Menopausal Acne: Causes, Treatment, and Prevention Strategies

Last updated 11.30.2023 | by Dr. Karen Pike | 9 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Around 85% of people experience acne, but this common condition usually shows up between the ages of 12 and 24. However, during menopause, acne can return, taking many women by surprise. 

Acne isn’t usually a painful condition, but it can shatter your self confidence. So, if you’re going through menopause and you’ve suddenly been struck down with an acne breakout, you’re probably looking for a way to restore your once clear skin. After all, everyone wants to face the world looking their best, and unsightly acne can make you feel like hiding away. So, learning how to treat the condition and prevent it from coming back is key.

Like many other women, I suffered from acne as a teenager, and I tried everything to banish my blemishes and achieve clear skin. Eventually, the problem disappeared on its own, and I enjoyed an acne free adulthood for many years. But as I entered perimenopause, I suddenly noticed pimples forming for the first time in decades. 

Unfortunately, I’m not alone. Since I’ve been researching menopause I’ve met countless women who share the same experience, as they’re forced to battle acne all over again. 

Thankfully, as menopausal women, we’re older and wiser than we were in our teens. But I’d be lying if I said that my newfound acne didn’t affect my self-esteem. 

So, I decided to research the latest science surrounding menopause related acne and find a solution that worked. And now, my skin is drastically clearer, and I can face the world again with confidence. 

So, in this post, I’ll share the best treatment and prevention strategies I found in my quest for clear skin during menopause. But first, let’s explore the relationship between acne and menopause and find out why so many women develop the condition at this stage of life.

Menopause and Acne: What’s the Connection?

Although acne predominantly affects adolescents, it’s common for it to reoccur during menopause. And according to research, menopausal acne is on the rise. Studies suggest that at least a quarter of women in their 40s experience breakouts, and around 15% of us are still noticing acne in our 50s.

Even women who never had acne during their teenage years may notice oily skin, blackheads, and pimples as they go through this transitional time. But why does it happen?

The answer is hormones. Like all symptoms of menopause, acne at this stage of life is caused by fluctuations in estrogen and progesterone.

These fluctuations can lead to an increase in androgens, such as testosterone. Androgens are responsible for an increase in oil production, which clogs pores and leads to breakouts. Higher levels of androgens can also cause other unwanted side effects, such as hair loss on the scalp and hirsutism: excessive hair growth in areas where hair is usually absent.

What Treatments Are Available for Menopausal Acne?

Treatments Are Available for Menopausal Acne

Dermatologists often treat acne with a topical approach, using creams, gels, soaps, and serums to keep the problem at bay. But while these can help, when it comes to menopausal acne, it’s best to address the root cause of the issue.

Correcting the hormonal imbalance is the key to clearer skin during menopause. Several treatment options can help, including:

Spironolactone

This is an oral medication commonly used to treat blood pressure problems. However, doctors and dermatologists also prescribe it to treat acne and excess facial hair (hirsutism). It works by blocking the androgen receptors in the skin, which leads to less oil production and fewer clogged pores.

Oral Contraceptive Pills

Oral contraceptive pills are primarily used to prevent ovulation and pregnancy. But they’re also commonly prescribed to treat the symptoms of menopause, including menopause-related acne.

They work by regulating hormone levels, and so, in the right formulation, they can lower androgens and decrease oil production in the skin.

HRT

Hormone replacement therapy (HRT) is used to treat a wide variety of menopausal symptoms, particularly hot flashes and night sweats. Like birth control pills, it works by rebalancing hormone levels, and some women find it can also help to clear up their skin. It certainly helped to reduce my own pimples. While I wasn’t taking HRT primarily for acne, I was pleasantly surprised at how my skin improved once I began treatment.

However, HRT isn’t always the answer. Some women find that it actually makes their acne worse. This is most likely to happen when taking a formulation containing progestin, a synthetic form of the naturally occurring hormone progesterone.

Topical Medications

The treatment options above address the root cause of menopausal acne; however, like all medications, they all come with potential risks.

So, if your acne is relatively mild, you may want to try a topical approach.

Topical medications used to treat menopausal acne are the same as those used to treat acne in adolescents. Examples include prescription-strength salicylic acid, benzoyl peroxide, and retinoids.

