Understanding Skin Breakouts During Perimenopause: The Hormonal Connection

When you think of acne, you might picture the awkward teenage years, but hormonal acne doesn’t just belong in the past. For many women, breakouts return or even begin for the first time during perimenopause, a phase marked by hormonal turbulence. This article will delve into the causes of perimenopausal acne, how to manage it naturally, and the vitamins and minerals that can help maintain healthy skin.

What Causes Acne During Perimenopause?

Perimenopause, the transitional stage before menopause, is marked by fluctuating levels of estrogen, progesterone, and testosterone. These shifts can wreak havoc on the skin, resulting in breakouts that often appear on the lower face, jawline, and neck. Here’s a breakdown of the hormonal changes behind perimenopausal acne:

1. Estrogen peaks and troughs

The irregular fluctuations of estrogen in perimenopause are driven by the body's shifting reproductive priorities. Unlike menopause, when ovulation has ceased entirely and estrogen levels remain consistently low, perimenopause is a transitional phase where ovulation becomes less frequent but is not entirely absent. This leads to unpredictable ovarian activity, which causes:

• Sudden surges (High peaks)
  As the ovaries attempt to ovulate, they may release surges of estrogen in preparation for egg maturation. These peaks often occur inconsistently and may result in:
  • Increased oil (sebum) production, as estrogen stimulates the sebaceous glands.
  • Clogged pores, which can lead to acne breakouts.
  • Enhanced vascularity in the skin, making redness or inflammation more visible.

• Abrupt drops (low troughs)
  Following ovulatory attempts, estrogen levels may plummet, especially if ovulation does not occur. These low phases can leave the skin vulnerable due to:

  • Reduced collagen and elastin production, leading to thinner, less resilient skin.

  • Lower skin hydration, making the skin appear dull and dry while also increasing sensitivity.

  • Greater susceptibility to scarring and slower healing from acne lesions.

2. Progesterone decline

One of the defining features of perimenopause is the decline in progesterone levels. This happens because ovulation becomes less frequent as women approach menopause. Progesterone is primarily produced after ovulation, when the ovarian follicle transforms into the corpus luteum, which secretes this hormone. With fewer ovulatory cycles, progesterone levels drop.

Progesterone serves as a natural anti-inflammatory, calming the skin and reducing sensitivity. Its decline leads to:

• Increased inflammation, exacerbating acne.

• A relative dominance of estrogen and testosterone, which can stimulate oil production and worsen breakouts.

3. Testosterone increase

As estrogen and progesterone decline, testosterone may relatively dominate. This hormone stimulates the sebaceous glands to produce more oil, creating an environment ripe for clogged pores and acne-causing bacteria.

3. Stress and cortisol

Perimenopause heightens sensitivity to stress due to declining progesterone and fluctuating estrogen. Progesterone has a calming effect on the nervous system, helping to regulate the body’s response to stress. As progesterone declines, the body becomes more reactive to stressors, resulting in elevated cortisol (the stress hormone).

Additionally:

• Fluctuating estrogen impacts serotonin and other mood-regulating neurotransmitters, increasing susceptibility to anxiety and irritability.

• Elevated cortisol levels can worsen hormonal imbalances, increasing inflammation, oil production, and acne.

The combination of hormonal instability and stress sensitivity creates a perfect storm for skin issues during perimenopause

What Does Perimenopausal Acne Look Like?

Acne during perimenopause often manifests as deep, painful cystic bumps on the lower face, jawline, and neck. Unlike teenage acne, which typically affects the T-zone, these breakouts tend to be more persistent and inflammatory. Acne may also appear on the back, chest, and shoulders, accompanied by redness and tenderness.

How to Manage and Prevent Perimenopausal Acne

While hormonal fluctuations are natural, you can take steps to manage and prevent breakouts during perimenopause. Here’s how:

1. Balance Your Hormones Naturally

Support your body by:

• Eating a diet rich in whole foods, fiber, and cruciferous vegetables to promote estrogen detoxification.

• Incorporating phytoestrogens (e.g., flaxseeds) to help modulate estrogen levels.

• Managing blood sugar levels to reduce insulin spikes, which can aggravate acne.

2. Prioritize Gut Health

A healthy gut is crucial for hormone regulation. Gut-supportive foods like fermented vegetables, kefir, and bone broth can aid in hormone metabolism and reduce inflammation.

3. Reduce Inflammation

Combat inflammation with an anti-inflammatory diet:

• Include omega-3 fatty acids from sources like salmon, walnuts, and chia seeds.

• Minimize processed foods, sugar, dairy, and alcohol, as these can worsen inflammation and breakouts.

4. Stress Management

High cortisol levels can exacerbate hormonal imbalances and skin issues. Incorporate stress-reducing activities like yoga, meditation, or simply spending time in nature.

5. Cleanse Gently and Respect Your Skin

Use a gentle cleanser that purifies your skin without disrupting its natural balance. Brands like Maiwe en Lesse offer cleansers with ingredients that clean and soothe the skin, such as:

• Calendula: Helps reduce inflammation and soothes redness.

• Jojoba Oil: Gently cleanses and hydrates without clogging pores.

• Kakadu Plum: A powerful source of vitamin C that brightens the skin and stimulates collagen production.

• Rosehip Oil: Rich in antioxidants, supports skin repair and renewal.

Protect with Natural Sunscreen

Opt for a mineral sunscreen containing zinc oxide or titanium dioxide. These ingredients shield the skin from harmful UV rays while being gentle on sensitive skin.

Avoid Harmful Chemicals

Steer clear of products with synthetic fragrances, parabens, or alcohol, as these can dry out or irritate the skin.

The Role of Vitamins and Minerals in Healthy Skin

Maintaining healthy skin during perimenopause is about more than just external care—it starts with supporting your body from within. 

1. Vitamin A: Vitamin A contributes to the maintenance of normal skin. Retinoids, derivatives of vitamin A, are widely used in topical treatments for their role in promoting skin renewal and reducing clogged pores.

Sources: Found in liver, eggs, and orange-colored vegetables like carrots and sweet potatoes.

2. Vitamin C: This antioxidant maintains collagen production, and supports skin elasticity. 

Sources: Citrus fruits, bell peppers, strawberries, and broccoli.

3. Zinc: Zinc contributes to the maintenance of normal skin and supports the normal function of the immune system. It also helps protect cells from oxidative stress.

Sources: Meat, shellfish, legumes, seeds, and nuts

4. Selenium: Selenium contributes to the protection of cells from oxidative stress, which is important for skin repair and reducing inflammation.

Sources: Found in Brazil nuts, fish, and eggs.

5. Arctium Lappa (Burdock Root): it  has been historically used to support detoxification and skin health. It may contribute to the balance of skin through its effects on liver function.

6. Vitex (Chaste Tree): is often used to support hormone regulation by influencing progesterone levels. This may help with hormone-related skin issues like acne.

7. Red Clover: is rich in phytoestrogens and traditionally used to help modulate hormone fluctuations. It may support skin health during hormonal transitions

By focusing on these nutrients and maintaining a balanced diet, you can support your skin’s health while navigating the challenges of perimenopause. Remember, healing takes time, so be patient with your body as it adjusts to this new phase of life. For tailored advice, consult with a healthcare provider or skin specialist. 

If you have questions, get in touch with us. We’ll be able to guide you in the right direction. Just head over to our website and start a chat with us.