As a teenager, acne is par for the course — you know, because of that whole raging hormones thing. But once you reach midlife, those pimples should be long gone, right? Not necessarily. Menopause — along with the stage right before this, called perimenopause — can cause your skin to erupt with blemishes. But, this time, instead of skyrocketing hormones, it is caused by the fact that they are plummeting.
According to experts, it’s crucial not to treat menopausal acne the same way you did teen breakouts because aging skin has different needs. One thing to note: For the sake of brevity, when referencing acne caused by perimenopause and menopause in this story, I’m just calling it by the latter.
To find out exactly how you should treat midlife breakouts, I spoke with medical professionals. I also asked them for products that can help address menopausal acne and to explain why this stage in life can cause skin issues.
The best products to treat menopausal acne
To round up the best products to treat menopausal acne, I asked dermatologists and medical experts for their top recommendations. I also sourced favorites from NBC Select staffers who are in perimenopause.
Best cleanser
This cleanser comes recommended by Dr. Shamsa Kanwal, a board-certified dermatologist and consultant at the beauty hub My Psoriasis Team, because it addresses acne without stripping skin.
One of the things that happens during menopause is your epidermal turnover slows down, so dead skin cells build up and can clog pores, says Marlee Bruno, a board-certified physician associate and founder of Mind Body & Soul Medical. The fragrance-free face wash contains salicylic acid to exfoliate that skin and reduce blemishes. It also contains three different ceramides to nourish and protect the skin’s barrier.
Best moisturizer
One of the side effects of the hormones that drop during menopause is that your skin starts producing excess oil — which is why you may start to get more blemishes, says Kanwal. That said, you don’t want to dehydrate your skin — that can kick oil production into an even higher gear. Instead, try a lightweight moisturizer, like this one from Medicube. It contains squalane to hydrate and niacinamide to boost skin’s moisture barrier, according to the brand. It also contains hydrolyzed collagen to maintain your skin’s firmness and elasticity, making it a nice choice for older skin.
NBC Select senior editor Shalwah Evans is a devotee of this moisturizer, saying she particularly likes it in the summer months when she’s even sweatier and hot flashes feel compounded.
Best serum
I’ve been using this serum for about a month and have noticed a significant reduction in blackheads around my chin and jawline. The main ingredient in this serum is mandelic acid, which exfoliates without being too harsh, according to the brand. The serum can be applied to areas you are breaking out in to help clear skin, but it can also be used all over to give you a glowier look overall.
Best retinoid
Kanwal says this is one of the better over-the-counter retinoids available. It exfoliates skin to get rid of pimples and also helps increase cell turnover and stimulate collagen to help mild scarring and pigment go away over time, according to the brand. When you first start using it, you should only use it a few times a week so your skin gets used to it. You can talk to your derm about when and how to ramp up use after your skin is acclimated to it.
Best spot treatment
Evans swears these are the best pimple patches she’s ever used. “I’ve tried nearly every patch on the market and these are the only ones that really worked, especially when I had cysts that looked and felt terrible,” she says.
The hydrocolloid patches are infused with salicylic acid, retinol and aloe vera to absorb oil and soothe inflammation. You get a total of 20 patches in a box and you should use them on clean skin. Evans says she also likes the Peace Out 2% Salicylic Acid Early Stage Acne Dot to combat her perimenopausal breakouts when she feels one budding.
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How I picked the best menopausal acne skin care
If you are going through “the change,” all of the experts I spoke to recommended talking to your doctor about bioidentical hormone replacement therapy (commonly called HRT) — a process that can replenish some of the hormones you’re losing during menopause and, therefore, ease the symptoms. In the meantime, there are ways you can directly address acne caused by menopause. To pick products that will support your skin, rather than strip it, experts suggest paying attention to these factors:
- The right kind of hydration: Here is where things get a little complicated. Declining hormones can cause a loss of moisture throughout your entire body. At the same time, lowering androgens like testosterone (yes, women have testosterone, too) can cause an increase in oil production around your jawline, says Bruno. And if you don’t hydrate your skin, your oil glands will go into overdrive. So, what should you do? The key is to hydrate with a lightweight moisturizer. Gel or lightweight lotions tend to work well for this time of life, according to our experts. And look for ingredients like hyaluronic acid, ceramides, and peptides to support hydration and barrier function, says Dr. Sonia Badreshia-Bansal, a board-certified dermatologist and co-founder of EliteMD.
