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HOME Learn Perimenopause, Menopause and Its Impact on Your Skin

Perimenopause, Menopause and Its Impact on Your Skin

BY Lili Frances Kerr
Perimenopause, Menopause and Its Impact on Your Skin

The passage towards menopause is a time of hormonal changes that can significantly affect women's physical and emotional wellbeing. During this period women who have never experienced blemishes before, or not since their teenage years, may begin to experience breakouts.

Blemishes over the age of 40 can be emotionally difficult, especially for those women who had moderate or severe breakouts when they were younger and thought that it was behind them.

Luckily, perimenopausal blemishes are much less common than other types of hormonal blemishes experienced by younger women. It is also temporary and will clear up once the woman enters into menopause.

This article will explain what perimenopausal blemishes are, why they happens, and how they can be treated.

First, let’s look at the difference between perimenopause and menopause to avoid any confusion.

Perimenopause vs menopause

Perimenopause is the transitional time, the passage each woman goes through as her hormonal system changes. The end result is menopause. Once a woman reaches menopause her hormonal system stabilises into how it will be for the remainder of her life. At this point any symptom or discomfort that she was feeling from the process of perimenopause will alleviate.

When a woman has not had a menstrual cycle for at least twelve months, she has officially reached menopause.

The average length of perimenopause is four years, but it can be as little as a few months or for as long as fifteen years. It’s during this time in perimenopause that fluctuating hormones can cause blemishes.

Typically women will begin perimenopause in their mid-40’s, and enter into menopause at an average age of 51. Menopause before the age of 40 is called early menopause or premature ovulation failure. Menopause after the age of 55 is late-onset menopause.

What perimenopausal hormonal changes cause blemishes?

A woman going through the passage of perimenopause has many changes happening within her hormonal system, including:

  • Decreased estrogens
  • Increased, then decreased follicular stimulating hormone (FSH)
  • Decreased progesterone
  • Increased sex hormone-binding globulin (SHBG)
  • Increased androgens (male-sex hormones)


Perimenopausal women develop blemishes for much of the same reason as puberty – hormonal fluctuations. However, perimenopausal blemishes are much less common, as women over the age of 40 are usually not producing enough sebum in their skin to be able to cause breakouts as this decreases with age. Blemishes require both excess sebum production and bacteria to be present.

When perimenopausal blemishes are not caused by hormones

While perimenopausal and menopausal women produce less sebum and are therefore less likely to experience blemishes, they are not completely immune to breakouts. They can also experience blemishes that are not caused by hormonal fluctuations, for example cosmetics or skincare, dairy consumption, disease and certain medications can also be responsible. In fact it is recommended to check these potential causes before trying hormonal treatments.

Hormonal Replacement Therapy (HRT) and blemishes

Hormone replacement therapy (HRT) is a commonly used pharmaceutical treatment to alleviate the symptoms of perimenopause.

HRT is often prescribed when perimenopausal symptoms are significantly adversely affecting a woman’s quality of life. These symptoms may include:

  • Hot flashes
  • Insomnia
  • Anxiety or depression
  • Night sweats
  • Reduced libido


Typically HRT for perimenopause is a combination of estrogens and progesterone. They can be very effective at alleviating perimenopausal symptoms, including blemishes. However in some cases the use of HRT can also cause the side effect of breakouts. This is because some HRTs use progestin, the synthetic form of progesterone that is also found in some hormone releasing birth control pills. Progestin is a known cause of excess androgens in the body, and therefore breakouts.

If a woman is experiencing perimenopausal blemishes from HRT medication, she then has the option to change to an alternative HRT or to try alternative methods of treatment.

Treating perimenopausal blemishes

Like all treatments of blemishes in women, there is always a choice to treat the skin condition using natural or pharmaceutical methods.

The first step in treating the skin through either method is to determine if the blemishes are in fact caused by the perimenopausal hormone fluctuations, or if it’s caused by another factor such as cosmetic use or medication.

For natural treatment the best option is to make an appointment with a certified naturopath doctor or herbalist. They will likely prescribe herbs in addition to diet and lifestyle changes.

If the woman is experiencing perimenopausal blemishes and is on HRT, it is recommended to talk with her doctor to consider changing the pharmaceutical as the HRT may be the cause of the breakouts.

Topical treatments such as salicylic acid and benzoyl peroxide can also be used, however it’s important to note that these will cause a further drying of the skin. And as perimenopausal women already typically experience dryer skin, this side effect can be difficult.

In conclusion

A woman’s passage towards menopause is a very significant time in her life, but it can come with many challenges in the form of both emotional and physical symptoms.

For women who experience breakouts as a symptom of perimenopause, there are options for both natural or pharmaceutical treatment. The hormonal blemishes will also completely clear up after the period of perimenopause has ended and you enter into menopause.

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