Menopause is often recognized for hot flashes and mood fluctuations, but it also brings along a variety of lesser-known symptoms, like changes to the skin.
Research indicates that many women experience skin issues as they age, especially some that haven’t troubled them since their teenage years.
Dr. Amy Wexler, a dermatologist and psychiatrist based in Manhattan, frequently treats women going through perimenopause and menopause who are facing acne, often for the first time in their lives.
“It can be really unsettling because they’re not used to it. It feels so unfamiliar,” she shared. “There’s a significant psychological aspect; acne can really affect self-esteem and confidence, leading to anxiety or even depression.”
Midlife Paradox
Wexler explained that women typically experience two phases of acne: once in adolescence and then again during perimenopause and menopause.
“Many women who haven’t had acne in years suddenly see breakouts around age 40,” she noted. “This time, it’s primarily around the lower part of their face, particularly the chin and jawline, where hormonal acne tends to flare up.”
Women between 35 and 55 often express concerns about having wrinkles alongside acne, feeling caught in a strange phase of life where they seem too young for wrinkles but too old to be struggling with acne again.
While men genetically prone to acne might see it persist into older age, women’s acne during this time is usually tied to hormonal changes occurring in their late 30s to early 50s.
Wexler indicated that breakouts tend to diminish after menopause.
Some studies hint that using GLP-1 medications and certain antidiabetic drugs might lead to increased acne, but this isn’t universally accepted.
“We encounter patients on GLP-1 regularly, so if there was a strong link, we might have recognized it by now,” she commented.
Treatment for Adult Acne
The primary approach towards aging-related acne often involves hormone-related medications.
“Spironolactone works particularly well for hormonal acne in women, as it prevents testosterone from linking to the receptors in the lower facial area,” she explained.
Additionally, hormone replacement therapies and oral contraceptives can aid in acne management, though treatments vary from individual to individual.
“Some patients might only have minor blackheads or whiteheads and may not need oral medications,” she noted.
For those who require topical treatments, options include retinoids known by names like Differin, Retin-A, or Tretinoin, which can help with both acne and have anti-aging benefits since they promote collagen growth.
Wexler mentioned sometimes prescribing low doses of doxycycline, which can act as both an antibiotic and an anti-inflammatory.
“If the acne is more extensive or affects large areas of the face, considering a lower dose of Accutane can be an option,” she said. “It all depends on individual circumstances and acne severity.”
Active Defense
Although genetics and hormones play a significant role in acne, stress is another contributing factor, according to Wexler. One major way to counteract this is by ensuring you get adequate sleep, which acts as an anti-inflammatory period for your body to recuperate.
“Regrettably, many Americans don’t get enough sleep,” she pointed out. “It’s advised that adults aim for seven-and-a-half to eight hours, which is when cortisol, the stress hormone, is at its lowest, allowing healing molecules to thrive.”
Besides rest, reducing cortisol levels throughout the day—through exercise, fresh air, social connections, stretching, and deep-breathing techniques—is advised to help alleviate stress.
Wexler also noted the critical importance of selecting appropriate skincare products if you’re prone to acne.
“It’s essential that all skincare products are non-comedogenic or oil-free,” she advised. “This means those products have been tested to ensure they won’t clog pores or worsen acne.”
Moreover, she emphasized the importance of cleansing your face post-exercise and before bed, as well as avoiding sleeping in makeup.
If you’re dealing with acne and don’t see improvement after two months of using over-the-counter treatments, Wexler recommends consulting a dermatologist.
