Acne and Premenstrual Syndrome in a Final-Year Medical Student: Case Report on Combined Drug and Herbal Management

Acne vulgaris and Premenstrual Syndrome (PMS) are common among women of reproductive age and often share hormonal, inflammatory, and psychosocial triggers. In high-stress settings such as medical training, the manifestation of these conditions may be intensified by lifestyle factors, including poor diet, disrupted sleep, and emotional strain. Integrative therapeutic approaches that combine conventional treatments with evidence-based herbal and lifestyle modifications are increasingly recognised for their holistic, patient-centred benefits. This report presents the case of a 26-year-old final-year medical student who developed acne and PMS symptoms over a three-month period, coinciding with intense academic stress. Acne was characterised by red, tender papules on the face and upper back, while PMS included mood swings, abdominal cramps, skin sensitivity, and intermittent headaches. Sleep disturbances and anxiety were also present. Laboratory and imaging investigations were unremarkable. A comprehensive management plan was initiated, incorporating dietary adjustments (removal of dairy and refined sugars), increased hydration, physical activity, and stress management. Herbal therapies included Vitex agnus-castus (to support hormonal regulation) and Taraxacum officinale (to aid hepatic detoxification). Nutritional supplementation with zinc, omega-3 fatty acids, and vitamin A was added. Pharmacological therapies were considered as adjuncts. The patient reported substantial improvement in both dermatological and menstrual symptoms following exam completion and lifestyle adherence, with sustained benefit during remote and in-person follow-up. This case highlights the utility of an integrative approach in managing stress-aggravated acne and PMS. It demonstrates the potential benefits of addressing both physiological and psychosocial domains and supports further investigation into combined herbal-pharmacologic care models.