Menopause Acne: What to Know About Causes and Treatments

Key Takeaways:

• It’s common to experience acne during menopause, typical as a result of fluctuating hormones. 

• Treatment options for menopause acne include over-the-counter (OTC) products and prescription medications, which may be hormonal or non-hormonal.

• A variety of lifestyle changes can also help prevent or reduce menopause acne. Consider avoiding harsh products or anything that can clog pores, keeping your face clean, and reducing stress.

From hot flashes and night sweats to vaginal dryness and mood shifts, menopause can bring about many changes that stand to affect various avenues of women’s health — and skin health is no exception. Enter: menopause acne.

Menopause acne happens as a result of fluctuating hormone levels. Other factors, like genetics, diet, and skin care routine, may also contribute to menopause acne.

The good news is that if you experience menopause acne, a variety of effective treatments are available to help you manage flare-ups.

Below, get additional details on menopause acne, including its causes and various treatments that can help.

Menopause acne happens around the time of menopause. It’s a form of adult acne, which is acne that occurs outside of your teen and adolescent years, typically after the age of 25.

Acne is pretty common in women who are going through perimenopause (aka the transition stage before menopause) and menopause. One study found that 26.3 percent of female participants aged 40 to 49 and 15.3 percent of those over age 50 reported experiencing acne. (Many women go through perimenopause between the ages of 45 and 55, and 52 is the average age of menopause onset in the United States.)

According to a 2024 review of adult acne and the influence of menopause, there are a few hallmarks of menopause acne, in particular. For example, this form of the skin condition often impacts the area around the mouth and lower chin and may involve deep inflammatory nodules or cysts. Notably, acne that occurs deep in the skin can be painful and persistent. It’s also more prone to scarring. The review also noted that whiteheads and enlarged pores may appear around the cheeks and nose in cases of menopause acne.

Sex hormones are a significant contributor to menopause acne. During this stage of life, the ovaries quickly begin producing less estrogen and progesterone while the levels of hormones called androgens tend to decrease more gradually. For many people, the resulting hormonal imbalance can mean clogged pores and skin irritations.

Estrogen receptors are found in your skin. The hormone can help protect against acne by inhibiting the activity of sebaceous glands, which make an oil called sebum.

Meanwhile, androgens like testosterone and dihydrotestosterone (DHT) actually boost sebum production. A lower proportion of estrogen to androgens can lead to a hormonal imbalance that promotes a skin environment where acne is more likely to occur.

Non-Hormonal Causes of Menopause Acne

In addition to hormonal changes, several other factors can contribute to or aggravate menopause acne:

• Genetics: Researchers have identified a variety of genes that are associated with acne. This means that if other women in your family experienced menopause acne, you may be more likely to develop it as well.

• Diet: Consuming certain types of foods can contribute to acne. One 2020 study found a significant associating between a higher intake of fatty foods, sugary foods, and milk and adult acne.

• Stress: An increased level of stress is common during perimenopause, and a 2016 study listed high levels of psychological stress as a risk factor for adult female acne.

• Cosmetic products: Some cosmetic products, such as those containing oils, are comedogenic, meaning they contain ingredients that may clog pores and lead to acne.

There are several treatments available to help manage menopause acne, including over-the-counter (OTC) products and prescription medications.

Over-the-Counter Treatments for Menopause Acne

If you have mild acne, topical OTC products may be effective for keeping it in check. To treat adult acne, the American Academy of Dermatology (AAD) recommends using products that contain the following active ingredients:

• Adapalene: A retinoid that can help reduce inflammatory acne and improve signs of aging

• Azelaic acid: An anti-inflammatory ingredient that works to unclog pores and has antimicrobial properties

• Benzoyl peroxide: An ingredient that can unclog pores and that also has antimicrobial properties

• Salicylic acid: An active ingredient that exfoliates your skin and unclogs pores

A 2019 review suggests exercising caution with benzoyl peroxide, which may exacerbate dryness or skin irritation in women of advanced age. Opting for a low-strength version may help mitigate these effects.

