MenoLabs News | Wed, May 27, 2020

Maintaining healthy skin during menopause is a significant concern for women throughout the world. For many women, combating fine lines and wrinkles is the ultimate challenge, but did you know you may experience a third obstacle? Around 25 percent of women ages 40-49 experience menopausal acne. 

You may think that your battles with acne are over after puberty. Yet, for many women, hormonal acne continues to be a struggle well beyond their teenage years. As part of "Acne Awareness Month," we're taking a dive into menopausal acne. What is it? What causes it, and how can you treat it?

What Causes Menopausal Acne?

Menopausal acne is an increase of acne appearing on the skin leading up to and during menopause. It's most often seen on the face, but it can show up in other areas of the body. While menopausal acne is largely considered to be a type of hormonal acne, there are a variety of factors that can cause it, as well as worsen it. 

Why is it, for the most part, a type of hormonal acne? During menopause, hormonal levels become imbalanced. In the years leading up to menopause, these hormonal levels will fluctuate before they finally begin to taper off and decrease at a steadier pace. The two primary hormones that contribute to menopausal acne, particularly in women who experienced severe acne issues during puberty, are estrogen and androgen. 

We know what estrogen is, but what exactly is androgen? Androgens are a group of hormones that play a significant role in males; an example of a commonly known androgen is testosterone. Androgens occur naturally in women's bodies and are converted into estrogens. 

During menopause, a relative increase in androgens occurs just as estrogens begin to fluctuate and deplete. When these androgens cannot be converted into estrogens as effectively, they begin to manifest on the skin as acne. How does this happen? 

Androgens interfere with the growth and thickness of hair follicles on the skin. They cause thinner, colorless hair follicles to become thick and pigmented. When this happens, it becomes easier for oils to build up and get trapped in the pores of your skin. On top of that, androgens also stimulate the amount of oil released from your skin through the sebaceous glands. This oily substance, known as the sebum, helps lubricate the skin and hair follicles. 

Through the increase in the release of oils on the skin, coupled with the thickening of the hair follicles, your skin becomes the perfect breeding ground for bacteria and acne. 

Degrees of Menopausal Acne Vary

Because menopausal acne is largely attributed to changes in hormones, every woman will experience different degrees of acne. Some women only experience small areas of acne on the zones of their face (forehead, cheeks, and chin). Some women may have large patches of acne throughout their face, even around their lips and nose. Some women may develop deep-seated cystic acne, traveling from their faces down to their neck and in other areas of the body. 

Depending on the type of acne you have (mild, moderate, or cystic), your treatment options will vary. For women with mild acne, topical ointments, adjustments in diet, and even just changing the pillowcase more often can help reduce it. For women with moderate to cystic forms of acne, prescription-strength medications may yield more benefits. 

However, menopausal acne can be affected by factors other than changes in hormones. 

What Factors Can Worsen Menopausal Acne?

We live in a world full of dangers to our skin. Wind, rain, heat, and dry air are just a few natural harmful agents. What about aspects of our routine? What are some common factors that contribute to acne that we're not noticing? 

Stress

 

You've no doubt heard that stress exacerbates acne problems, but do you know why? Stress increases levels of stress-specific hormones, primarily cortisol. When cortisol levels are high, these hormones send signals to your sebaceous glands that it needs to make more oils.

Why? When you're stressed, your heart rate increases. When your heart rate increases, your body naturally prepares for your body temperature to rise with it. The body starts to release natural oils in the skin. Additionally, it starts to release sweat in an attempt to cool the body down. When combined, sweat and sebum clog up the pores of your skin and worsen acne. See the problem?

Reducing stress and stress-inducing circumstances can help reduce acne. So find ways to manage stressful situations, take in a few deep breaths, and keep your cortisol levels low. 

Diet

You may not think of acne when you think of the health issues you can address through diet. Changing your diet can help you maintain a healthy weight and maintain muscle mass, but it can also help keep your skin clear. 

Certain foods can increase blood sugar levels in the body. When blood sugar is high, the body quickly releases insulin to turn those sugars into stored energy. Having high insulin levels in your blood can stimulate your sebaceous glands and increase the production of oils in your skin. Adjusting your diet to include more fruits and vegetables and cutting down on refined sugar can help improve your acne. 

Dehydration

Another contributing factor that you may take for granted is dehydration. When we think of dehydration, we tend to think of dehydration's effects like dizziness, headaches, and fainting. However, dehydration has just as much of an impact on your skin as it does on your cognition. 

Dehydration makes your skin rough and dry, which causes the sebaceous glands in your skin to overproduce oils to make up for the lack of moisture. When this happens, the dry, dead skin cells left on the top layer of the skin buildup and clog the pores. So be sure to drink those eight glasses of water a day, every day. 

What Are Your Treatment Options?

When it comes to treating menopausal acne, there are a variety of options to choose from. Menopausal acne is different for every woman. You may have a case of mild acne, or you may have more severe acne concerns. So, what treatment options are best for you?

Mild Acne: Slight Changes to Lifestyle and Topical Ointments

If you have more mild acne issues, try making slight adjustments to your lifestyle like drinking more water and cutting down on sugary foods. If you make adjustments to your lifestyle through diet or other means and you're still not seeing results, try using over-the-counter topical creams and store-bought face washes. 

Moderate Acne: Stress Management and Medications

Moderate acne may lessen with changes in diet and using creams. However, more often than not, women with moderate acne will have more complicated underlying hormonal fluctuations. Talking to a dermatologist about what medications might be right for you could point you in the right direction. If you lead a stressful life, try implementing some stress-relief techniques into your daily routine. Take notice if that makes a slight difference in your acne (i.e., texture, redness).

Cystic Acne: Prescription Medications and Procedures

Cystic acne can be tough to combat. Be sure to speak to a dermatologist to get the best recommendations. If they prescribe you a strong medication through your pharmacist, make sure to use it as instructed. Ask your dermatologist about what procedures could help reduce your acne and how they work. 

Menopausal acne doesn't have to be an uphill battle. If you can recognize your symptoms and concerns, you're one step closer to finding the right treatment. Make sure to check out next week's post for an in-depth look at how probiotics can help improve your skin's health!