POSTED: 8 Aug 2023

What is Menopausal Acne and How To Treat It

Menopause is a time of significant change in a woman’s life and health. One of the unexpected challenges that may arise is menopausal acne and how to treat it. In this article we explore the causes and best menopausal acne treatments.

What is Menopausal Acne?

Menopausal acne is a specific type of acne that can occur during the menopausal transition. This is a period in a woman’s life when the ovaries stop producing eggs, and the production of hormones like oestrogen and progesterone decreases. The menopause typically occurs in the late 40s to early 50s and signifies the end of a woman’s reproductive years.

The hormonal shifts during menopause can lead to an increase in androgens (male hormones), which may result in increased oil production in the skin. This excess oil, coupled with stagnant dead skin cells can clog pores. This creates an environment where acne-causing bacteria can thrive.

What Does Menopausal Acne Look Like?

Menopausal acne can appear similar to the type of acne experienced during adolescence. It may have both inflammatory and non-inflammatory lesions, including whiteheads, blackheads, pustules and even cysts. The main difference is that menopausal acne often occurs on the lower face, particularly around the jawline and chin. Additionally, it can be more challenging to treat due to the ageing skin’s decreased ability to regenerate and heal quickly.

Alongside acne, you might also notice noticeable changes in skin texture during menopause. The skin becomes less resilient, leading to fine lines, wrinkles and a loss of elasticity. This can make the acne appear more prominent and affects how the skin responds to treatments.

Skin sensitivity may also increase during menopause. As such, acne might come with dryness, redness or irritation. Acne lesions may heal more slowly, increasing the risk of scarring or post-inflammatory hyperpigmentation. Menopausal symptoms like hot flashes and night sweats might heighten the feeling of skin irritation and discomfort.

What Causes Menopausal Acne?

The causes of menopausal acne are rooted in the complex hormonal changes that occur during the transition to menopause. Understanding these causes helps in forming an effective treatment strategy.

Decreased Oestrogen Levels

As women approach menopause, oestrogen levels naturally decline. Oestrogen helps to keep the skin clear and youthful, so a reduction in this hormone can lead to a drier and more sensitive skin. This contributes to acne development.

Increased Androgen Levels

Whilst oestrogen decreases, levels of androgens might stay the same or even increase slightly. Higher levels of androgens stimulate the skin’s oil glands which leads to excess oil production. This can clog pores and create a breeding ground for acne-causing bacteria.


The menopausal period is might be accompanied by significant life changes and stress. These can further exacerbate hormonal imbalances. Elevated stress hormones such as cortisol can trigger additional oil production. This adds to the risk of getting acne.


If acne was a concern earlier in life, you may be genetically predisposed to experience it again during menopause. Your family’s history with acne can also play a significant role in whether you develop menopausal acne.

Certain Medications, Supplements & Skincare Products

Some medications including steroids, hormonal treatments and anti-epileptics might trigger acne. Supplements containing high levels of iodine can potentially lead to acne breakouts, although this is relatively rare. Discuss with your doctor if you are using any medications or supplements to check if they can cause acne. Certain cosmetics and skincare products like heavy creams may also cause or exacerbate breakouts.

Diet and Lifestyle

Consuming a diet high in sugars and processed foods might contribute to inflammation and lead to acne breakouts during menopause. Likewise, smoking and excessive alcohol intake can negatively affect the skin’s overall health.

Underlying Health Conditions

Sometimes, menopausal acne might be a sign of an underlying health issue, like Polycystic Ovary Syndrome or other hormonal imbalances that persist into the menopausal years.

If you are experiencing hormonal acne or skin changes, the best thing to do is first consult with a doctor who experienced in treating menopause related skin conditions. This will pinpoint the precise causes in your individual case and will help tailor an appropriate treatment plan. Always consult with your healthcare provider if you suspect a medication or skincare product is contributing to acne. Never stop taking prescribed medications without first discussing it with your doctor.

How to Treat Menopausal Acne

Treating menopausal acne requires a combination of targeted skincare, lifestyle changes, and, in some cases, medical intervention.

Medical Treatments

Medical treatments for menopausal acne can provide targeted solutions to address the underlying hormonal changes and specific skin concerns that come with it.

