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Middle-aged woman observing in a mirror skin changes due to perimenopause

How to Stop Perimenopause Acne In Its Tracks

Endocrinologist Explains How to Stop Perimenopause Acne In Its Tracks

Written by: Dr. Ana María Kausel, Endocrinologist at Anzara Health

Published: 01-25-2023

Perimenopause acne can be one of the unexpected changes to your skin brought about by the onset of menopause. Though it might induce some of the anxiety of your teen years, it’s important to remember that you’re not alone.

The thought of dealing with acne during your golden years might be perplexing, but I’ll break it down simply to help you navigate why you’re having breakouts again, what causes them, and, more importantly, what you can do about it.

The Relationship Between Menopause and Acne

One of the hallmarks of menopause is that your body’s estrogen levels start to decline. This female hormone is crucial in maintaining your skin’s elasticity by promoting collagen production while keeping sebaceous (oil) glands in check. 

With its decline, a hormonal shift starts to take place where the dominance of androgens (male sex hormones), like testosterone, becomes more pronounced. 

Testosterone can stimulate your sebaceous glands to produce more oil. Excess sebum, combined with other changes to the skin, fosters an environment prone to the development of acne

Additionally, the decrease in estrogen contributes to a loss of skin thickness and hydration, making the skin more susceptible to inflammation and breakouts. 

What happens to your skin at menopause: a comparison of Young and aged skin. Collagen, Elastin and fibroblasts in younger and older skin. age-related changes in the skin when Collagen fibers atrophy, and Elastin broken. Vector illustration

Who Experiences Perimenopause Acne?

Perimenopause acne tends to affect women in their late 30s to early 50s, aligning with the average age range of perimenopause onset.

However, it’s essential to note that each woman’s journey through perimenopause is unique.

While some may sail through this phase with minimal skin disruptions, others might grapple with unexpected acne breakouts.

Studies suggest that perimenopause acne is caused by factors such as genetics, lifestyle, and overall health.

Understanding the potential contributors to this skin condition can empower you to make informed choices in managing your skincare during this phase of life.

Perimenopause Acne Symptoms

Unexpected breakouts between ages 30 and 50 can be caused by several factors, such as stress and, in some cases, hormonal imbalances. 

Find some of the common symptoms of menopause acne below. 

1. Increased Breakouts

A sudden surge in acne breakouts is one of the primary indicators, as it could be linked to perimenopause hormonal changes.

Acne on the jawline and chin has been traditionally associated with menopause. Still, recent clinical research suggests that acne caused by menopause is more widespread and general, similar to acne experienced through puberty.

2. Oily Skin

As mentioned earlier, perimenopause triggers an uptick in sebum production. If your skin feels oilier than usual, and you’re experiencing shine even shortly after cleansing, hormonal shifts might be the culprits.

3. Persistent Adult Acne

While skin breakouts during adulthood can occur for various reasons, it’s worth looking into the hormonal connection if you’re grappling with ongoing acne beyond your usual skin woes.

Especially if, at the same time, you start to experience other perimenopausal symptoms.

4. Changes in Skin Texture

Perimenopause can make your skin feel rougher or uneven due to loss of moisture and collagen. If you’ve noticed a shift in how your skin feels, it could be associated with hormonal fluctuations during this phase.

Remember, while these signs can be indicative, it’s always best to consult a healthcare professional for a personalized assessment and guidance on managing perimenopause-related skin changes.

How to Treat Perimenopause Acne

Effective and medically validated treatments can help you regain control over your skin. Let’s explore a range of proven strategies to address breakouts and restore your confidence.

Topical Retinoids

Science backs topical retinoids as an effective remedy in treating acne as they counter comedones and microcomedones (pimples and smaller black and white tops) while reducing inflammation.

Retinol-based substances approved for acne treatment usually include tretinoin, isotretinoin, tazarotene, and adapalene. 

These substances work as single agents in treating mild to moderate acne, with potential side effects such as dryness, itching, and stinging. 

Retinoids will likely be prescribed as a part of a holistic skin treatment by your doctor, who will help you maximize their benefits and mitigate any downsides.

Hormone Replacement Therapy (HRT)

HRT is the solution for stubborn perimenopausal acne that’s unresponsive to conventional treatment.

It’s especially helpful as it directly addresses the underlying cause: hormonal imbalances stemming from the onset of menopause.

The end goal of this therapy is to limit the amount of sebum produced by oil glands in your skin, restoring its balance. 

Endocrinologists usually call for progesterone and estrogen intake in HRT, but ultimately, the types and amount of hormones prescribed to regain skin balance will vary on a patient basis.

Anti-androgen medication can also be used in tandem with hormonal replacement, but its use will depend on the patient’s androgen levels. 

Oral Antibiotics

Oral antibiotics have been a staple in moderate to severe acne treatment for decades.

Doctors usually prescribe doxycycline or minocycline to reduce acne-causing bacteria on the skin, effectively controlling inflammation and preventing further breakouts.

The downside is that you’ll need to take antibiotics over prolonged periods to sustain the acne-preventing effects.

Acne will resurface once you stop because these medications don’t treat the root causes.

Benzoyl Peroxide

An accessible over-the-counter option, benzoyl peroxide, proves an effective first line of defense in managing acne. 

This compound has antibacterial properties and also helps unclog your pores.

Its dual action of reducing inflammation and controlling bacterial proliferation is also a staple in acne treatment.

Chemical Peels

These treatments are administered by dermatologists and aim to remove the top layer of skin and promote new skin growth using approved chemical substances. 

Despite being used mainly for refreshing your complexion, peels can help unclog pores and remove excess oil from your skin.

Text HRT Replacement Therapy on light box. Menopause, hormone therapy concept. Oestrogen replacement therapy awareness. Pink background with alarm clock, exotic leaves, pills, estrogen gel.

Is HRT the Best Treatment for Perimenopause Acne?

The primary advantage of HRT over other perimenopause acne treatments is that it tackles its root cause: hormonal imbalance.

Alternatives like antibiotics or retinol, on their own, only address symptoms with effects relying on continued use. Moreover, severe acne caused by hormones might be unresponsive to all other types of treatment, leaving HRT as the only viable treatment. 

However, like any medical therapy, it has its pros and consOn the positive side, it addresses not only perimenopause acne but also other menopausal symptoms like hot flashes, night sweats, and mood swings while boosting bone health.

If you have a personal history of breast cancer, migraines, and clotting disorders, you might not be a candidate for certain hormonal formulations. That’s why consulting with an endocrinologist is paramount to assessing the feasibility of this therapeutic avenue. 

Hormone Replacement Therapy at Anzara Health

At Anzara Health, we approach Hormone Replacement Therapy (HRT) with personalized care tailored to individual needs.

With a focus on optimizing hormonal balance, our specialized HRT therapy can effectively address perimenopause symptoms, including acne.

We offer comprehensive assessments, individualized treatment plans, and ongoing support from experienced healthcare professionals.

We strive to provide a unique and empowering experience for individuals seeking effective and personalized HRT solutions.


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