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 signals 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. It can also be more challenging to treat, because ageing skin is less able to regenerate and heal quickly.
Alongside acne, you might also notice 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, which increases the risk of scars or post-inflammatory hyperpigmentation. Menopausal symptoms like hot flushes and night sweats might increase 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. The most common contributors include:
- Decreased oestrogen levels: As women approach menopause, oestrogen levels naturally decline. Oestrogen helps keep the skin clear and youthful, so a reduction can leave it drier and more sensitive, which contributes to acne.
- Increased androgen levels: Whilst oestrogen falls, androgen levels may stay the same or even rise slightly. Higher androgens stimulate the skin’s oil glands, which leads to excess oil that can clog pores and create a breeding ground for acne-causing bacteria.
- Stress: The menopausal period might bring significant life changes and stress, which can further upset hormonal balance. Elevated stress hormones such as cortisol can trigger additional oil production and add to the risk of breakouts.
- Genetics: If acne was a concern earlier in life, you may be genetically predisposed to experience it again during menopause. Your family history with acne can also play a significant role.
- Medications, supplements and skincare products: Some medications including steroids, hormonal treatments and anti-epileptics might trigger acne. Supplements high in iodine can occasionally contribute, though this is rare, and heavy creams or cosmetics may also make breakouts worse.
- Diet and lifestyle: A diet high in sugars and processed foods might contribute to inflammation and breakouts during menopause. Smoking and excessive alcohol can also affect the skin’s overall health.
- Underlying health conditions: Sometimes menopausal acne can signal an underlying issue like polycystic ovary syndrome (PCOS) or other hormone imbalances that persist into the menopausal years.
If you are experiencing hormonal acne or skin changes, the best thing to do is first consult a doctor who is experienced in treating menopause-related skin conditions. This will identify the precise causes in your individual case and help tailor an appropriate treatment plan. Always consult your healthcare provider if you suspect a medication or skincare product is contributing to acne. Never stop taking prescribed medications without first speaking with your doctor.
How Do You Treat Menopausal Acne?
Treating menopausal acne usually requires a combination of targeted skincare, lifestyle changes and, in some cases, medical intervention. Medical treatments can address the underlying hormone changes and the specific skin concerns that come with them. The main options a doctor might consider include:
- 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 can help balance the hormones that drive acne, and HRT can also ease 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 boost collagen and elastin production, which improves the signs of skin ageing. For more severe acne, a doctor might suggest a course of oral isotretinoin.
- Oral antibiotics: For persistent or inflamed acne, a doctor might add short-term oral antibiotics. These work systemically to reduce bacteria and inflammation, which can lead to a significant reduction in acne. Long-term use is typically avoided due to potential side effects and antibiotic resistance.
- Spironolactone: If your acne doesn’t respond to other treatments, a doctor may prescribe oral spironolactone. This has anti-androgen effects, so it treats menopausal acne by targeting the specific hormonal pathways that trigger it. A meta-analysis of randomised trials found oral spironolactone significantly improves acne in women.
What Professional Skin Treatments Can Help?
Certain in-clinic treatments can help treat acne, reduce the appearance of scars and fade hyperpigmentation. However, professional skin treatments are not without risks and can involve downtime. You should only see a trained and experienced medical practitioner to ensure you receive the best and safest treatment for you. The most commonly used options include:
- Chemical peels: Performed correctly, chemical peels remove the top layer of skin to unclog pores and stimulate new skin growth. The strength and type of peel can be tailored to your skin type and severity of your acne.
- Laser therapy: Certain laser therapies can help treat menopausal acne. They penetrate the skin’s surface to exfoliate, target bacteria and stimulate collagen, which helps reduce the appearance of scars and improve overall skin texture.
- Medical facials and extractions: Some dermatologists and skincare professionals offer advanced facials and extraction procedures. These remove debris from pores and provide deep cleansing, often to complement other medical treatments.
How Do Lifestyle and Skincare Changes Help?
Regardless of whether you opt for a medical treatment or not, it is important to look after your health and your skin. This will not only help with the acne but will also enhance the effect of any medical or professional treatments. Eating a balanced diet rich in antioxidants can support your overall skin health and help treat menopausal acne. Avoiding smoking, excess alcohol and sugary or processed foods can also improve breakouts. Stress management is crucial too, so try techniques like meditation and yoga to help reduce stress. Also remember that sleep is vital for both your skin and your stress levels, because your skin and organs regenerate at night, which makes getting enough sleep key to improving menopausal skin.
A good menopausal acne skincare routine balances acne treatments with products that protect and nourish your skin:
- Gentle cleansing: Use a gentle cleanser to remove excess oil without stripping the skin.
- 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.
- Moisturising: Keep your skin hydrated and maintain your skin barrier with a good moisturiser. Look for humectants like hyaluronic acid and emollients like ceramides.
- Sun protection: A broad-spectrum sunscreen with at least SPF 30 is vital, as menopausal skin is more prone to sun damage.
Menopausal acne can be a frustrating and unexpected side effect. However, the right combination of medical, skincare and lifestyle interventions can manage it effectively. The experience and severity of menopausal acne vary widely between individuals. Because of its unique characteristics, you’re best off seeing a dermatologist or skincare professional familiar with the special challenges of menopausal skin. They can provide treatments tailored to your needs. Remember that patience and persistence are key, because even with the right treatments it might take some time to see significant improvement. Stay committed to your treatment plan, and understanding your skin’s specific needs will always lead to the best results.
At City Skin Clinic, we believe that skincare is personal and should always centre around your needs. Our doctors offer custom topical skin treatments for acne using ingredients like tretinoin, azelaic acid, clindamycin and spironolactone where appropriate. If you are interested in a personalised skincare treatment please use our online skin consultation form or book a video consultation. Start your treatment journey today and take your first step towards great skin.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your skin or treatment options.
