Perimenopause Acne: Causes, Topical Options and What Trials Show
Start with our pillar guide: What Is the Skin Barrier? The Science of Hydration, Ceramides and Occlusives, or browse all Skincare Fundamentals articles.
Perimenopause acne is usually blamed on falling estrogen that leaves relative androgen excess, which can enlarge oil glands and raise oil output. Topical azelaic acid, retinoids and benzoyl peroxide all treat acne in trials, but no randomized trial in our sources enrolled perimenopausal women specifically, so their results are borrowed from younger adults.
Evidence: Limited for perimenopausal women specifically; Well-established for topical acne treatment in younger people.
Key takeaways
- A 2026 review attributes added complexity in perimenopause to declining estrogen and relative androgen excess (Parkinson, 2026).
- A 2017 expert review reports no data directly comparing women aged 25 to 44 with perimenopausal women aged 45 and up (Zeichner et al., 2017).
- A 2020 Cochrane review of 49 trials found azelaic acid probably less effective than benzoyl peroxide and probably similar to tretinoin, based on 1 trial for each comparison (Liu et al., 2020).
- A 2019 systematic review of 54 trials found topical retinoids safe and effective for acne, with adapalene the best tolerated (Kolli et al., 2019).
- The SAFA trial randomized 410 women, and 82% on spironolactone vs 63% on placebo reported acne improvement at week 24; mean age was 29.2 (Santer et al., 2023).
Topicals may work better when they fit a routine your skin can tolerate, so our skincare routine order guide covers where each step goes. For the bigger picture, see our menopause skin care guide.
What causes perimenopause acne?
Reviews point to a hormonal shift: estrogen falls, leaving androgens relatively higher. That explanation is plausible, but no study in our sources has proven it as the single cause of perimenopause acne.
Androgens are hormones such as testosterone and dehydroepiandrosterone. Women normally make them in the adrenal glands, ovaries and skin, and they play a "necessary but insufficient" role in female acne, according to a 2019 review (Bienenfeld et al., 2019). In other words, androgens contribute, but they don't fully explain who gets acne.
A 2025 systematic review of 20 articles reported that androgens can stimulate oil gland growth and increase sebum, the skin's oily secretion (Telkkälä et al., 2025). The same review linked adult acne to family history and high-glycemic diets, which raise insulin and insulin-like growth factor 1. Its authors declared no conflicts, and the review covers adult women generally, not perimenopause.
A 2026 review adds inflammation, skin barrier impairment and microbiome shifts to the picture (Parkinson, 2026). A 2019 review of menopausal acne also names thyroid problems, high prolactin, insulin resistance, stress, poor sleep and diet or exercise changes as possible contributors (Khunger & Mehrotra, 2019). If your skin also feels tight or reactive, our guide to how the skin barrier works explains the basics. Evidence: Limited; these are reviews of mechanisms, not trials in perimenopausal women.
What do perimenopause pimples look like?
The abstracts we reviewed don't define a distinct pattern for perimenopause pimples. A 2019 review calls menopausal acne a special subtype and covers its clinical presentation (Khunger & Mehrotra, 2019), and a 2026 nursing review written by a GP working in aesthetic practice also covers it (Parkinson, 2026), but the only abstract-level description of what the acne looks like comes from a 1991 paper on postmenopausal acne, which reported small closed comedones, or whiteheads, with a scattering of tiny inflamed bumps.
That paper called postmenopausal acne "low-grade" and "long-smoldering." It described women who were darker-skinned, had formerly oily skin and large pores, and usually had no teenage acne, with a seeming link to chin and upper-lip hair growth (Kligman, 1991). This was an observational description of women at or after menopause, not a measured study of women in perimenopause.
Later reviews don't fully match that picture. A 2021 review describes adult female acne mainly as facial inflammatory lesions with more sensitive skin (Bagatin et al., 2021). A 2017 review notes that the old belief has been challenged that adult women's acne stays on the lower third of the face (Zeichner et al., 2017).
Those authors treat women 45 and up as a separate perimenopausal group based on their experience, while stating that no data directly compare the groups. Our sources don't show that location alone identifies hormonal acne. Evidence: Early / preliminary.
Should a doctor check hormones for perimenopause acne?
A doctor may or may not test, depending on your severity and other symptoms. A 2019 review says most menopausal women with a few isolated lesions have normal androgen levels and don't need extensive investigation.
The same review calls baseline tests, including total testosterone, useful (Khunger & Mehrotra, 2019). It says a detailed history can help exclude polycystic ovarian syndrome, late-onset congenital adrenal hyperplasia (an inherited adrenal hormone disorder) and medications as causes. It also recommends evaluating related conditions such as obesity, diabetes, high blood pressure and abnormal blood fats.
A doctor may pay closer attention if acne appears with increased facial or body hair, or with androgen-related hair loss, since the review groups these together as signs of androgen excess. Still, a 2019 paper notes that no dermatology guideline sets out when women with acne, hirsutism or female pattern hair loss need an endocrine workup (Bienenfeld et al., 2019). A 2019 expert guide to adult female acne also gives recommendations on laboratory investigation (Bagatin et al., 2019); one author is a Bayer medical consultant. Evidence: Limited; expert review, no trials of testing strategies.
Which topical actives suit perimenopause acne on aging skin?
All 3 main options have acne trial data, and the choice may depend on strength, tolerance and whether you also want an aging benefit. A topical retinoid is the only one here with a randomized aging trial, while benzoyl peroxide beat azelaic acid in a single comparison.