But it’s important to exercise caution. Menopause can dry out your skin, and these topical creams and gels can leave your skin feeling even more parched and irritated. If you suffer from dry skin and acne, consider a natural treatment plan before resorting to harsher prescription products.

Natural Treatments and Preventions Strategies for Menopausal Acne

Natural Treatments and Preventions Strategies for Menopausal Acne

Menopausal acne is frustrating, but thankfully, there are several natural interventions and lifestyle changes that can treat and even prevent breakouts.

So, before reaching inside your medication cabinet, consider the following:

Stress Less

While stress isn’t a direct cause of acne, it can worsen the symptoms or trigger a new breakout due to its effect on the body’s hormonal balance. When I developed menopause related acne, I noticed my skin became significantly more inflamed during periods of high stress.

So, if you’re already prone to breakouts, try to keep your stress levels as low as possible. A calm and contented mind leads to faster healing and clearer skin.

Eat a Low-Carb Diet

For many years, doctors thought that acne and diet were unconnected. But more recent research suggests that what we eat can directly impact our skin.

Studies have shown that people who follow a low-carb or ketogenic diet are less prone to breakouts than those who eat a high-carb diet.

This was one of the most significant interventions of my own journey to clear skin, and I’ve met several women who completely eradicated their acne using a low carb diet.

So, if you’ve developed pimples during menopause, consider cutting back on the carbs for a few weeks and see if you notice an improvement.

Avoid Milk and Dairy

Dairy can affect hormone receptors found in the skin and lead to breakouts. Not everyone is affected, but many people find that cutting our milk and other dairy products, such as ice cream, butter, and cheese, significantly improves their skin.

Exercise

Exercise not only keeps you in shape and boosts your mood. It can also make your skin glow and your acne disappear.

Acne is an inflammatory condition, and regular exercise reduces inflammation in all areas of your body, including your skin.

DIM Supplements

Diindolylmethane, or DIM, is a naturally occurring compound created in the body when we digest Brassica plants such as cabbage, broccoli, Brussels sprouts, and cauliflower.

Some research suggests that DIM supplements can treat hormonal acne in a similar way to the prescription drug spironolactone, which we discussed earlier in this post.

But unlike its pharmaceutical counterpart, DIM is a natural product with fewer risks of side effects.

DIM has been shown to balance hormones and block the effects of excess androgens, such as testosterone. As a result, the skin produces fewer acne-causing oils, leading to fewer breakouts.

FAQs

Q. What are some other causes of acne during menopause?

Menopausal acne is caused by a natural and normal shift in hormones. But several other conditions and disorders can also cause acne breakouts in women during their 40s and 50s. These include insulin resistance, thyroid abnormalities, polycystic ovary syndrome (PCOS), and hyperprolactinemia.

Q. How long does menopausal acne last?

Acne can strike at any time in our lives, but it’s especially common during perimenopause.
Everyone is different, but the average duration of perimenopause is around 4 years. Once you hit menopause and have gone 12 months without a period, you’ll enter the post-menopausal phase. That’s when the hormonal fluctuations leading to side effects such as acne will start to settle down. As your body adjusts, your symptoms, including acne, will begin to taper off until they eventually disappear completely.

Q. When should I see a doctor?

Most menopausal women with mild acne breakouts don’t need to see a doctor. Simple lifestyle changes and natural interventions are often enough to treat the problem and even get rid of it completely.
But if supplements, diet changes, exercise, and stress management aren’t working, it’s time to speak to a healthcare professional. They can rule out any underlying conditions, such as insulin resistance or PCOS, and recommend a treatment plan that works for you.

Conclusion

Acne is something we all hope to leave behind in our youth. But unfortunately, more than 25% of women, including myself, experience a surge of hormonal acne during their menopausal years.

Yet thankfully, there are several ways to control, treat, and even prevent menopausal acne. These include lifestyle interventions, natural treatments, and pharmaceutical drugs.

If you’re experiencing acne during menopause and it’s affecting your quality of life, talk to your doctor or dermatologist. Help is out there, and with a little time and patience, you can look and feel your best as you journey through your menopausal years.

References:

Author

  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.