How To Deal With & Treat Menopause Acne

Menopause can bring a host of fun symptoms including chills, night sweats, insomnia, irregular periods, muscle aching, and mood swings. However, the majority of women do not anticipate acne breakouts as a side effect of menopause. In fact, frequent acne breakouts in women over 40 are one of the first signs of perimenopause. Perimenopause is the transition period the body goes through before menopause begins. This can happen anywhere from 3-9 years before menopause actually starts.

Whether you are 18 or 50 the menstrual cycle is controlled by hormones. The hormonal fluctuations due to your period, pregnancy, or menopause can cause a variety of side effects, including hormonal acne breakouts on the face, neck, chest, back, and shoulders.  

In some instances, these breakouts can be accompanied by inflammation and scarring – even if you wash your skin daily and moisturize. 

In this post, I’ll explain the science behind why menopausal acne happens and how it might be treated to prevent future breakouts from occurring.

What is Menopause Acne, and How Does it Happen?

During menopause, you lack many things that your body once had in abundance, including the sex hormone progesterone. When your progesterone levels decrease, you experience common menopause symptoms like irregular periods, mood changes, and lower sex drive. Additionally, lower progesterone levels can actually trigger acne breakouts. Progesterone regulates many things, including the skin’s oil production. If you have too much or too little progesterone, an acne breakout may be a sign that something is wrong. If you believe your hormonal levels are not in a healthy range you should talk to your doctor before trying to self-medicate.  

When it comes to menopause and skincare, several options are available to find what works for you while providing relief from discomfort during this transitional time.  

Additionally, many people use natural ingredients like cocoa butter or shea butter to reduce their risk of certain health complications associated with aging, such as hot flashes. These natural, topical remedies work by applying them directly on areas where they are experiencing issues (such as neck pain).

Why Do Breakouts Occur During Perimenopause?

For many women, the first sign of perimenopause is acne. Fluctuating hormones increase sebum oil production, which can cause these breakouts. In addition, during this period, the body’s natural cooling system causes an increase in oil gland production. This excess oil then clogs pores which leads to hormonal acne flares.

For this reason, many women begin menopausal hormone therapy (MHT) in order to regulate their estrogen and progesterone levels and reduce symptoms like acne, night sweats, and mood swings.

Another issue for some women is polycystic ovarian syndrome (PCOS), which increases the production of male hormones such as testosterone, furthers sebum production, clogging pores with excess oils, leading to more hormonal acne. 

Ultimately, any part of the menstrual cycle changes hormones, including ovulation, and therefore, can trigger acne breakouts in some women.

How can you Treat Breakouts to Prevent Them from Reoccurring?

If you are experiencing breakouts due to menopause, there are several things you can do in order to treat and prevent future breakouts. Treating your menopausal acne can be done in multiple ways, including over-the-counter or prescription drugs. 

If you are suffering from acne breakouts I recommend using a face wash that contains benzoyl peroxide, salicylic acid, retinoids (such as tretinoin).

If that does not help using topical antibiotics like clindamycin or erythromycin can help clear your acne breakouts.

If these treatments do not work for you speak with you doctor about an oral antibiotic, such as minocycline, along with a cream containing azelaic acid to help treat menopausal acne. This will help reduce surface bacteria on the face while simultaneously preventing new breakouts. 

For women experiencing their first breakout, you may want to try this combination for at least six weeks or more. If your breakouts do not stop after trying these treatments, it is time to visit the dermatologist. 

In addition, your doctor can help treat your menopausal acne with prescription medications, including oral contraceptives (birth control) and isotretinoin (a strong medication used for severe menopausal acne).

If you are looking for a more natural alternative there is compelling research that supplements, like chasteberry, can help naturally manage hormone fluctuations and reduce hormonal acne breakouts.

Preventing Future Breakouts by Eating Healthy Foods

The best way to prevent acne breakouts is through your diet. Most people do not realize how often sugary, processed foods can trigger acne breakouts. We explain this in depth in the Unmasking Acne Clear Skin Resource Guide. To prevent future breakouts due to hormonal changes, you have to eat healthy foods. Fruits and veggies are high in Vitamin A, which is essential for keeping your skin clear; anti-inflammatory foods will help heal hormonal acne faster after pimples appear on the surface of your face. 

Other anti-inflammatory foods include dark leafy greens, berries, turmeric root, and ginger root. They also contain Omega fatty acids that help prevent hormonal changes that keep the inflammation down around the follicle where a breakout begins at its source beneath the surface of your skin.

