It happens—one day you’re cruising through your 30s, not worried about the pimples and breakouts of your youth—and the next day, bang, a massive breakout. Some women in a certain age group, think Xennials and even some Millennials, are experiencing the early onslaught of dreaded menopause and it’s wreaking havoc on our skin. If you’re dealing with the kind of breakouts that give you flashbacks to life before junior prom, here’s what’s going on.
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What Is Perimenopause?
Harrison, NY dermatologist Jennifer S. Kitchin, MD says it’s those pesky male hormones doing a number on us: “Most people don’t realize that women have testosterone, the ‘male’ hormone, in their bodies. The level is low, but during menopause, as levels of the female hormones are shifting, the testosterone levels proportionally increase.”
According to Bloomfield, MI dermatologist Linda Chung Honet, MD, that hormonal imbalance comes with a lot of side effects. “Our bodies become like aliens to us, and skin is a major victim to menopause,” she says. “It seems like all of a sudden, we need to navigate a health landscape that is completely foreign to us. It’s when our internal thermostats are randomly heating us up, leaving us a sweaty mess. It’s when our weight starts to creep up no matter what we do. It’s when our skin loses its glow and resiliency. It’s when our hair starts thinning on top while our chins start growing whiskers. Then to add insult to injury, it’s when we start to get acne when we may have never experienced it before.”
Why Does Our Skin Freak Out During Perimenopause?
Much like teenage hormones, Spring House, PA dermatologist Margo Weishar, MD says hormones are ramping up oil production. “The changing hormonal landscape upsets the balance between the estrogen (female) and androgen (male) hormones. A slight tip in that balance can lead to more oil production and especially deeper cystic acne that forms around the perimeter of the face. It can happen in women who have never before experienced acne.”
New Orleans dermatologist Mary Lupo, MD says we can blame cortisol too: “The relative shift of hormones is a factor. The emotional stress increases cortisol which then stimulates the sebaceous glands. Cell turnover slows, so pores have more oil and that oil backs up from the abnormal cell turnover blocking the pore opening. Lastly, the flushing increases inflammatory mediators that trigger papules.”
How We Can Fix It
Unfortunately, the experts we spoke to say we may not have the power to complete stop perimenopausal outbreaks, but treatments and lifestyle changes can help keep them at bay. Birmingham, AL dermatologist Holly Gunn says, “Prevention can be difficult because genetics play a major role of whether or not you will get perimenopausal acne. But it can be made worse by stress and diets high in processed sugar, fat and cow’s milk. Sometimes even aggressive exercise can lead to more acne. A healthy diet and balanced exercise routine can help with all ailments of the skin.”
Rutherford, NJ dermatologist Aanand Geria, MD, says, “Spironolactone is hands down the most effective treatment option. I also like SkinCeuticals Blemish + Age ($92) defense as a topical.” Astoria, NY dermatologist Lilly-Rose Paraskevas, MD says her go-to is the medication colloquially referred to as Accutane. “If the acne is very resistant to treatment, I like to use a short course of oral isotretinoin. Even at low doses, this drug is very effective.” Dr. Honet adds, “In-office treatments like LightStim, Dermal Infusion, microneedling, and chemical peels can be very effective adjuncts to prescription treatment and can directly address secondary scarring.”
While the onset of perimenopause and menopause may be inevitable, so is the need for a qualified and experienced expert to help zero in on the right solution. “A board-certified dermatologist will become one of your favorite physicians because we are able to effectively help you with your perimenopausal skin and hair,” says Dr. Honet. “Perimenopause isn’t going away anytime soon, and dealing with it is far from easy. But with your dermatologist’s help, you can beat the myriad perimenopausal insults to your skin and keep those nasty zits away.”