Understanding Postmenopausal Acne: Causes, Implications, and Solutions

By Dr Olivia Naturals Support • July 02, 2024

Acne is typically thought of as a teenage affliction, something that is expected to fade away with age. However, for many women, acne can persist or even worsen as they get older, particularly during postmenopause. It is a frustrating and often embarrassing issue that can have a significant impact on one’s self-esteem and quality of life.

In this blog post, we will explore the phenomenon of postmenopausal acne, understand why it occurs, debunk some common misconceptions, and discuss the importance of hormone levels, particularly testosterone, in managing skin health for women over 50.

Why Acne Persists in Older Women

The expectation that acne will disappear with age is not always met, especially for women entering their postmenopausal years. In fact, skin flare-ups can become more frequent and severe during this time. This happens more often in women than in men, and the underlying causes can be multifaceted.

Hormonal Changes and Acne

One of the primary reasons for acne flare-ups in postmenopausal women is hormonal changes. During menopause, the body undergoes significant hormonal shifts that can affect the skin. Estrogen levels drop, which can lead to an imbalance between estrogen and androgens (male hormones, including testosterone). This imbalance can result in increased oil production in the skin, clogging pores, and leading to acne.

The Role of Testosterone

Contrary to popular belief, high testosterone levels are usually not the culprit behind acne in postmenopausal women. Instead, it is the relative decrease in estrogen that leads to an imbalance. However, it is still crucial for postmenopausal women to have their testosterone levels checked.

Testosterone, although primarily known as a male hormone, is also vital for women. It plays a crucial role in several bodily functions, including:

  1. Bone Density: Testosterone helps maintain bone density, which is especially important as women age and become more susceptible to osteoporosis.

  2. Muscle Function: Adequate testosterone levels help maintain muscle mass and strength, which can decline with age.

  3. Cognitive Health: Testosterone is also important for cognitive function, helping to prevent cognitive decline as women age.

Therefore, ensuring healthy testosterone levels is important for overall health and well-being, even though it is rarely the direct cause of acne in women over 50.

The Importance of Estrogen

Estrogen plays a key role in skin health by helping to maintain skin thickness, elasticity, and moisture. As estrogen levels decline during menopause, the skin can become drier, thinner, and less elastic. This can exacerbate acne and make the skin more prone to damage and slower to heal.

Other Factors Contributing to Postmenopausal Acne

Aside from hormonal changes, several other factors can contribute to acne in postmenopausal women:

  1. Stress: Increased stress levels can lead to higher cortisol levels, which can, in turn, lead to acne flare-ups.

  2. Diet: Certain foods, particularly those high in sugar and dairy, can contribute to acne.

  3. Skincare Products: Using the wrong skincare products can irritate the skin and clog pores, leading to acne.

  4. Medications: Some medications, including certain hormone replacement therapies, can cause acne as a side effect.

  5. Genetics: Genetics can play a role in the likelihood of developing acne at any age.

Managing Postmenopausal Acne

Managing postmenopausal acne requires a comprehensive approach that addresses both the hormonal and non-hormonal factors involved. Here are some strategies that can help:

1. Hormone Replacement Therapy (HRT)

For some women, hormone replacement therapy can help balance estrogen levels and reduce acne. However, HRT is not suitable for everyone and can have side effects, so it is important to discuss this option with a healthcare provider.

2. Skincare Routine

Developing a gentle, consistent skincare routine is essential. This can include:

  • Cleansing: Use a mild cleanser to remove dirt and oil without irritating the skin.
  • Exfoliating: Gentle exfoliation can help remove dead skin cells and prevent clogged pores.
  • Moisturizing: Keeping the skin moisturized can help maintain its barrier function and reduce irritation.
  • Sunscreen: Protecting the skin from UV damage is crucial for overall skin health.

3. Diet and Lifestyle

Adopting a healthy diet and lifestyle can have a significant impact on skin health. Consider the following:

  • Diet: Focus on a balanced diet rich in fruits, vegetables, lean proteins, and healthy fats. Reduce intake of sugar and dairy if these are found to trigger acne.
  • Hydration: Drinking plenty of water helps keep the skin hydrated and can improve its overall appearance.
  • Exercise: Regular physical activity can help reduce stress and improve overall health.
  • Stress Management: Practice stress-reducing techniques such as yoga, meditation, or deep breathing exercises.

4. Professional Treatments

In some cases, professional treatments may be necessary to manage postmenopausal acne. These can include:

  • Topical Treatments: Prescription-strength topical treatments, such as retinoids or benzoyl peroxide, can help reduce acne.
  • Oral Medications: In severe cases, oral medications such as antibiotics or hormonal treatments may be prescribed.
  • Chemical Peels: Professional chemical peels can help exfoliate the skin and reduce acne.
  • Laser Therapy: Laser treatments can help reduce acne and improve the overall texture and appearance of the skin.


Postmenopausal acne can be a frustrating and challenging issue, but it is important to understand that it is not uncommon and can be managed with the right approach. Hormonal changes, particularly the decline in estrogen, play a significant role in postmenopausal acne, but high testosterone levels are usually not the primary cause. Ensuring healthy testosterone levels is important for overall health, including bone density, muscle function, and cognitive health.

By adopting a comprehensive approach that includes hormone management, a consistent skincare routine, a healthy diet and lifestyle, and professional treatments when necessary, women can effectively manage postmenopausal acne and improve their overall skin health.

If you are struggling with postmenopausal acne, consult with a healthcare provider to develop a personalized treatment plan that addresses your specific needs. With the right strategies in place, you can achieve clearer, healthier skin and improve your quality of life.