This post was updated in June 2021

Acne In Menopause? Seriously?

Just when I began to accept some of the midlife changes that turning 50 brings, menopausal acne started rearing its ugly head. Like the not-so-tidy body shape and the gray in my hair that, although annoying, actually had started to give it body for the first time – mother nature decided to add insult to injury.

Never in my wildest dreams did I imagine I’d be struggling with menopausal acne. We’re not talking about an occasional blemish here – we’re talking about full-blown what-is-that-thing-on-my-face, don’t wanna leave the house outbreaks that were a completely new experience.

Acne and Menopause Skin

No matter how well we care for our skin, acne and menopause skin can go hand in hand. As our estrogen levels drop, the hormonal fluctuations may bring changes that we haven’t prepared for. For many of us, the memory of our teenage years battling breakouts still stings.

The difference with mature skin is that it may be more sensitive to the types of treatments required to keep acne at bay.

What Causes Acne After Menopause?

Blame the hormones! As our estrogen declines during perimenopause and menopause, the amount of androgen or testosterone increases.

According to the National Center for Biotechnology Information (NCBI), acne can take several forms:

• Persistent: When acne begins in an adolescent and continues to persist during adulthood
• New Onset: When acne begins in adult life
• Recurrent: When it begins in adolescence, disappears for some time, and then re-occurs again during adulthood

Insult to Injury

As if dealing with this outbreak wasn’t enough in itself, the apparent practice of age discrimination by my insurance company was shocking.

Having never had this problem before, I visited a dermatologist who immediately diagnosed it as menopause acne and prescribed a prescription cleanser and Retin A, a common medicinal duo for my type of outbreak. My kids had at one time or another used Retin A or other acne meds during their teenage years, so I was familiar with it. Happy to have a diagnosis and anxious to get this taken care of, I took my prescription to my local pharmacist. I was bowled over to find that

a) my insurance company would not cover the cost of this prescription, and…

b) it would cost me about $200 for what was supposed to be about a month’s supply.

Most distressing of all was to see – in writing –the reason they didn’t cover this prescription. Simply put, I am considered – dare I say it? Too old.

That’s right. Too old. Too old for skin care medication. I mulled on that for a bit…what exactly did they mean? Too old to have acne in the first place – like they didn’t believe it? Like I’m a scrub? Or, did they mean I’m just too old for the treatment itself, in which case, what does THAT mean? That I should somehow have control over it? That acne during menopause is a natural state of affairs – an event to simply be endured? Or is it simply that because I’m a fifty-year old woman, my appearance is no longer important. After all, if I were 16 or 20, they would certainly cover it. It is rapidly becoming apparent that there is a link between insurance benefits and age discrimination for baby boomers when it comes to menopause and acne.

My dermatologist was eager to help, offering me samples of the product and providing me with a letter assuring the insurance company that the Retin A is truly for acne and not cosmetic purposes. (By cosmetic, do they mean the absence mere of huge zits on my face?)

Ultimately they declined to cover the medication.

Insurance coverage for treatment for menopause acne varies. According to GoodRX, Medicare will not cover acne or cosmetic treatments, but it may cover Clindamycin / Benzoyl Peroxide treatment for acne.

My real beef? Being told that I’m too old for the same treatment they willingly provide for younger people, when menopausal acne is a well-known condition. Amazing.

The good news? Post menopause, it disappeared…now it’s just the dry skin and the wrinkles!