Following a strict anti-inflammatory diet controls future outbreaks from occurring as well as provides antioxidants that fight against free radicals present in our environment due to pollution and sunlight damage (the sun can worsen an existing blemish). 

In addition, foods rich in omega fatty acids like walnuts and fatty fish (salmon, tuna, and mackerel) help fight against inflammation, which can increase the side effects of menopausal acne. 

Lean protein foods like lean beef, chicken, and turkey are great for getting rid of your hormonal acne because it helps decrease testosterone levels in women that cause breakouts during this transitional stage of life. 

Finally, avocados are rich in essential fatty acids; specifically, omega-rich avocados will do wonders for clearing up skin blemishes because their monounsaturated fat content is easily absorbed by the body’s cells, giving you a healthy glow from within, so why not eat more?

The importance of Seeking Medical Attention

It is important to seek medical attention from your doctor if you are experiencing this type of menopausal symptoms including acne. You should never try to self-diagnosis yourself. Your physician can help you determine what is causing these breakouts and will be able to recommend a treatment for controlling them.

If you are experiencing signs of early menopause, your doctor may recommend hormone replacement therapy. For many women, this treatment can help with their menopausal acne problems. 

In addition, if you are suffering from hyperandrogenism, your doctor may prescribe a hormonal acne treatment medication that will help reduce the number of androgens in your body. This is especially effective for women experiencing acne problems while undergoing menopause.

Also, certain menopausal acne medications can help decrease the number of sebum (oil) glands on your face, reducing the oil produced by these glands. So, you may find that your menopausal acne goes away due to taking these medications.

Perimenopausal Acne Causes & Treatment Options

Perimenopausal Acne develops in women for similar reasons as our puberty years. These changes affect our bodies’ hormone systems and can cause acne. Acne in menopausal women is rarely severe enough to need medical attention, but it often disappears after your hormones level off. 

This can cause a deeper depth of voice and face growth for some women. It seems unfair to go through all the symptoms related to menopause simultaneously.

Hormonal acne typically begins as a deep cyst beneath the skin, which is why it’s so difficult to cure. Topical treatments such as salicylic acid or benzoyl peroxide can only go so far. Oral medicines are typically the most effective treatment for perimenopausal acne, but you should discuss the best options for you with a medical professional.

The Approach to Managing Menopause

The there are dozens of different ways to treat menopausal acne, and there is no “best cure” other than following a healthy, low inflammation diet.

Everyone is different and what works best for you may not yield substantial results for someone else. Your best treatment options will depend on the extent of your symptoms, preexisting medical issues, and risk profile. For acne specifically, the therapy selection depends on the etiology and severity of acne. Your doctor will also access if your skin type is dry and sensitive or thick and oily.

Treatment aims to help with scars, acne complications, dermatitis, and hyperpigmentation without irritating mature skin. Topical treatments should be chosen carefully as they may cause dryness and irritation to older women who are already suffering from dry, sensitive skin. 

Many people who suffer from intermittent or persistent Acne will also acquire post-acne scars as a consequence of their condition. As a result, many women find hormonal therapy is the most effective strategy for treating adult menopausal acne.

Many uncomfortable symptoms of menopause can be relieved by HRT. Still, there are some risks with starting HRT, primarily for women with a history of breast or endometrial cancers that diminish these changes. However, if all this seems overwhelming, a board-certified dermatologist can create an effective treatment plan that delivers noticeable results.

Root Cause of Menopausal Acne

Acne is usually a pilosebaceous (sebacous glad) inflammatory disorder and can be triggered by several factors.

The ovary is hormonally active during the postmenopausal period and secretes various androgens and estrogen. After menopause, estrogens fall firmly while androgens are reduced slowly.  

Additional receptor sensitivity enhancements increase susceptibility to the potent estrogen androgen, dihydrotestosterone, and dehydroepiandrosterone sulfate. As a result, hyperandrogenism (high androgen hormone levels that typically trigger acne and other skin conditions) occurs in rare but tumor-like manifestations.

Menopausal Acne Evaluation

Without question the best way to prevent and treat menopausal acne is to get an evaluation from a certified dermatologist or medical professional. They will use your detailed medical history, including the use of medications, supplements, tobacco, alcohol and other important biomarkers to come up with a plan that is custom to your body and needs.

