Menopause Acne: What It Is and How to Get Rid of It
If you notice more blemishes on your face perimenopause or after menopause, then you are not alone!
One study found that 26% of women in their forties and 15% of women in their fifties and older experience acne.
Menopause acne is a type of hormonal acne that occurs during perimenopause and menopause. It is majorly due to hormonal changes. This article will discuss the symptoms, causes, and how to get rid of menopause acne.
Symptoms of Menopause Acne
Acne during menopause tends to look slightly different than adult acne. Acne in adults under the age of 40 typically presents as lesions on the lower half of the face. Menopausal acne can appear on the body or anywhere on the face.
Other symptoms of menopausal acne include:
- Closed comedones (whiteheads) that are visible when the skin is stretched
- Enlarged pores on the nose and cheeks
- Oily skin OR dry skin
- Lesions around the mouth
Acne can be mistaken for rosacea, an inflammatory skin condition, or folliculitis, which is a bacterial infection of the hair follicles. It is important to consult a dermatologist to ensure that you receive a proper diagnosis.
Causes of Acne During Menopause
Acne can have one root cause or multiple.
If you are experiencing acne for the first time during perimenopause, it is likely due to the natural hormonal changes that occur during menopause.
Hormonal Changes
After menopause, estrogen, which plays an important role in skin health, decreases rapidly.
Androgens, a group of hormones that include testosterone, decrease more slowly than estrogen. This often leads to excess androgen in the body that can cause acne to appear.
Excess hair on the face and the loss of hair on the scalp, which are also due to excess androgen, often occurs along with hormonal acne.
Polycystic Ovary Syndrome (PCOS)
Another source of hormonal imbalance can be polycystic ovary syndrome, known as PCOS.
In PCOS, women do not ovulate regularly due to a hormonal imbalance. This condition causes irregular periods, infertility, insulin resistance, and the development of cysts on the ovaries. Women that have PCOS also experience symptoms of hormonal imbalance like acne, excess hair on the body, hair loss on the scalp, and weight gain.
PCOS is typically diagnosed in adolescence. However, symptoms persist well into menopause.
Diet
White bread, potato chips, pastries, white rice, and similar foods that contain high amounts of carbohydrates without much fiber may be one culprit of acne.
These are high-glycemic foods and cause blood sugar to rise quickly.
Blood sugar “spikes” can cause inflammation in the body and excess sebum on the skin. Sebum is an oily substance that can clog pores and cause acne.
The American Academy of Dermatology suggests that cow’s milk may be linked to acne.
One study found that women who drank 2 or more glasses of skim milk per day were 44% more likely to have acne than other women.
Weight Gain
Women often gain weight due to menopause-related hormonal changes that cause a decrease in lean body mass. Due to visceral fat deposition, weight gain around the body’s midsection occurs more commonly in menopausal women.
Visceral fat is problematic because it can cause your cells to stop responding properly to insulin. This is known as insulin resistance.
In insulin resistance, blood sugar and insulin levels remain chronically high. Too much insulin can increase androgen levels and cause acne.
Chronically high blood sugar levels and PCOS can also cause insulin resistance.
Stress
Developing acne during menopause can be stressful. Unfortunately, stress can make your acne worse!
When you are in a stressful situation, your body releases cortisol and androgens. This stimulates oil production. Excess oil on the skin can cause acne to flare up.
Lack of sleep and anxiety can also cause stress on the body.
Other Lifestyle Factors
Acne remains a relatively mysterious condition, and it can be difficult to determine a singular root cause. Other things that may be affecting your skin during menopause include:
- Hair and skin products
- Smoking
- UV radiation
- Some medications
- Some undiagnosed medical conditions
- Family history
Healing Your Menopausal Acne
There are a number of actions you can take to begin healing your menopausal acne.
Change Your Diet
The American Academy of Dermatology suggests that a low-glycemic diet may be the key to reducing acne lesions.
A low-glycemic diet can also help to improve insulin resistance.
The glycemic index is a way of ranking foods according to their effect on blood sugar levels.
A low-glycemic diet includes slowly digested and absorbed foods, causing a small and gradual rise in blood sugar levels.
Grab a printable list of low-glycemic foods here.
Foods to Eat More Often
There is no restriction to proteins, fats, oils, and herbs on the low-glycemic diet because these foods do not contain any carbohydrates and do not affect blood sugar.