- Create a gentle routine: You may be tempted to throw the acne kitchen sink at your skin once a breakout occurs, but that would be a mistake. “I recommend a gentle, consistent routine rather than an aggressive one,” says Kanwal. “A non-comedogenic moisturizer and a mild salicylic acid cleanser can help keep pores clearer without stripping the skin. I also recommend being careful with heavy oils, fragranced products and over-exfoliation, because those things can irritate skin.”
- Try a retinol: “Retinoids are one of the most studied ingredients we have and they directly address clogged pores and collagen loss,” says Bruno. However, they can also irritate skin, so you need to be careful. Bruno recommends starting slowly by using one a few times a week and then gradually increasing usage to see how your skin tolerates it.
Why does menopause cause acne?
Before you can understand why menopause can cause acne, it’s helpful to understand a few basics about this time of life. Here’s a quick primer:
A woman is officially in menopause when she hasn’t had a menstrual cycle for 12 months. The period that proceeds that is technically called perimenopause — though many people use the term menopause for both stages. During perimenopause, hormone levels — like estrogen, progesterone and testosterone — are consistently dropping, says Dr. Cristina Del Toro Badessa, a board-certified physician specializing in personalized and integrative medicine and director at Artisan Plastic Surgery. These hormone fluctuations can cause a slew of symptoms — including hot flashes, brittle or thinning hair, brain fog, skin breakouts and more.
When it comes to your skin specifically, these hormone deficiencies can cause increased oil production, especially in your lower face — which is why many women start noticing jawline and chin acne, says Bruno. Another thing that happens is skin cell turnover slows with age. “Studies show epidermal turnover decreases by 30 to 50 percent,” says Bruno. “This means dead skin builds up faster and clogs pores easier.”
Finally, stress can play a major role in blemishes at midlife. “Middle aged women are usually dealing with higher stress loads and cortisol has been shown to increase sebum production and inflammation,” adds Bruno. “Really, it’s not a single thing that causes the acne — it’s a perfect storm of more oil, inflammation and slower regeneration.”
How do you get rid of menopause acne?
“I often see patients try to clear up midlife acne the same way they did as a teenager — using strong products and scrubbing the face,” says Bruno. “This will weaken the skin barrier and create even more issues like inflammation.”
The ideal is to take a more mature approach. “I suggest using a gentle cleanser, a retinoid to normalize cell turnover and ingredients like niacinamide or azelaic acid that calm inflammation and regulate oil,” says Bruno. “Sleep and stress also matter in this equation. There’s real data linking poor sleep quality to increased inflammatory skin conditions, including acne. If your cortisol is constantly elevated, your skin will show it.”
Both Kanwal and Bruno also highlight that bioidentical hormone replacement therapy can also make a big difference. A doctor can prescribe things like estrogen patches and progesterone to replace some of the hormones you are losing, which can alleviate symptoms — including acne, hot flashes and beyond.
Meet our skin care experts
At NBC Select, we work with experts with specialized knowledge and authority based on relevant training and/or experience. We also ensure all expert advice and recommendations are made independently and without undisclosed financial conflicts of interest.
- Dr. Shamsa Kanwal is a board-certified dermatologist and consultant at the beauty hub My Psoriasis Team
- Marlee Bruno is a board-certified physician associate and founder of Mind Body & Soul Medical
- Dr. Sonia Badreshia-Bansal is a board-certified dermatologist and co-founder, CEO, and medical director of EliteMD in Danville, California
- Dr. Cristina Del Toro Badessa is a board-certified physician specializing in personalized and integrative medicine and director at Artisan Beaute, a medical spa in Atlanta
Why trust NBC Select?
I am a commerce editor at NBC Select and a journalist who regularly covers beauty, home and lifestyle. I have written about double cleansing, taking care of the skin on your hands, spicule skin care and more. For this story, I spoke with skin experts on what causes acne during menopause.
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