Acne in midlife? Here’s how to deal with menopause skin

I didn’t get spots as a teen. But fast forward a few decades, and, well, let’s just say that the reckoning has come. Some days it feels as though my chin is a pinboard charting the locations of the world’s volcanoes. Get to safety: it’s about to blow! Oh, the ignominy.

Welcome to “menager” skin, when thanks to the menopausal years you have the skin problems of a teenager to contend with (on top of everything else). In my menager skin state, I’ve found myself reaching for products from ranges that are actually tailored to teenagers; there’s a raft of them now, offering well-made, effective but gentle formulations – and even packaged beautifully. I’m not alone: in an inversion of the norm, since skincare has become a serious category mothers are now stealthily stalking the bathrooms of their daughters to snaffle their products.

Take Spots and Stripes, a range created by former beauty director, Charlotte-Anne Fidler, and formulated for tweens and teens. I’ve become partial to their Gentle Exfoliating Liquid 2% Salicylic Acid (great for cleaning pores) which sold out in two weeks when it launched last year. It turns out, Fidler always had the aim that adults would like it too. “My idea was to make Spots & Stripes products seriously good – as good as the mother’s/parent’s skincare – very effective, the absolute best ingredients, manufactured with exceptional care by the best naturals manufacturer in the UK. And sell it to them at a price that was appropriate for kids. The inside joke was that, once the mothers worked out how good it was, they’d ‘borrow’ it from their teens. And that’s exactly what’s happening.”

The founder of Bubble, a brand more commonly associated with Gen-Z, says she wasn’t surprised at all to realise they have a strong menager following. “When you sell the best for less, everyone tends to get excited,” says Shai Eisenman, founder and CEO. “We always say that Bubble is for every face at every age. Menager hits include Bounce Back Balancing Toner Mist, and Super Clear 2% salicylic acid blemish prevention serum. I recommend their Soft Launch hydrating cream cleanser.

Bubble Soft Launch Hydrating Cream Cleanser, £16, Boots

Meanwhile youth-skewed Clarifying Serum  is also high on my menager skinometer; I use their Clarifying Serum. Laura Bamidele, head of innovation, says its Sensitive Retinol Oil is “clinically proven to maintain a healthy skin barrier and reduce sensitivity so ideal for any skin sensitised by the menopause process”.

Clarifying Serum, £12.99 and  Sensitive Retinol Oil, Byoma

So why does skin regress during the menopause transition?

Although menager skin feels very teenager-like, the menopause element does change things. “During these years, our oestrogen and progesterone levels fluctuate, and this causes many of the symptoms women can experience,” explains Dr Sigi Joseph, menopause specialist and hormonal health doctor and women’s health lead for Scotland (and GP of 20 years clinical experience). “Additionally, the balance we have with our oestrogen /progesterone ratio with testosterone levels means we can have a hyperandrogenic state – this contributes to symptoms such as increased facial hair growth, thinning of our scalp hair and acne-prone skin. We also have declining collagen structure in the skin and women often report drier and itchier skin.”

You might have acne, but the prescription is different

“Acne often experienced by women around this time may seem to be the same as a teenager’s but it’s different and if treated as teenage acne can do more harm than good,” warns Dr Emma Craythorne, consultant dermatologist at OneWelbeck Skin Health and Allergy, and founder of Klira skincare. “The skin changes are more than just the quick hormonal fluctuations that occur in teens but often related to areas of zones of the skin where the spots appear again and again and can be related to factors such as poor sleep, poor diet, stress etc - something that is usually less relevant in teenager acne.”

If you’re looking at more medical route it’s important, she says, that you don’t get fobbed off by NHS guidelines which “are designed for teenage acne and typically overlook important medicines that we might use in adult female acne like spironolactone or hormonal control and concentrate on antibiotics etc”. A prescription-grade retinoid, like tretinoin (this requires a prescription and is not the same as the over-the-counter retinol or retinal), is the first-line treatment for both teenagers and adults with acne, but the base in which it is delivered determines how well it will work or be tolerated.

For more high street offerings Craythorne warns against the ingredient benzoyl peroxide: “It’s very helpful for teenage acne but typically very irritating and much less effective for adult female acne — in fact the opposite of the oxidation effect of benzoyl peroxide is the effect of antioxidants like Vitamin C which can be helpful in adult female acne.” She highlights the importance of knowing your skin type (her klira.skin website has a free online consultation).

The ideal menage skincare routine 

So, what should a good menager skincare regime look like? All the experts I spoke to agreed: keep it simple. Dr Shereene Idriss, a board-certified dermatologist and founder of Idriss Skincare, says for some this may even mean ditching hyaluronic acid: “HA is a popular humectant, but not my favourite; using one shouldn’t generally contribute to breakouts but if you’re sensitive to HA look instead to glycerine-based products to hold on to moisture,” she advises.

Amanda Lacey, a legendary London facialist, emphasises that cleansing is key. “Twice a day is of great importance. Scrubbing the skin must be avoided. Oily skincare formulations like cleansing balms can be too oily and stimulate oil production.” For a high street option, she suggests La Roche Posay Effaclar Purifying Cleansing Gel; Craybourne advises using a gentle cream cleanser. Include an antioxidant, use an SPF (ideally factor 50), and apply your active skincare at night.

 La Roche Posay Effaclar Purifying Cleansing Gel, £24, La Roche Posay

For masks, Lacey says use something that will gently exfoliate overnight; she recommends Medik8 Sleep Glycolic Overnight Mask and Avène Soothing Radiance Mask for sensitive skin.

Medik8 Sleep Glycolic Overnight Mask, £39, Medik8

Avène Soothing Radiance Mask for sensitive skin, £16, Boots 

And finally…

The other thing they all agree on to help banish menager skin: consider HRT, if you’re suitable for it. “HRT can have multiple benefits in terms of smoothing out hormonal fluctuations and settling multiple perimenopause symptoms,” says Joseph.