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21st October, 20215 min read

Menopause acne: causes and treatment

Medical reviewer:Dr Adiele Hoffman
Author:Wendy Davies
Last reviewed: 22/10/2021
Medically reviewed

All of Healthily's articles undergo medical safety checks to verify that the information is medically safe. View more details in our safety page, or read our editorial policy.

Skin breakouts during the menopause

The menopause, when you stop having periods, can cause lots of different symptoms, including oily skin, spots and acne. Some people only get acne for the first time when they’re adults, and menopause is a common trigger.

Learn more about why you might get acne during the menopause and the time leading up to it (perimenopause), and what you can do about it.

What causes acne during the menopause?

Like other perimenopause and menopause symptoms, if you get acne during this time of your life, it’s probably caused by changing hormone levels.

During perimenopause, your levels of the hormone oestrogen start to drop, so you have less oestrogen compared with your male hormones (androgens) than you did before. This means androgens may have more of an effect on your body.

Testosterone is the androgen that plays the biggest role in hormonal acne. It can cause your skin to make too much of an oil-like substance called sebum, which can then block your pores and lead to a breakout of spots.

Acne can also be triggered by a few different things in adulthood, including certain medications and skin products. Read more about what causes adult acne.

When to see a doctor about menopause acne

If you have mild acne, you could treat it without going to the doctor, by asking a pharmacist for advice.

However, it’s best to see a doctor if you have moderate or severe acne, to help prevent scarring.

If you have severe acne, you may already have some scarring. You’ll have lots of large, painful spots. These may be:

  • cysts – big lumps that are filled with pus
  • nodules – big, hard lumps underneath the skin’s surface
  • papules – small red bumps that may be sore
  • pustules – similar to papules, but with a white tip

Read more about when to see a doctor about acne.

Treatment for menopause acne

There are several ways to treat menopause acne, including prescribed medication, pharmacy treatments and lifestyle changes.

Hormone replacement therapy (HRT)

Available as tablets, patches or a gel, hormone replacement therapy (HRT) can be an effective way to treat perimenopause and menopause symptoms, including acne.

It replaces the hormones you lose at this time and contains either a combination of oestrogen and progestogen (a synthetic version of progesterone), or just oestrogen.

The progestogen in HRT can occasionally trigger acne. However, it’s not safe to stop this part of HRT if you have a womb (uterus), so you should talk to your doctor if you have any concerns, or if you want to discuss whether HRT is suitable for you.

Pharmacy treatments

There are several acne treatments you can buy from a pharmacy, including:

  • benzoyl peroxide – an antiseptic that helps reduce the number of germs (bacteria) on your skin
  • salicylic acid – a chemical exfoliator that helps unblock your pores and reduce the amount of sebum your skin makes
  • niacinamide – a gel that can help reduce acne redness, swelling and oil production

Read more about acne treatments available from a pharmacist.

Prescribed medications

If your acne doesn’t get better after trying pharmacy treatments, your doctor may prescribe medication, such as:

  • antibiotics you apply to your skin (topical) or take (oral)
  • retinoids, which can also be topical, or taken as tablets when prescribed by a skin specialist (dermatologist)
  • azelaic acid

Read more about prescribed acne medications.

General skincare

To help prevent menopause acne, there are things you can try as part of your daily skincare routine, including:

  • washing your face gently with a mild soap or cleanser and warm water. Avoid doing this more than twice a day, however, as too much washing can make spots worse
  • avoiding make-up, as it can block pores. If you do wear it, choose products that are water-based and oil-free
  • not picking or squeezing your spots – this can cause scarring

Menopause and skincare

Lifestyle changes

Other lifestyle factors can also play a part in menopause acne, so you may want to try making some changes.

Stress may trigger menopause acne, so it could help to try to lower your stress levels and relax. Read about how to manage stress.

Eating a healthy, balanced diet is good for your general health and may also help reduce your chances of acne. It’s also thought that some foods may trigger acne, including cow’s milk and foods with a high glycaemic index, such as sugary foods.

Not getting enough sleep may also be a trigger for menopausal acne, so try some techniques to help you get better sleep.

Finally, here’s another reason to stop smoking: smoking means you’re more likely to get acne scars.

Read more about lifestyle changes that may help your skin.

Your health questions answered

  • Does acne go away after menopause?

    Menopause acne is usually caused by changing hormone levels, so when your hormones have settled postmenopause, your acne should get better. For some people, however, this can take a long time. See a doctor if you’re worried about menopause acne.

Key takeaways

  • acne is a common symptom during perimenopause and menopause
  • it can be caused by changing hormone levels in your body
  • mild acne can usually be managed with skincare and pharmacy treatments
  • see a doctor if you acne is more severe – they may prescribe other treatments
  • once your hormones have settled postmenopause, your acne should improve
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