Breakouts During Perimenopause: Where to Start

Why do breakouts happen during perimenopause?

Fluctuating hormones can contribute to adult acne, including during perimenopause and menopause. Stress, family history, medicines and skincare can also play a part. Having breakouts does not by itself confirm a hormonal cause or diagnose perimenopause. The AAD explains common causes of adult acne.

The first step is to establish what the spots are. Keep a note of when they appear, where they occur and whether they are painful. Mention any recent changes in your health, medicines or skincare when you’re assessed.

Can skin be dry and acne-prone at the same time?

Yes. Breakouts do not mean that every part of your face needs to be dried out. Around menopause, harsher acne products may be difficult to tolerate, and further drying the skin can make matters worse. See the AAD’s advice on acne around menopause.

If this sounds familiar, tell your clinician about both concerns. The aim is to find an approach you can use consistently while keeping your skin comfortable. Our dry-skin guide covers the moisture side of that conversation.

Start with a routine you can stick with

Cleanse gently rather than scrubbing. Choose products labelled non-comedogenic or “won’t clog pores”, including your sunscreen and moisturiser. Avoid squeezing spots, which can increase the risk of scarring and lingering marks. The AAD’s acne skincare advice covers these everyday habits.

Try to resist changing several things in the same week. If you’ve started a suitable acne treatment, it needs time to be assessed. The AAD suggests allowing six to eight weeks for an appropriate at-home treatment for mild acne, used as directed, before judging improvement. This does not mean continuing through a significant reaction. Read its guide to adult acne treatment.

During a review, be honest about what you actually use. If a product is too drying, expensive or complicated to fit into your day, that matters. A plan only becomes useful when it works in ordinary life.

When to book a medical assessment

Deep, painful spots, acne that is leaving scars, or breakouts that persist despite appropriate care deserve medical assessment. You do not need to keep cycling through shop-bought products. A GP or dermatologist can discuss treatment options and whether another condition needs to be considered.

Tell your clinician if you are pregnant or trying to conceive before choosing acne treatment, because some options are unsuitable. Also mention any hormone therapy or other medicines you use; changes to these should be discussed with the clinician who manages them.

You can seek help because breakouts bother you, too. You don’t have to wait for them to become severe before asking for a clearer plan.

Think beyond the next spot

It can help to separate your priorities: managing active breakouts, keeping your skin comfortable, then reviewing any remaining marks or texture concerns. Ask which step comes first and when you’ll reassess. That makes it easier to understand why a particular product or treatment has been suggested.

For the broader changes that can happen at this stage of life, read our guide to skin changes during menopause. If a cosmetic retinol product is irritating your skin, our retinol and sensitivity guide explains what to bring to a review.