Hormonal Treatments

Since menopausal acne often stems from hormonal imbalances, hormone replacement therapy (HRT) or another hormonal medication might be prescribed by your doctor. These medications can balance the hormones that lead to acne. HRT can also treat other menopausal symptoms.

Prescription Retinoids

Unlike over-the-counter products like retinol, prescription-strength retinoids like Adapalene and Tretinoin are more effective at treating acne, scarring and hyperpigmentation. These potent creams and gels increase skin cell turnover, control oil production and unclog pores. They also stimulate your skin to produce more collagen and elastin which also improves the signs of skin ageing. For more severe acne, your doctor might even suggest a course of oral isotretinoin.

Oral Antibiotics

For persistent or inflamed acne, short-term oral antibiotics might be needed. These medications work systemically to reduce bacteria and inflammation in the skin. This can lead to a significant reduction in acne. Long-term use is typically avoided due to potential side effects and resistance.


If your acne doesn’t respond to other treatments, your doctor may prescribe oral spironolactone. This medication has anti-androgen effects and so treats menopausal acne by targeting the specific hormonal pathways that trigger it.

Professional Skin Treatments

certain skin treatments can help to treat acne, reduce the appearance of scars and fade hyperpigmentation. However, professional skin treatments are not without potential risks and can have downtime. You should only see a trained and experienced medical practitioner to ensure that you receive the best and safest treatment for you.

Chemical Peels

If performed correctly, chemical peels remove the top layer of the skin. This unclogs pores and stimulates new skin growth. The strength and type of peel can be customised to the individual’s skin type and acne severity.

Laser Therapy

Certain types of laser therapies can effectively treat menopausal acne. These treatments penetrate the skin’s surface to exfoliate the skin, target bacteria and stimulate collagen production. This helps to reduce the appearance of scars and improve overall skin texture.

Medical Facials and Extractions

Some dermatologists and skin care professionals offer specialised facials and extraction procedures. These treatments remove debris from pores and provide deep cleansing. This is often done to complement other medical treatments.

Lifestyle Changes

Regardless of whether you opt for a menopausal acne treatment or not, it is important to improve your health and look after your skin. This will not only help with the acne but it will also enhance the effect of any medical or professional skin treatments.

Eating a balanced diet rich in antioxidants can support your overall skin health and help treat menopausal acne. Avoiding smoking, excess alcohol consumption and sugary or processed foods can also improve your acne breakouts. Stress management is also crucial. Try techniques like meditation and yoga to help reduce stress. Also remember that skin is vital for your skin and for stress. Your skin and organs regenerate at night so getting enough sleep is key to improving your menopausal skin.

Menopausal Skincare Routine

A good menopausal acne skincare routine will contain a balance of acne treatments and products that protect and nourish your skin.

  1. Gentle Cleansing: use a gentle cleanser to remove excess oil without stripping the skin.
  2. Use Actives Wisely: in the mornings use Vitamin C to help reduce oxidative stress and in the evenings use a retinoid to target acne and skin ageing. Once or twice a week, use an enzyme or beta hydroxy acid exfoliant.
  3. Moisturising: keep your skin hydrated and maintain your skin barrier with a good moisturiser. Look for products containing humectants like hyaluronic acid and emollients like ceramides.
  4. Sun Protection: a broad spectrum sunscreen with at least SPF30 is vital, as menopausal skin is more prone to sun damage.

Menopausal acne can be a frustrating and unexpected side effect. However, with the right combination of medical, skincare and lifestyle interventions, it can be effectively managed. The experience and severity of menopausal acne can vary widely amongst individuals. Because of its unique characteristics, you’re best of seeing a dermatologist or skincare professional familiar with the special challenges of menopausal skin. They can provide you with appropriate treatments tailored to your needs. Remember, patience and persistence are key. Even with the right treatments, it might take some time to see significant improvement. Stay committed to your menopausal acne treatment plan. Whether you’re new to menopausal acne or have been grappling with it for a while, understanding your skin’s specific needs will always lead to the best results.

At City Skin Clinic, we’re passionate about personalised skincare. We offer a variety of skincare treatments that can help treat menopausal acne. Check out our online skin clinic which offers prescription-strength skincare products for skin ageing and concerns like melasmaacne and hyperpigmentation.  Book a virtual consultation with one of our doctors and take your first step towards better skin.


Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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