Just when you thought you'd got the hang of caring for your skin, along comes menopausal acne – Acne 2.0. Beauty writer Jocelyn Bailey shares her tips for tackling midlife hormonal breakouts.
🕒 6 min read
According to a study, more than one in four women in their 40s experiences adult acne, although only 15 per cent still have it in their 50s. What's going on?
During menopause and its approach (perimenopause), skin goes through a lot of changes. It's thinning and losing elasticity, and collagen is declining, so not only is your face developing lines and wrinkles, but pores look larger, too. It's often hypersensitive and prone to inflammatory conditions such as rashes, dermatitis, rosacea and, unfortunately, acne.
What is acne?
Acne is an inflammatory disorder that produces enlarged pores, blackheads, and spots; sometimes resulting in scarring and hyperpigmentation. No wonder it can affect confidence and quality of life.
The condition can have many contributory factors, most notably hormone changes. The perimenopausal period lasts between two and eight years and occurs between the mid-to-late 40s to early 50s. During this time, levels of oestrogen and progesterone begin to fall, so the proportion of androgens, including testosterone, becomes relatively higher.
This imbalance can lead to thinning hair, facial hair growth and excess sebum production. As pores become clogged, the back-up of oil turns those pores into breeding grounds for bacteria, resulting in blackheads, whiteheads and deeper, cystic under-the-skin spots, especially around the mouth, chin and jawline. With skin now repairing itself more slowly, scarring is another concern.
Fortunately, once those hormone fluctuations slow down and your body adjusts to steadier levels, things should improve. By the time menopause occurs in your early- to mid-fifties, acne problems should be declining.
Menopausal acne can run in families, so if your mother or other female family members had it, you're more likely to experience it, too. It also tends to occur more often in those who had it as a teenager. Alternatively, you may be unlucky and develop the condition without having had it before.
Acne or rosacea?
The good news is that menopausal acne is usually less severe than teenage acne. It's also worth noting that with skin also being more sensitive, assumed acne is often confused with rosacea.
Rosacea is largely a skin barrier problem, mostly affecting the cheeks and nose, and characterised by redness, sensitivity, small inflamed bumps and dilated blood vessels. In comparison, acne is oily and features a variety of blackheads, whiteheads and red cystic bumps across a wider area.
Treatments are different, too, with acne treatments potentially making rosacea worse. As a result, it might be worth checking in with a dermatologist to check you're treating the right issue.
MenoSerene
Vitamins, minerals and plant oestrogens to support women through the menopause
- Vitamin B6 to regulate hormonal activity, high dose of vitamin E
- Calcium, magnesium and vitamin D for healthy bones
- Phytoestrogens from soy and omega 3 from flax
What else might be causing midlife acne?
Health and lifestyle
This complicated condition can have lots of contributory factors, usually related to health and lifestyle. Maintaining a normal weight and taking regular exercise might help – and if you smoke, stop.
In addition, conditions such as diabetes, hypertension, high cholesterol, stress, insomnia, even the side effects of medication may be involved and, since many conditions (or their consequences) can overlap, it's best to ask your doctor for advice.
Diet and nutrition
Diet is often a major factor, with recent studies suggesting that dairy products may make you more prone to troublesome skin. But sensitivities vary; other common culprits include sugar, processed foods, refined carbohydrates (such as white bread and pasta) and red meat. Replace these with more wholegrains, fresh fruits and vegetables, nuts, seeds, legumes, and oily fish. Salmon and mackerel in particular contain omega 3 fatty acids, which are anti-inflammatory.
More phytoestrogen-rich foods such as soy, tofu, flaxseed, seeds, nuts and nut butters are also recommended. These foods contain weak plant hormones that latch onto oestrogen receptors in the cells and help balance your oestrogen levels if they're too low.
To identify your personal trigger foods, keep a food diary and try an elimination diet. Slowly returning them one at a time helps you uncover the likely culprit.
Do remember that if you eliminate a whole food group such as dairy, you may need to make up the nutrient shortfall with a supplement. Try MenoSerene, which contains calcium and vitamin D for good bone health, plus a plant oestrogen complex and vitamin B6 to help regulate hormone activity.
Alternatively, MultiVitality 50 Plus contains 25 vitamins, minerals and micronutrients to fill other nutritional gaps, since the Health & Food Supplements Information Service reports that nutrient absorption in the gut becomes less efficient with age.
Stress
Since adult acne is often upsetting, it can lead to a rise in cortisol (your stress hormone). This can, in turn, trigger more breakouts, so it's important to find ways to relax. Exercise, deep-breathing, yoga, meditation and anything that relieves stress can help and may even contribute to better sleep and weight control.
What you can do
Mild acne can often be controlled with the right skincare, although it can take up to 12 weeks to see a difference, so be patient. Gentle but effective cleansing is vital. Cleanse twice daily with a mild formulation like the Replenish Facial Wash. Take care to remove all cleanser residue by rinsing well or applying the Replenish Gentle Toner afterwards.
Resist picking spots, as it can cause infection and lead to scarring. If necessary, try spot treatments containing benzoyl peroxide. Long used for mild-to-moderate acne, it works by killing bacteria, minimising oil production and unblocking pores, but it can be drying and irritating if used too often, so follow directions.
Alternatively, retinol has the added bonus of smoothing lines and wrinkles as well as treating acne. It is a form of vitamin A that acts as an exfoliant, keeping pores free of excess oil, encouraging cell turnover, reducing inflammation and fading scars. Try the Replenish Intensive Pigmentation Reducing Complex or the Intensive Night Treatment Cream, whose retinol is time-released to reduce possible irritation, alongside antioxidant vitamin C and hydrating hyaluronic acid.
For daytime, the Vitamin C Serum includes antioxidant vitamins C and E, plus niacinamide and ferulic acid, which are both antioxidant and anti-inflammatory. These work synergistically to protect skin, shrink pores, calm blotchiness and reduce signs of ageing. Follow with the lightweight Vitamin C Face Cream, which also has niacinamide to even out skin tone, plus additional protective antioxidants and soothing, healing aloe vera.
Vitamin C Serum
Restores youthful radiance and targets fine lines
- Triple source vitamin C to support collagen formation
- Ferulic acid to work in synergy with other antioxidants
- With added hyaluronic acid and vitamin E
Adult acne treatment
If over-the-counter treatments don't help, your doctor may prescribe medication such as HRT (which, sadly, doesn't work for everyone), antibiotics (less popular because of rising antibiotic resistance) or spironolactone (which helps block androgen receptors, so it may prevent facial hair as well as acne.) There is help out there!