Maria was 47 and dealing with acne for the first time since her twenties. Her period was irregular, her sleep disrupted, and her skin felt like it was going backward. 


Just when you thought you were done with acne after your teen years, perimenopause and menopause can bring back an unwelcome surprise: adult breakouts. This type of acne is often frustrating and confusing, but it's a common issue that many women face during this stage of life. The good news is, there are effective ways to manage it.


Let's explore what causes menopausal acne and how you can support your skin from the inside out..

Why Acne Happens During Perimenopause:

Teenage acne is typically linked to a surge in androgens, hormones like testosterone, which drive up oil production. Menopausal acne, however, is a different story. It’s caused by a decline in female hormones, particularly estrogen and progesterone, which throws the ratio of your hormones out of balance.


Here’s a simple breakdown of the hormonal shift:


  • Estrogen Drops: Estrogen helps keep your skin plump, hydrated, and firm. As it declines, your skin can become thinner and drier.
  • Progesterone Drops: Progesterone has a calming effect on the body. As it falls, your skin can become more sensitive.
  • Androgens Stay Constant: While estrogen and progesterone are decreasing, your androgen levels remain relatively stable. This creates a state of "androgen dominance," where the effects of hormones like testosterone are more pronounced.


This hormonal imbalance leads to overactive oil glands, which can clog pores and cause breakouts. These pimples often show up as deep, painful cysts on the jawline, chin, and neck, and they can be more persistent than teenage acne.

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Beyond Hormones: Other Factors at Play

While hormones are the primary cause, other factors can make menopausal acne worse. Addressing these can significantly improve your skin.


  • Stress: The hormonal changes during menopause, combined with life stressors, can lead to elevated cortisol. This stress hormone triggers increased oil production and inflammation, making breakouts more likely.
  • Gut Health: A healthy gut microbiome is crucial for hormonal balance and reducing inflammation. As you age, your gut health can change, which can impact your skin.
  • Inflammatory Diet: Consuming too many processed foods, sugar, and dairy can fuel inflammation in the body, which directly contributes to acne.

What Can Help:

You’ve likely heard a lot about hormonal acne, but it's these other underlying issues—like chronic inflammation, gut imbalances, and stress—that are often the missing pieces of the puzzle. They’re the reasons why so many conventional treatments fail to provide lasting relief.


I take a deep dive into these exact topics and more in my free webinar, 3 Reasons Your Acne Isn’t Clearing (That Your Doctor Never Told You).


If you're tired of guessing games and ready to learn what's truly behind your stubborn breakouts, this webinar is for you.