The skin side of menopause: Why acne happens and how to treat it

While many of us look forward to bidding farewell to acne after our teenage years, the reality is that menopausal acne can become a frustrating reality. Hormonal fluctuations during menopause can trigger acne breakouts on both the face and body.

Because this transitional phase can be challenging enough, adding adult acne to the mix can be a really challenging experience.

But it's important to remember that you have plenty of options if you do notice adult acne while navigating menopause. To steer you in the right direction, we've pulled together a comprehensive guide about the connection between menopause and acne, exploring the causes, symptoms, and various treatment options available.

What is menopause, and when does it start?

Menopause is a natural biological process that typically occurs within or after 12 months of a woman's menstrual cycle stopping. This transition often begins between ages 45 and 55, usually lasting about 7 years (but can be as long as 14 years [1]).

In the years leading up to menopause, you might notice a range of changes to your body including fluctuations in your monthly menstrual cycle, hot flushes, or other symptoms. This life stage is often called the menopausal transition or even perimenopause.

There are some common symptoms of perimenopause and menopause that most people will be familiar with, such as irregular or no periods, premenstrual syndrome (PMS), breast tenderness, weight gain, heart palpitations, headaches, and loss of sex drive.

But did you know that another common symptom of menopause can be acne [2]? That's right, many menopausal women experience adult acne.

What's the connection between menopause and acne?

While many assume that acne is exclusively associated with puberty, it can persist or even arise during menopause due to similar hormonal fluctuations. So if you're experiencing menopause acne breakouts, you're not alone.

The reason that menopausal acne occurs is the same reason that hormonal acne happens during puberty. It's thanks to fluctuating hormone levels.

These hormonal imbalances are primarily caused by the decline in oestrogen levels [3], which leads to an increase in androgen (or male) hormones, like testosterone, relative to other hormones in the body.

Hormonal factors are one of the biggest causes of noticing menopause symptoms, such as worsening acne on your mature skin.

What are the trigger factors of menopausal acne?

The most common trigger factor for menopause acne is fluctuating hormone levels. During this time, female hormones, such as oestrogen levels, drop, and testosterone levels rise. This fluctuation often causes a hormonal imbalance that can lead to acne breakouts [4].

When androgen levels rise, sebum production can also increase [5]. Sebum, an oily substance produced by the sebaceous glands, helps lubricate and moisturise the skin.

This excessive sebum or oil production can lead to clogged pores and the growth of bacteria, resulting in acne breakouts.

Another common reason for menopausal acne is that during this time, the skin stops exfoliating as effectively as it once did. These dead skin cells can lead to clogged pores and lead excess sebum production in pores, which is the perfect environment for the bacteria that causes acne to thrive.

The decrease in oestrogen levels during menopause can also contribute to the thinning of the skin. Thinner skin is more susceptible to irritation and inflammation, making it easier for acne to develop and become more persistent [6]. With so many skin changes at play, it's no wonder that you might notice more skin problems than usual during menopause.

Body acne during menopause

Menopausal acne is not limited to the face; it's also common for menopausal acne to also affect the body. Many menopausal women may experience body acne, even if they have never had it before.

Similar to facial acne during menopause, body acne often occurs due to the shedding of dead skin cells.

Body acne during menopause can also occur because of the hormonal fluctuations that happen in our bodies during this time. It's also common to experience menopausal acne before and after menopause, thanks to these hormonal changes.

Body acne might also be triggered by or worsened by an increase in body temperature and sweating associated with hot flushes. This can create a more favourable environment for bacteria growth, leading to acne breakouts on various parts of the body.

What does menopause acne look like?

The hormonal changes responsible for menopausal acne can lead to imbalances between oestrogen and testosterone, spiking testosterone levels and causing a drop in oestrogen. This causes the sebum production in the skin can increase, resulting in acne during menopause.

Typically with any type of hormonal acne, including menopausal acne, breakouts commonly present as a surge of whiteheads, more cystic under-the-skin type spots, or deep, inflamed pimples, often concentrated around the chin, jawline, and lower face [7].

But because this isn't the only cause for acne during menopause, breakouts during this time might also appear as whiteheads, blackheads, or small red bumps on any part of the body.

Will my acne clear up after menopause?

Unfortunately, there isn't a guarantee that menopausal acne will clear up on its own after menopause. That's because when this type of acne is caused by a drop in oestrogen levels and an increase in androgen hormones like testosterone, these hormone levels won't return to pre-menopausal levels.

The good news is there are a variety of ways to help clear menopausal acne. The first step is to see a trusted healthcare professional so you can determine what is causing your menopausal acne, and address any hormonal imbalances if needed.

From there, you'll be able to explore a range of treatments to reduce acne, including retinoids, medical treatments and even over-the-counter treatments designed to reduce inflammation and make managing acne that little bit easier.

How do you treat hormonal acne?

There are a lot of ways to treat menopausal acne, depending on what the trigger is, so it's important to figure that out first. There are some over-the-counter treatments and oral medications available for menopause acne, but it's best to start with simple lifestyle changes as this might be a quick way to kick the acne.

If your acne is triggered by hormonal changes, then you'll want to adjust your skincare routine to include some of the key ingredients in acne treatment. These include benzoyl peroxide and salicylic acid.

It's important to note that benzoyl peroxide can be quite harsh on delicate or sensitive skin, so tailoring your skincare routine to your skin type is important. For example, if you're navigating dry skin it might be best to use a gentle cleanser in combination with active acne treatments such as hyaluronic acid.

If you've adjusted your skincare routine but just can't get rid of the spots, a dermatologist may recommend hormone replacement therapy to help get your hormonal imbalances and resulting acne under check.

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After a simple quiz and telehealth consult with an Australian doctor, you'll score personalised advice and a tailored acne treatment perfect for whatever concerns you're navigating. Not only do our treatments get delivered to your door, but we'll continue to check in on your progress and tailor your treatment to meet your changing skin needs.

Looking for something that will tackle your acne from the inside out? Software's Acne Kit will fight breakouts during all stages and includes both oral and topical medications.

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