Combination Therapies For Treating Menopausal Acne

My suggestion to all my friends dealing with menopausal acne is to use multiple tools in the tool belt. I always suggest starting small and slowly ramping up treatment options to see what works. A combination of benzoyl peroxide with adapalene works for some women, which is great since they can both be bought over the counter. However, other women require an HRT intervention. Additionally using non-comedogenic moisturizing products is a great way to keep your skin healthy, hydrated, and acne free.

Azelaic Acid For Acne

Azelaic acid (20% creams and 15% gels) has anti-inflammatory, comedolytic, and antibacterial properties and can help reduce severe acne and scarring. It is also a hypopigmented agent; hence it is used in patients with post-inflammatory hyperpigmentation. It is generally well-tolerated and is mildly effective for mild skin conditions like acne. 

Systemic Therapy

Antigens such as spironolactone are the primary treatment of choice, particularly when hyperandrogenic symptoms such as hirsutism or androgen. Combined oral contraceptives are effective but can potentially cause side effects in women dealing with menopausal acne.

Often times dermatologists will recommend Antiandrogen hormonal therapy isotretinoin antibiotics when treating, severe acne is found in women over the age of 40.

Hormonal Replacement Therapy

Your doctor may prescribe antibiotics, androgen blockers like spironolactone, or a low dose of severe acne medication such as Accutane. Hormone Replacement Therapy (HRT). Hormonal therapy is the most common treatment for adult acne. 

For women going through menopause, this means hormone replacement therapy. Some women who start HRT claim that their complexions have cleared up, while others state that it has exacerbated their acne problems. The only way to know if this is a good option for you is to be evaluated by a medical professional.


This article has provided you with an overview of the menopause and menopausal acne relationship. We hope this information helps dispel any myths about why women experience acne during menopause and give insight into what can be done. 

If you are still experiencing symptoms, please consult your physician for more advice on managing your condition. 

Also, always consult your physician before starting or stopping any medications.

Frequently Asked Questions

What are the Symptoms of Hormonal Imbalance During Menopause?

During perimenopause, women may experience hot flashes and night sweats. This is because your body’s hormone levels fluctuate more than they typically do throughout a woman’s lifetime. 

What is the Best Strategy for Clear Skin in Menopause?

Talk to your doctor about the best options for controlling menopausal acne. It is essential that you take good care of yourself and treat any health conditions accordingly. Remember, proper skincare can go a long way in improving the appearance of your skin and menopause acne specifically!

How do I Treat Menopausal Acne?

Many women can control breakouts by eating healthy, sleeping well, and managing stress. A gynecologist can give you an honest opinion and recommend if medications and prescriptions are needed. Schedule an appointment through this site with an audiologist. 

Originally Published: December 08, 2021

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Analyzed by Ashley Wilson

Hi, I’m Ashley Wilson. I’m a part-time personal trainer, yoga instructor, and mom of three. I had a little bit of acne as a teenager, but it pretty much went away after high school. However, during my first pregnancy, I constantly suffered from hormonal acne breakouts.

Because I was pregnant, I refused to take medications to manage my hormones to clear my acne. This led me to try lots of self-experimentation with natural remedies that would not jeopardize the health of my pregnancy.

During the course of my self-experimentation and research, I found GoodGlow’s blog which helped me quickly manage my acne by following a low inflammation diet.

After implementing a lot of the natural acne management strategies Sam and the rest of the team were writing about I asked if I could join the team and document some of my own experiences of dealing with acne during and after my pregnancy. They were gracious enough to accept my offer, and I have been on the team ever since.

While I never considered myself to be “unhealthy”, I was never really proactive about taking charge of my health. When I began experiencing a bunch of adverse side effects due to my pregnancy (acne breakouts, taste changes, mood swings, joint inflammation) I knew I had to take better control of my health.

Since I made this decision to follow a low-inflammation diet, my skin has cleared, I have more energy, and I’ve had two acne-free pregnancies.

However, my diet was just the beginning. Since joining GoodGlow I’ve also learned to prioritize my physical and mental helath. At the encouragement of the GoodGlow team I have begun to regularly practice yoga, resistance training, and meditation. This not only reduces inflammation throughout the entire body but also gives me the foundation to raise three kids while working part time.

In my “free time” I am typically running my kids to soccer practice, piano lessons, and teaching healthy cooking classes at my local community center.

If you have any questions or want to get in touch please send us an email or message our social channels and I’ll be sure to get back to you within 24 hours.

Read more of Ashley's articles.

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