This just isn’t fair. You thought you left spots behind in your teens…
Now you’re a grown woman and you’re in breakout hell. What are you meant to do? Mix blemish treatments with your anti-wrinkle cream?
Yes, sadly it’s true. Acne during the menopause. It’s estimated that a quarter of women in their forties and 15% of women aged 50 or older suffer from problem skin.
Just like during puberty, hormonal fluctuations are mainly to blame. As our bodies enter the menopause, oestrogen declines but the level of androgens (male sex hormones) stay the same. Androgens can overstimulate oil glands and clog hair follicles, so this imbalance can lead to acne.
Even if you are taking HRT to replace oestrogen in your body, you may still have to deal with unpleasant pimples. This is because hormone replacement therapy floods your body with progestin which can also upset your skin.
In contrast to teenage acne, which peppers your forehead, nose and chin, menopausal acne typically pops up on the bottom of your cheeks and around your jawline.
You might also find you have spots now when you didn’t have them when you were young. Dermatologists are finding that instances of acne in older women have been increasing for the last 10-20 years, with women often battling with breakouts for the first time as they reach middle-age.
Our advice and guidance
We understand developing acne can be deeply upsetting. It can make you self-conscious and undermine your confidence.
But before you attack your face with every treatment under the sun to try and banish a crop of hormonal spots, please take a deep breath and read on.
How bad is it?
Acne can take the form of blackheads, whiteheads or cysts that are sore but don’t come to a head on the surface. The latter is due to oil and dead skin cells building up deep in your follicles and causing a boil-like infection.
Talk to your doctor, particularly if your skin is very inflamed or you keep getting cysts. They can advise on whether you need prescription medication.
Is anything else going on?
Too many androgens – either natural or because of taking them (like testosterone therapy) can also cause extra hairs on the face and other ‘male body changes’ like deepening voice, greasy hair, hair loss and growth of the clitoris.
If you’ve noticed any of these signs in addition to acne, then please also go and see your GP. Most older women with angry skin have normal androgen levels – but occasionally other hormonal irregularities can be at fault.
Don’t go cleansing crazy
Although it’s tempting to exfoliate the hell out of your face or slap on a tonne of anti-blemish gel – don’t go mad trying to exterminate your pimples. You’ll either dry out or further irritate your skin, and make it produce even more oil to overcompensate.
Use gentle, non-comedogenic products that don’t clog your pores or strip your skin. If you do want to try acne treatments, then only use a pea-sized blob. Cleanse your face in the morning and at night. Resist washing it more than this.
If you’re not sure what to do for the best, then get some help from a registered dermatologist.
It can take 8-12 weeks of sticking to one routine to see a real difference in the condition of your skin.
So be patient and, above all, be consistent. Chopping and changing your plan of attack will only confuse or irritate your system and make your acne worse.
Play spot the difference
The exact role of diet and acne is still being investigated, and different women will have different diet sensitivities.
Although the exact role between hormones in dairy products and hormonal acne is still being investigated, recent studies have suggested that consuming dairy products containing hormones may make you more prone to acne. If you do decide to cut out or cut back on dairy products, take a supplement to ensure that you’re getting enough calcium and Vitamin D to maintain good bone health.
Scoffing a lot of sugar, refined carbohydrates like white bread and pasta, and red meat also isn’t a great idea if your skin is playing up.
Focus on cleansing yourself from the inside by eating whole grains and unprocessed fruits and vegetables high in antioxidants. Pop salmon, mackerel, and other kinds of fatty fish on your shopping list as they contain anti-inflammatory Omega-3. Drink plenty of water too as it will flush toxins from your skin.
Most importantly, find out what works for you by playing Inspector Clouseau and keeping a food and skin diary as you make changes.
Find time to relax
Researchers suspect that stress pumps up your body’s production of sebum, the oily substance that blocks your pores.
Calm down by doing yoga, meditating, or simply taking some time out of your day to go for a walk or read a relaxing book. It won’t just help your skin, it will help your body deal with a host of other menopausal symptoms.
Our advice to them
Acne can be a long-term problem, which is why our advice to them includes sticking to a single skincare routine as it can take up to three months to start working properly.
We’ve also suggested they reduce their sugar and dairy intake (and adds calcium and Vitamin D supplements), as these foods can trigger an outbreak – keeping a food diary of flare-ups can help them identify any other problematic ingredients. It’s also important they make time to relax, as stress can add fuel to the fire.
Go with the flow
You might notice they’re not as keen when you’ve made plans. The truth is going to social events when you’re under attack from acne can feel like a really big deal because often self-confidence takes a massive hit.
Be prepared for plans to change at short notice and try not to put them under any pressure, even if it means you are missing out as well.
Encourage them to speak to a doctor
If they have been struggling with acne for a while or it seems to be getting worse, gently encourage them to speak to a GP. You could even offer to go to the appointment with them to show your support.
Suggest a supplement
Some people find Omega-3 supplements help calm their skin.
Why not gently ask if they have tried anything like that?
The last thing someone needs when they’re dealing with pimples is for someone to draw attention to it by exclaiming: “Look at that mountain on your forehead.”
Don’t try to lighten the mood by making a joke about it. They might put on a brave face, but nine times out of 10 it’s not funny for them.
Instead, perhaps you could treat them to some new skincare that might help – but we suggest you sound them out first by asking if that’s something they would like, rather than just presenting them with a box of ‘stuff to sort out their face’.
Don’t take it personally
We appreciate it may feel like a personal slight if they are being off with you or generally withdrawn. But it’s most likely nothing to do with you.
Bear in mind that they might be feeling sensitive or physically rotten due to their fluctuating hormones. Take a deep breath and either ask them if anything is wrong or if she needs some space.
If you’re worried about acne, you should see your GP who can discuss your symptoms in the context of the menopause.
If you’d like more information, we have put some further references below for you: