Skin \u00b7 Menopause
Adult acne in menopause: the androgen shift
When estrogen falls faster than androgens, the ratio shifts and adult acne can emerge. Standard dermatology care combines with hormonal consideration \u2014 spironolactone, HRT, or combined pills where appropriate.
Key points
- Topical retinoid
- Consider spironolactone 50–100mg
- HRT if concurrent menopause symptoms
- Rule out PCOS-adjacent picture
Frequently asked questions
Why am I breaking out at 45?
Relative androgen excess as estrogen falls faster.
Does HRT help?
Often yes — restores the estrogen-androgen ratio.
What about spironolactone?
Effective for hormonal acne; often combined with topical therapy.
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Medically reviewed by Kindr Health Clinical Team · Last reviewed 2026-06-19. Compounded medications are prepared by FDA-registered 503A pharmacies and are not FDA-approved drug products.