Prescription Treatments for Menopause Acne

Spironolactone is a prescription medication that has anti-androgen effects. It works by reducing the oil production in your sebaceous glands and can either work alone or in conjunction with combined oral contraceptives (COCs). (COCs contain estrogen and progestin (a synthetic progesterone) and work by reducing the production of androgens and sebum).

A 2020 study found that a daily spironolactone dosage of 100 milligrams (mg) in people with adult acne led to a positive response in two-thirds of participants. About 85 percent of participants had a partial or complete response to spironolactone treatment.

Antibiotic Treatments for Menopause Acne

Healthcare providers may prescribe oral antibiotics for inflammatory acne that doesn’t respond to topical medications. These medications kill bacteria and may also help to lower inflammation.

Some examples of antibiotics that may treat acne include tetracyclines like doxycycline and minocycline. Another option is macrolides like azithromycin and erythromycin.

A 2024 review notes that antibiotics should be used for no more than 3 months. It also notes that antibiotics may be ineffective in adult women.

Another non-hormonal option for acne is isotretinoin, an oral medication sold under the brand names Absorica^®, Claravis^®, and Zenatane^®. Providers may prescribe it for severe acne that’s cystic and nodular and has been resistant to other treatments.

The exact way that isotretinoin works isn’t known. However, researchers have found that it can effectively reduce oils released from sebaceous glands, limit levels of bacteria associated with acne, prevent clogging of pores, and lower inflammation.

In addition to the aforementioned medical treatments, several lifestyle changes can help you prevent or improve menopause acne. These include:

• Prioritizing skin care products that are labeled as “non-comedogenic” or say that they “won’t clog pores”

• Applying a moisturizer designed for acne-prone skin if your face starts to feel dry

• Keeping the skin on your face clean by gently washing your face with a mild cleanser when you wake up in the morning, before going to bed, and after sweating

• Resisting the urge to touch, squeeze, or pop existing pimples or menopause acne cysts

• Finding effective ways to reduce stress in your daily life

• Eating a healthy, balanced diet

If you’ve also just started treating your menopause acne, it’s important to be patient and give your treatment time to work. It may take several weeks before you start to see results using many acne treatments.

It’s common to experience acne as an effect of menopause. One of the main causes of menopause acne is hormone fluctuations, although factors like genetics, diet, and stress levels can also contribute.

Several treatment options are available for menopause acne. Using OTC products may help if your acne is mild. There are also prescription medications, both hormonal and non-hormonal, that can help manage menopause acne.

If you’re currently dealing with menopause acne, make an appointment with a healthcare provider like a board-certified dermatologist. They can recommend a treatment plan that meets your individual needs and is appropriate for the severity and type of acne that you are experiencing.

How many women experience menopause acne?

Some research has found that 26.3 percent and 15.3 percent of women in their 40s and 50s, respectively, report experiencing acne. It’s common for women to go through perimenopause and menopause in their 40s and 50s.

Where does menopause acne typically pop up?

Menopause acne typically appears in the area around the mouth and chin.

Are certain types of acne more common in menopause?

Types of acne found deep in the skin, like nodules and cysts, are common in women in menopause.

Is menopause acne related to hormones?

Yes. An increase in androgen levels relative to a decrease in estrogen levels plays a big role in menopause acne.

How long does menopause acne last?

Women who are postmenopausal may notice that their menopause acne eventually clears as hormone levels stabilize. However, others may continue to experience breakouts.

Can hormone replacement therapy help with menopause acne?

Hormone replacement therapy (HRT) supplements estrogen and progesterone levels and can often address symptoms of menopause like hot flashes, night sweats, and vaginal dryness.

One 2025 review notes that HRT may have a positive effect on skin changes in menopause, but current evidence doesn’t support using it specifically for skin issues.

What’s the best diet for menopause acne?

A healthy, balanced diet has a number of benefits for your overall health. Research suggests that fatty foods, high-sugar foods, and milk could boost the risk of acne, so consider lowering your intake of these items.