A Guide To Managing Perimenopausal Acne

animated woman with acne and magnifying glass on face

Even if you didn’t have to worry about them when younger, menopause can still bring unwelcome breakouts and acne. Although it may seem strange, this is a surprisingly common issue for many midlife women. Fluctuating hormones wreak havoc on women’s skin during the perimenopausal stage, leading to outbreaks of acne reminiscent of the teenage years. With delicate hormone levels out-of-whack, our body’s natural defences struggle to keep breakouts in check.

Causes of Perimenopausal Acne

When it comes down to the root of perimenopausal breakouts, hormones are responsible, but let’s explore this a little further.

close up of woman's cheek with acne and pigmentation

Decreased estrogen

When a woman enters menopause, her body undergoes major changes due to the rapid decrease in estrogen levels. This shift disrupts androgen production; testosterone is especially affected. Even though it happens naturally with age, it can be unsettling for many women as their bodies experience this transformation. Just as with other transitions like puberty or adulthood, the balance between estrogen and testosterone can cause unwelcome breakouts. When estrogen levels decrease significantly, it causes an increased production of testosterone which results in clogged pores and oily skin on the lower face – due to more receptors being present there. A disruption of this hormone equilibrium is a common player when sudden acne appears during any stage of life.


Menopause, particularly during the peak perimenopausal stage, can be an extremely stressful time for a woman, and unfortunately this stress has the potential to cause unwelcome outbreaks of acne. It’s even possible that rising levels of cortisol in the body – sometimes known as ‘the stress hormone’ – could lead to increased oil production on your skin which brings about breakouts. While managing these heightened emotions isn’t ever easy, it is essential to do what you can throughout menopause (and before and after) to try reduce any extra stresses or worries where you can.

How do women feel when they come to you about menopausal acne?

Acne can cause more than just skin deep issues, especially for women going through menopause. As a vicious circle it triggers unhappiness and social anxiety, worsening the acne due to increased stress hormones. Teens may accept spots as normal but adults rightly seek help when dealing with such impacts on mental health, confidence and wellbeing – particularly if they have to face this mid-life challenge at 50 years old. Treatment is key in reducing these effects so that sufferers can get back their lives without feeling stripped of self worth or happiness.

How do I know if my acne is hormonal or regular acne?

pink pills collating as a question mark with pink background

Adult skin care concerns can be especially heightened during menopause. What many don’t know is that the source of breakouts and acne, whether for teens or adults, has a similar root cause: ineffective exfoliation leading to clogged pores brimming with bacteria-friendly sebum build-up. Perimenopausal issues often trigger these unpleasant reactions – so keep in mind this common understanding if you’re looking for ways to help your flares.

What about menopause acne and redness?

A common misconception is that Rosacea and Acne are the same, but these skin conditions couldn’t be more different. Rosacea causes impaired protection of the skin, whilst those with acne typically have oily surfaces that can be more resilient.

Rosacea affects the cheeks and nose with small red bumps, sensitivity to touch and dilated blood vessels. Acne is a more extensive problem that can appear on any body surface in many different forms, from whiteheads to blackheads, pustules or cysts.

What is the best treatment for perimenopausal acne?

Menopause acne can feel overwhelming, but with the right advice from a professional and some trial-and-error exploring of treatments – both skincare products or in shifts at an aesthetic clinic – you can find something that works for your unique skin. Going on this journey with informed confidence is always the best way forward.


Acne may not be a bacterial infection, but antibiotics can soothe deep and painful skin outbreaks.

Steroid Cream

Steroid creams can bring relief to those struggling with certain varieties of acne. However, topical creams won’t necessarily be effective if the underlying issue lie with an imbalance of hormones.

Hormone Balancing 

If your hormones are out of whack, hormone-balancing medication can get them back on track.


To achieve the best complexion, creating an individualized skincare plan that assesses your lifestyle and diet can be highly effective. Adding a supplement like zinc can also work wonders for skin health. Additionally, combining at-home products with in-clinic treatments such as chemical peels or HydraFacial’s will take care of any present breakouts while helping keep those pesky pimples away in the future.

Skincare tips for perimenopausal acne

woman holding skincare cream pumping onto finger

  1. Choose a suitable cleanser 

When it comes to clean skin, your cleanser is the cornerstone of success. Steering clear of overly active ingredients is usually a safe bet, although when dealing with perimenopausal acne, reaching for one mildly formulated with Salicylic Acid could be just what you need. Otherwise Vitamin C can often cause an undesirable reaction – so proceed carefully.

2.  AHA moisturiser 

For breakouts, don’t reach for the rich ceramide-filled moisturisers – they could make the issue worse. Instead go with a good AHA to help speed up skin cell turnover and keep blemishes at bay.

3. Use Retinol 

For smooth skin, opt for topical retinoid creams. Not only will they clear up pesky breakouts but also work wonders on lingering acne scars or marks. It works to penetrate the cells and reduce inflammation and oil production to help keep your pores looking refreshed whilst boosting cell turnover so you can glow with confidence.

When using Retinol for the first time, start off small by using a pea-sized amount once per week at night, then gradually increase to twice and three times weekly. Over the course of several weeks, you’ll build up your tolerance so that you can eventually apply nightly without any redness or discomfort.

4. Consider Benzoyl Peroxide 

Benzoyl peroxide has a powerful punch when it comes to treating acne. For mild to moderate cases, there are many over-the-counter products readily available in various strengths. This treatment works by blasting the bacteria on your skin that causes breakouts and helps keep oil production low, pore clogs away and reduces redness & swelling associated with pimples – though not without its drying side effects, so an expert consult is always recommended for personalised care advice tailored just for you.

5. Use steroids for extreme or persistent acne 

Even if you’ve exhausted all other solutions, intense breakouts like nodules and cysts can have an effective treatment. Steroid injections provide a fast-paced solution to reduce inflammation and pave the way for your skin’s healing process.


Perimenopausal acne can be an unwelcome surprise, but luckily there are a variety of treatments to consider. From home remedies to potentially more invasive solutions, consulting with a board certified dermatologist is the best way to ensure you find something that works for your body and lifestyle!

Leave a Reply

Your email address will not be published. Required fields are marked *