perimenopausal acne

Dealing with Perimenopausal Acne: Understanding Causes and Finding Solutions

Perimenopause is a tough time for a lot of women. It’s a huge transition that brings with it so many physical and emotional changes. To add insult to injury, for some women it’s a time when perimenopausal acne rears it’s ugly head.

If you’ve noticed your skin acting up as you approach menopause, it’s likely because of the hormonal changes that can lead to increased oil production and, subsequently, acne. Understandably, this can be frustrating, especially if you thought your days of battling blemishes were behind you.

The good news is that there are effective strategies to manage perimenopausal acne. Skincare regimens may need an update to accommodate your skin’s new needs. Ingredients that may have served you well in the past might no longer be as effective. So you might need to incorporate products that specifically target hormonal acne. For instance, treatments containing glycolic acid or retinol may help in treating not only acne but also pigmented scars left behind.

Adjusting your routine isn’t the only path to clearer skin during this time; lifestyle factors also play a crucial role. For fear of sounding like a broken record.. stress management, a healthy diet, and adequate sleep all contribute to your overall hormonal balance and therefore skin health. Remember, what works for one person may not work for another, so it’s important to find the right combination that works for your unique skin. But with patience, and a little trial and error, you can achieve the clear complexion you desire during perimenopause.

Understanding Perimenopausal Acne

Perimenopausal acne can be surprising and frustrating, but it’s a common condition stemming from hormonal changes in your body. Let’s explore what causes these breakouts and where they’re likely to occur.

Hormonal Fluctuations and Their Impact on Skin

During perimenopause, your estrogen levels decline, while androgens like testosterone may have a more pronounced effect. This hormonal shift can cause your skin to produce more oil, which can lead to acne. Your skin’s increased sensitivity to androgen receptors may also exacerbate the situation.

Triggers and Risk Factors

Stress and lifestyle factors can act as triggers for perimenopausal acne. Additionally, if you have a history of hormonal acne, you might be more predisposed. Certain medications or a family history of acne could increase your risk as well.

Common Symptoms and Acne Locations

Acne during perimenopause often manifests as deep, tender cysts. These can appear on the lower face, along the jawline, and sometimes on the neck—a pattern that’s characteristic of hormonal acne. Keep an eye out for blackheads and whiteheads in these areas as well.

Effective Treatment Strategies

When tackling perimenopausal acne, your strategy should consist of tailored topical treatments, systemic medications, and natural remedies that respect your body’s hormonal changes.

Topical Treatments and Retinoids

Topical treatments are often the first step in managing perimenopausal acne. Benzoyl peroxide effectively reduces inflammation and kills acne-causing bacteria. Salicylic acid can help to unclog pores and minimizing breakouts. And don’t for your daily sun protection! It helps prevent post-acne hyperpigmentation.

Retinoids, derivatives of vitamin A, promote skin cell turnover and can prevent the formation of new acne lesions. A study on Managing acne suggests that retinoids are also helpful in creating a uniform treatment strategy, with topical application being key in preventing acne recurrence.

Lifestyle Factors

Navigating the challenges of perimenopausal acne requires a holistic approach that includes tweaking your diet, refining your skincare routine, managing stress, and more. Each of these facets plays a crucial role in how your skin behaves during this transitional time.

Dietary Considerations and Supplements

Your diet can influence your skin’s health. Consuming a balanced diet rich in anti-inflammatory foods may help manage acne outbreaks. Consider foods high in omega-3 fatty acids like salmon and walnuts. Zinc supplements and probiotics can also support skin health; zinc aids in regulating oil production, while probiotics maintain gut health, which is linked to clear skin.

  • Omega-3 sources: Salmon, walnuts, flaxseeds
  • Recommended supplements: Zinc, probiotics

Stress Management and Physical Health

Because stress can increase cortisol production, aggravating acne, engaging in stress-reducing activities, like yoga or meditation can help. Ensuring enough sleep is also important as it helps regulate hormones and mood swings that impact your skin’s condition.

Importance of Adequate Sun Protection

Protecting your skin from the sun is essential. Ultraviolet rays can exacerbate acne marks and lead to premature aging. Apply a broad-spectrum sunscreen every day, even when it’s cloudy, and consider wearing a hat for additional protection.

  • Sunscreen: Broad-spectrum, minimum SPF 30
  • Clothing: Wide-brimmed hats, long-sleeved shirts for coverage

Quitting Smoking and Alcohol Moderation

Smoking can worsen perimenopausal acne by affecting blood flow and oil production. Limiting alcohol is also beneficial as it can lead to dehydration and poor sleep quality. Focus on keeping your body hydrated and well-rested to support your skin’s health.

Natural Remedies

Natural remedies like tea tree oil can serve as a gentle alternative to harsher chemicals, as its antioxidant properties help soothe the skin and reduce inflammation.

Healing Adult Acne by Richard Fried
For other supportive techniques, the book Healing Adult Acne is a great read and provides some valuable insights.


Skincare Routines

First step to healthy skin is to make sure you’re keeping it clean. Remove makeup and wash your face thoroughly before bed so your skin can breath and heal. Also, it’s a great time to invest in a skincare regimen suited for hormonal fluctuations. Look for products that minimize the likelihood of clogged pores to help combat acne.

  • Morning routine: Gentle cleanser, moisturizer with SPF, antioxidant serum
  • Evening routine: Makeup remover, cleanser, retinol or peptide cream
  • You’re worth it!

When to Consult a Dermatologist

If you’re struggling with acne during perimenopause, you might need some professional help. Dermatologists specialize in treating skin conditions, and they can provide you with a diagnosis and a tailored treatment plan.

When to Seek Dermatologic Advice

If over-the-counter products have failed to clear your acne or if your acne is causing scarring or significant distress, it’s time to seek a dermatologist’s expertise. Also, if you notice your acne coincides with other potential medical conditions, this warrants a professional assessment. Some things to watch for:

  • Persistent acne that lasts for weeks or months
  • Acne that suddenly appears and is severe
  • Signs of infection, such as pus or significant redness
  • Acne causing scars or dark spots on your skin
  • Acne negatively impacting your self-esteem

What to Expect in a Dermatology Assessment

During your visit, the dermatologist will examine your skin to determine the type of acne you have and its severity. They might ask about:

  • Your medical history
  • Any medications you’re currently taking
  • Your skin care regimen
  • Changes in your menstrual cycle

This information helps in the diagnosis and allows the dermatologist to create an effective treatment plan. You might also undergo tests to rule out underlying medical conditions that could be causing or exacerbating your acne.

Treatment Plans

After assessing your condition, your dermatologist will discuss treatment plans that may include:

  • Prescription medication such as topical retinoids, antibiotics, or hormonal treatments like birth control pills or anti-androgen drugs.
  • Procedures such as chemical peels or laser therapy.
  • Recommendations for skin care products tailored to your skin type.

It’s important to follow your dermatologist’s advice and use the prescribed treatments as directed to see improvement in your skin condition.


Dealing with acne during the perimenopausal phase can be a frustrating experience.  And while it’s a common part of aging for many women, it’s important to remember you have options to manage it.

  • Consult a dermatologist: They can offer treatments such as prescription creams or light therapies that may help.
  • Develop a skin care routine: Use gentle cleansers and non-comedogenic moisturizers to keep your skin balanced. Remember, over-washing can aggravate acne.
  • Consider lifestyle changes: A balanced diet and reducing stress can positively impact your skin.

Lastly, connect with others who are also navigating this phase in their lives. Sharing stories and solutions can provide comfort and practical advice. Remember, you’re not alone in this, and with some patience and care, you can maintain the health and appearance of your skin.