different things. That is why a skincare routine should adapt to how the skin is at that moment, not to the diagnosis alone.
“I've normalised the pain since my first period.”
IRENE · @ireneconde.astro
HER STORY · 01
When pain becomes “normal”
Irene remembers the pain from her very first period. Not as something exceptional, but as something she ended up making part of her life.
“Even today I still find it hard to understand that the pain I feel isn't normal, because I tend to carry it as if it were natural, as part of my life.”
For years she found no answer. At first, no solutions came. Later, the possibility of adenomyosis came up, though it was never confirmed.
Finally, at 39, she was diagnosed with endometriosis. Roughly 25 years after those first signs.
1 IN
10
Endometriosis affects roughly 10% of women of reproductive age worldwide.
The WHO estimates that diagnosis currently takes, on average, between 4 and 12 years.
Source: World Health Organization · Irene's roughly 25 years are her individual experience, not the average.
NAMING IT · 02
“I felt relief.”
Not because getting a diagnosis suddenly solved what was happening. But because it finally gave context to something she had been feeling for years.
“I've even felt as if I were making the pain up, or that I just couldn't handle it well enough.”
Irene also talks about the disabling pain and the digestive problems she had normalised for a long time. Endometriosis can cause severe pain and gastrointestinal symptoms, and affect fertility and quality of life; not everyone has the same symptoms.
WHAT HAPPENS INSIDE
What is endometriosis?
Endometriosis is a chronic disease in which tissue similar to the lining of the uterus grows outside it. It can cause inflammation and scar tissue and appear in different areas, most often in the pelvis.
OVARY
When it affects the ovary, an endometrioma can form, a type of cyst associated with endometriosis.
IMPORTANT
Pain intensity alone cannot determine how extensive the disease is.
AND THE
SKIN?
This is where the part we especially wanted to understand with Irene begins. Because her skin has also been part of the story.
“The only times I remember my skin being good were before my first periods, while on the contraceptive pill and during pregnancy.”
The rest of the time she remembers acne breakouts of varying intensity. And now, as she goes through new medication changes, she feels it is starting to settle.
HAPPENING
AT THE SAME TIME
DOESN'T MEAN
ONE CAUSES
THE OTHER.
WHAT WE KNOW
Does endometriosis cause acne or skin changes?
We cannot say that endometriosis causes acne. Nor is there a single type of “endometriosis skin”.
A cross-sectional study published in the International Journal of Women’s Dermatology in 2025 compared 835 women with endometriosis and 309 controls. It found a higher prevalence of alopecia areata, psoriasis and chronic urticaria, but no statistically significant differences in acne, melasma, rosacea or atopic dermatitis.
As a cross-sectional study, it can show associations, not prove causation.
ENDOMETRIOSIS
≠ TREATMENT
≠ SKIN
They can be part of the same story. But they are not the same thing. And telling them apart matters.
THE ROUTINE · 03
“I've been changing my routine my whole life.”
For years Irene tried to find what worked for her skin.
“I just couldn't find products for my skin type. And because I didn't know how to go about it.”
When breakouts appeared, she did something very easy to understand: look for a solution. And that's where the trends, the products and the actives promising to get rid of them came in.
“In many cases I ended up with drier or oilier skin, and more reactivity.”
We asked her what she does now when she notices something is no longer working.
“I don't know
what to do.”
And perhaps that is one of the most interesting answers in this whole conversation. Because when skin changes, our first reaction is usually to look for something to add. But first we can do something else: understand what has changed.
BEFORE ANOTHER ACTIVE · 04
Five questions.
Not every answer ends in a new product. Sometimes the answer is to simplify, restore hydration, review how often you use an active, or check a change that coincides with a treatment with the healthcare professional managing it.
And sometimes: nothing needs to change.
NUT · HOW WE SEE IT
SAME DIAGNOSIS.
DIFFERENT SKIN.
DIFFERENT NEEDS.
NUT doesn't start from “you have endometriosis”. It starts from how your skin is now.
Drier or tighter
We look at hydration, comfort and barrier.
More sensitive or reactive
We review actives, frequency and tolerance first.
Breakouts appear
We don't automatically assume they're “hormonal”: we try to understand what's happening before adding more.
Skin is fine
There's no reason to change a routine that works.
A QUESTION THAT ALSO CAME UP · 05
What about endocrine disruptors?
“I'm now much more careful with the ingredients in everything I use, especially endocrine disruptors.”
It's an understandable concern, and there is scientific research on certain environmental exposures and endometriosis.
A systematic review published in 2022 found associations in several studies with exposure to BPA and certain phthalates, although it also noted important limitations and inconclusive results for other substances.
That does not allow us to conclude that a specific cosmetic worsens endometriosis, nor to draw up a general list of “banned” cosmetic ingredients. That's why we'd rather not turn a scientific question that is still open into another source of fear around skincare.
LISTENING TO THE BODY · 06
Taking care of herself has also changed for Irene.
“I used to get much angrier because my body would stop me with pain. Now I breathe, try to slow down and listen to how far I can go, both physically and mentally.”
Irene talks about diet, strength training and emotional management as tools that are part of her personal way of taking care of herself and feeling better.
That doesn't mean they are proven treatments for endometriosis.
The ESHRE clinical guideline considers it important to discuss non-medical strategies related to quality of life and psychological well-being, but the available evidence does not allow a specific intervention — including exercise, nutrition or psychological interventions — to be recommended to reduce pain or improve the quality of life associated with the disease.
WHAT SHE WOULD TELL HER YOUNGER SELF
SPEAK UP MORE.
UNTIL
THEY LISTEN.
AND TO ANOTHER WOMAN
“That she's not alone. And that she should look for ways to feel better through self-care, and find a network where she can be understood and heard.”
ENDOMETRIOSIS AND SKIN · FREQUENTLY ASKED QUESTIONS
Three questions. Three clear answers.
Does endometriosis cause acne?
There isn't enough evidence to say that endometriosis causes acne. A 2025 cross-sectional study found no statistically significant difference in acne prevalence between the women with endometriosis studied and the control group.
Do I need to change my skincare routine if I have endometriosis?
Not because of the diagnosis itself. If your skin is fine and your routine works, having endometriosis is not in itself a reason to change it. If your skin changes, it's worth looking at what has changed, which products you use, how well you tolerate them and the context before changing your routine.
Are there cosmetic ingredients I should avoid if I have endometriosis?
Research has looked at associations between certain endocrine disruptor exposures and endometriosis, but that doesn't allow a general list of banned cosmetic ingredients to be drawn up for everyone with endometriosis.
byNUT · ADVICE
DOES THIS SOUND FAMILIAR?
If you have endometriosis and aren't sure what to choose to care for your skin, write to us.
We'll help you find a routine that makes sense for your skin and for the moment you're in.
TALK TO US →WhatsApp · byNUT
