Why acne and rosacea are common during menopause

Smiling middle aged woman satisfied with her nature beauty. Cosmetic facial care concept menopause woman acne
Menopause can trigger a number of skin conditions such as acne. (Getty Images)

Acne is a skin condition commonly associated with adolescence – but it can be prevalent later in life too.

For menopausal women in particular, their fluctuating hormones can result in a number of skin conditions developing.

“Declining oestrogen is a key factor for marked skin changes during the menopause,” Dr Aarthi Sinha, founder of Church Crescent Medical Practice, says. “This is because oestrogen is necessary for production of collagen and hyaluronic acid in the skin.”

Dr Sinha explains that collagen is a type of protein responsible for the skin’s firmness and tightness, and when levels are depleted, this can lead to the formation of fine lines and wrinkles.

Hyaluronic acid, on the other hand, helps with skin hydration. So, declining levels of it can lead to dry, dull, and even scaly skin.

“As we age, there is also a general shrinking of the bones of the face and the fat pads drop as they are no longer held firmly in place,” Dr Sinha adds. “This can appear as flattening of the cheeks, hollowing of the mid-face and sagging of the chin and jowl area. These changes can be exacerbated during the peri and post-menopause phase due to the lack of oestrogen.”

Dr Sinha adds that several skin conditions can be triggered during menopause, and that women who previously had acne in their teenage years are more likely to see it again when going through menopause.

“It is worth checking with a doctor about your hormone levels,” she adds. “There are lots of options that can be used to reduce acne, including a therapeutic skincare regime for home combined with in clinic treatments – these can offer remarkable results and really can make a difference to a menopausal woman’s quality of life.”

Woman with acne skin problem with hormonal acne, closeup. Hormonal acne, adult acne face before photo. Matching after photo with clear skin, retouched skin, available.
Fluctuating hormones can result in acne. (Getty Images)

As flushing is common during menopause, Dr Sinha says that this can exacerbate conditions such as rosacea.

“This can be managed with a combination approach,” she advises. “Addressing lifestyle factors such as reducing caffeine and alcohol intake, and using the right skincare, including an SPF for sensitive skin and specific treatments for redness.”

“Peri and post-menopausal women can also experience excess hair growth on the face,” Dr Sinha says. “This can be very distressing. It is worth asking your doctor to check if there are any particular hormone imbalances causing this, along with reviewing aesthetic and lifestyle treatments too.”

When treating any skin conditions, Dr Sinha says to be wary of products marketed towards menopausal women.

“There are lots of products advertised for menopausal skin, particularly collagen creams. Most collagen creams do not increase skin collagen levels - they may feel nice, but don’t do much for the skin,” she says.

“Many washes and soaps are too harsh and often strip essential oils from the skin and damage the pH of the delicate skin barrier. This worsens most skin complaints. There are lots of products being sold that often do not help the skin and can cause damage in the long run.”

A mature woman wakes up and stretches in early morning light
Sleep should also be prioritised during menopause. (Getty Images)

Dr Sinha recommends a holistic approach when it comes to treating menopausal skin, as other menopause symptoms such as insomnia, stress, anxiety, and irregular periods can also impact skin.

“Exercise increases blood flow to the skin, promoting regeneration of natural skin factors along with collagen, elastin and hyaluronic acid – whilst increasing your bone density at the same time,” Dr Sinha says.

“A regular sleep routine is important for regulated healthy cortisol production which influences all the hormones in your body, including those that affect your skin. Nutrition is also key for peri and post-menopausal women. Generally, women need to have enough protein to help with regeneration of skin proteins (such as collagen) and for their general wellbeing and enough micronutrients such as iron, b12 and zinc.

“Lastly, and perhaps most importantly, is the avoidance of stress. This causes dysregulation within the whole body and can offset positive benefits from aesthetic treatments and lifestyle changes. Mood can be greatly affected during the menopause, and I always talk about this openly with my patients. Some people may need extra support such as cognitive behavioural therapy.”