Up to half of all women will experience pimples as an adult at some point during their lives. It's common to have acne outbreaks during pregnancy or right before your period. But it's also common to get acne during or following menopause. In all of these cases, you can blame your hormones for your complexion problems.
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Your skin produces oil in response to hormonal signals from androgens, a group of male hormones that includes testosterone. If you have too much androgen in your body, you'll produce too much oil and get pimples. In menopause, your levels of the female hormones estrogen and progesterone drop, which can emphasize the effect of androgens on your system and lead to oilier skin. Oilier skin leads to more clogged pores, which in turn leads to more pimples and bacterial infection.
Acne in a woman past menopause potentially can indicate a more serious condition, according to the American Academy of Dermatology. A post-menopausal woman who suddenly gets acne might have a tumor that secretes hormones in one of her ovaries or in her adrenal gland. She might also have developed type 2 diabetes--the American Diabetes association says that up to 1/3 of all diabetics suffer from skin complications, including lesions that can look like acne.
In the majority of cases, however, acne after menopause doesn't indicate any other medical condition, and you can focus on getting your skin clear without worrying about other health concerns. Since the cause is hormonal, your first line of treatment might be hormonal as well--hormone replacement therapy containing estrogen and progesterone can help to halt pimple outbreaks. If you also suffer from other menopausal symptoms, such as mood swings, insomnia and anxiety, hormone replacement therapy could be an option. However, recent research indicates that hormone replacement therapy can increase your risk of heart disease.
Dermatologists also prescribe spironolactone, a diuretic with anti-androgen properties, for post-menopausal acne. The drug causes menstrual irregularities in many women who still menstruate and also can cause you to lose water, but an eight-year study published in 2002 in the Journal of Cutaneous Medicine and Surgery indicated spironolactone can safely treat acne in women.
In addition to using a gentle cleanser once or twice a day, you may need to take an oral antibiotic to knock out any bacterial infection driving your post-menopausal acne, according to the AAD. In addition, low doses of the acne powerhouse drug isotretinoin have helped adults in their 50s and 60s successfully beat their pimples.