Low-glycemic foods include:
| Bread | Choose bread high in fiber like whole grain, multigrain, rye, or sourdough |
| Breakfast cereals | Steel-cut oats or bran flakes are good options |
| Fruits | Apples, apricots, blueberries, cherries, grapefruit, peaches, pears, strawberries, raspberries, tangerines |
| Non-starchy vegetables | Asparagus, artichoke, avocado, broccoli, cabbage, cauliflower, celery, cucumber, eggplant, greens, lettuce, mushrooms, peppers, tomatoes, okra, onions, spinach, summer squash, zucchini, turnips. |
| Starchy vegetables | Sweet potato, squash |
| Beans and legumes | Black eyed peas, butter beans, chick peas, green beans, kidney beans, pinto beans, lentils, lima beans, navy beans, snow peas, hummus |
| Grains | Barley, rye, bulgur, wild rice, wheat tortilla, wheat pasta |
Foods to Limit
Foods that you should avoid on the low-glycemic diet include:
- White bread
- Bagels
- Instant oats
- Sweetened cereals
- Potatoes
- Corn pasta
- Instant noodles
- White rice (Jasmine, Arborio, Calrose)
- Rice milk
- Oat milk
- Watermelon
- Pretzels
- Rice crackers
- Corn chips
- Sweet desserts
- Candy
- Sugar-sweetened beverage
Milk and Dairy Products
Cow’s milk is a low-glycemic food. However, research has shown that consumption of cow’s milk can cause an increase in acne breakouts. There is no scientific evidence that yogurt or cheese can cause acne.
Try avoiding cow’s milk for 1-2 weeks and see if there is any difference in the appearance of your skin. There are several plant-based milk options available to use instead.
Focus on Gut Health
Healing your gut may help to improve your skin.
One study found that patients with acne also tend to have gut dysbiosis, an imbalance of good and bad bacteria. It is best to have more good bacteria than harmful bacteria.
Diet and lifestyle factors can cause the gut to fall out of balance. Alcohol, sugar, and processed foods all negatively impact gut health.
Healing your gut can also help with other menopause symptoms.
To heal your gut:
- Eat foods rich in probiotics and prebiotics
- Aim to eat at least 25 grams of fiber every day
- Include healthy fats
- Limit sugar, alcohol, and processed foods
Get your prebiotics and probiotic food list here.
Stress Less
Since stress can make acne worse, one of the best things you can do for your skin is to develop healthy stress reduction techniques.
Take up a hobby you enjoy, practice deep breathing exercises, get enough sleep, and try meditation.
Exercise is beneficial because it can release chemicals in the brain that make you feel happier and improve self-esteem.
When to See a Dermatologist?
It can be helpful to consult your dermatologist if acne persists. Your doctor can prescribe oral and topical medications to help with your acne.
Medications
Spironolactone is often prescribed as a treatment for menopausal acne.
This medication works by blocking the effects of androgens on the body. It can cause high levels of potassium in the blood and should not be used by anyone that has kidney problems.
Other medications used in the treatment of menopausal acne include flutamide, hormonal therapy, isotretinoin, and antibiotics.
Topical therapies have the added benefit of reducing signs of aging. However, because they are applied directly to the skin, they can cause irritation. Topical retinoids are a type of medication derived from vitamin A and a mainstay of treatment for acne. Benzoyl peroxide, azelaic acid, and dapsone are other topical therapies used for menopausal acne.
Procedures
There are a number of procedures performed by a dermatologist or aesthetician that can be useful for perimenopausal acne.
These treatments can be especially useful for reducing skin inflammation and even preventing the skin from scarring. Comedone extractions can help lesions heal more quickly. Chemical peels and lasers are helpful for active acne and scarring.
The Bottom Line
Menopausal acne can be difficult to manage, but with the right knowledge and dedication, you can find relief.
Experts have suggested that a healthy diet low in glycemic foods and less milk effectively reduce acne associated with menopause.
Additionally, focusing on gut health and reducing stress can be helpful.
If acne persists despite home remedies, consulting a dermatologist may help – they are able to prescribe medications or suggest procedures that could make all the difference. It’s time to take control of your skin health and start healing!
“Menopausal acne” was written by soon-to-be Registered Dietitian Emily Carney. Edited by Dr. Su-Nui Escobar, RDN.
Dr. Su-Nui Escobar is a Registered Dietitian/Nutritionist in Miami, FL. She is passionate about helping women over 40 live their best lives through healthy eating and a healthy lifestyle. Su-Nui is a doctor in clinical nutrition, able to translate complicated evidence-based science into practical advice. Su-Nui is the former spokesperson of the Academy of Nutrition and Dietetics.