Perimenopause Acne Breakouts
Breaking out in your 40s or 50s, especially if your skin was clear for years, is a genuinely common part of the perimenopausal transition — and it’s driven by the same hormonal shift responsible for most of the other skin changes in this life stage.
Why it happens
Multiple contributors to acne during the menopausal transition: Menopausal acne review (PubMed).
As estrogen declines during perimenopause, its relative balance with androgens shifts — even though androgen levels themselves often stay within a normal range. That changing ratio is enough to stimulate the sebaceous glands and trigger breakouts, typically concentrated on the jawline and lower face, similar to hormonal acne at any age. We cover the full mechanism and treatment approach in our Menopause Acne Causes guide and the broader Hormonal Acne guide.
The confusing part: breakouts and dryness at once
This is one of the more disorienting aspects of perimenopausal skin — you can be dealing with new breakouts and increasing dryness simultaneously, since both stem from the same underlying hormonal shift. This means acne treatment at this life stage needs to be gentler than a typical acne routine, since aggressive, drying treatments will worsen the barrier issues that are very likely already present. See Why Is My Skin So Dry in Perimenopause? for that side of the picture.
What to do differently than you might have in your 20s
Acne treatment and gentler skin care: 2024 acne guideline (PubMed); AAD menopause skin care.
- Choose gentler actives first — azelaic acid over benzoyl peroxide, for instance — see our full skincare routine for hormonal acne
- Pair any acne treatment with a ceramide-rich moisturizer rather than skipping moisturizer to “dry out” breakouts
- Watch for signs your skin is becoming irritated rather than improving — see Signs of a Damaged Skin Barrier
Related Dermlore guidance
Products mentioned in this guide
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- The Ordinary Azelaic Acid Suspension 10%, Formula for Uneven and Blemish-Prone Skin — The Ordinary · 1 oz, pack of 1. Azelaic acid 10% suspension; 1 oz tube.
- CeraVe PM Daily Facial Moisturizer, Skin Care for Dry Skin, Oil-Free, 3oz — CeraVe · 3 oz. Facial lotion with ceramides; 3 oz.
Where this fits into the bigger picture
Acne is just one of several changes perimenopause brings — alongside dryness, sensitivity, pigmentation, and firmness loss, all covered in our full Perimenopause Skin Care Guide. If breakouts are your dominant concern right now, the Hormonal Acne guide has the more detailed treatment breakdown; this page exists to connect that guidance specifically to what’s happening hormonally at this life stage.
FAQ
Is perimenopausal acne treated differently than acne in your 20s?
The underlying treatments overlap significantly, but the approach needs to account for skin that’s simultaneously becoming drier and more barrier-sensitive — gentler, more barrier-conscious than a typical 20s acne routine.
Will this acne go away on its own eventually?
Often it eases once hormones stabilize post-menopause, but this varies, and consistent gentle treatment in the meantime helps prevent the scarring and marks that untreated breakouts can leave behind.
References
- Menopausal Acne - Challenges And Solutions International Journal of Women’s Health · 2019
- Guidelines of care for the management of acne vulgaris Journal of the American Academy of Dermatology · 2024
- Caring for your skin in menopause American Academy of Dermatology
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