The major pooled analyses have a clear limitation. Trials in a network meta-analysis of 221 trials and 65,601 patients had a mean age of 20.4 (Huang et al., 2023), and most participants in the Cochrane review were aged 12 to 30, with a range of 10 to 45 (Liu et al., 2020). The authors of that Cochrane review declared nothing, while its clinical referee disclosed advisory, consulting or investigator roles with Allergan, Almirall, Cipher, Galderma and Valeant.
| Feature | Azelaic acid | Topical retinoids | Benzoyl peroxide |
|---|---|---|---|
| Acne evidence | 49-trial Cochrane review covers it with 5 other topicals (Liu) | 54 trials; better than vehicle (Kolli) | Beat azelaic acid in 1 trial; adds benefit to retinoids (Liu, Kolli) |
| Head-to-head result | Probably weaker than benzoyl peroxide (risk ratio 0.82, 351 people); probably similar to tretinoin (289 people) | Tretinoin and tazarotene showed no significant efficacy difference | Stronger response than azelaic acid in the same 351-person trial |
| Closed comedones (noninflammatory lesions) | Not stated in the abstracts we reviewed | Topical retinoids matched antibiotics on inflammatory lesions, while antibiotics did less for noninflammatory lesions; closed comedones weren't reported separately (Huang); tretinoin named in the 1991 description (Kligman) | Not stated in the abstracts we reviewed |
| Tolerability data | Evidence on minor side effects is uncertain or low quality; scaling reported | Adverse events ranged from 19% to 62% across tretinoin and adapalene strengths | Evidence vs azelaic acid is very low quality (30 people) |
| Aging-skin data | None in our sources | Adapalene 0.1% improved the Skin Ageing Score vs controls over 6 months; a dermoscopic aging score improved in both arms but didn't differ between groups (Tran) | None in our sources |
| Tested in perimenopausal women | No | No | No |
Azelaic acid. The Cochrane findings above rest on 1 trial for each comparison, rated moderate quality. In a randomized study of 40 women aged 25 to 44, 6 months of azelaic acid 15% gel and oral spironolactone both improved acne quality-of-life scores, with no difference between groups (Bomfim et al., 2024). LEO Pharma donated the medicines, the mean age was 32.7, and 85% had persistent acne.
A 16-week, investigator-blinded trial studied a skincare product containing azelaic acid and Myrtus communis (myrtle) extract in 53 adult women whose acne had already cleared or almost cleared (Bagatin et al., 2023). Relapses numbered 3 vs 8 with a light moisturizer, but the main severity score didn't differ statistically. The trial has Pierre Fabre Dermo-Cosmétique funding, with company-affiliated authors, and its authors say they developed the product.
Topical retinoids. These vitamin A derivatives include adapalene, tretinoin and tazarotene. In the 54-trial review, retinoids beat vehicle (the same base without the active), and pairing a retinoid with benzoyl peroxide improved Investigator Global Assessment scores by 26.1% to 34.9% vs 7% to 11.8% with vehicle at week 12 (Kolli et al., 2019).
The aging evidence is separate from the acne evidence. In a single-center randomized trial, 58 women with moderate skin aging completed 6 months of adapalene 0.1% or no added treatment, and all used sunscreen, moisturizer and cleanser (Tran et al., 2025). Skin Ageing Scores fell from 38.2 to 32.5 with adapalene and barely moved in controls, although a dermoscopic aging score didn't differ significantly. Stinging affected 64.3% and dryness 25%, mostly improving after 2 months. This study didn't test acne, and funding wasn't reported in the abstract.
For more on frequency and aging, see whether you can use retinol every night and what tretinoin trials show for wrinkles. Early breakouts on a new retinoid raise a separate question, covered in what skin purging is.
Benzoyl peroxide. Benzoyl peroxide beat azelaic acid in one trial, but no study in our sources examines its tolerability in perimenopausal or aging skin. A 2021 review flags proneness to sensitivity in adult female acne and calls for tailored skincare (Bagatin et al., 2021). It was also the shared background treatment in both arms of a 133-woman trial, discussed below (Dréno et al., 2024).
The 2016 American Academy of Dermatology guideline covers topical and systemic acne care across ages (Zaenglein et al., 2016), and a 2018 review stresses tailoring treatment to each woman (Tan et al., 2018), with publication costs covered by La Roche-Posay. No study in our sources tests a schedule for layering these actives in perimenopausal skin, so any alternating routine isn't trial-tested. Evidence: Well-established for retinoids and benzoyl peroxide in acne generally; Limited for azelaic acid head-to-head results; no direct evidence in perimenopausal women.
When is spironolactone discussed for perimenopause acne?
Spironolactone is a prescription anti-androgen that a doctor may discuss when topicals aren't enough. Randomized trials support it for adult women's acne, but none in our sources enrolled perimenopausal women specifically.
A 2019 review says prolonged topical therapy is the mainstay for mild menopausal acne without virilization (marked male-pattern changes), and names spironolactone first choice for those who need an oral anti-androgen (Khunger & Mehrotra, 2019). It also calls combined oral contraceptives effective but relatively contraindicated after menopause. Spironolactone is prescribed off-label for acne (Ghanem et al., 2025), meaning this use is outside its official approval.
In the National Institute for Health and Care Research-funded SAFA trial, a double-blind study in England and Wales, 410 women were randomized and 342 entered the primary analysis (Santer et al., 2023). Headaches were more common on spironolactone (20% vs 12%), and no serious adverse reactions were reported. One author disclosed advisory, consulting, research or honoraria ties to companies including Almirall, Galderma, LEO Pharma, La Roche-Posay and L'Oréal.
Show data table
| Group | Reported improvement (%) |
|---|---|
| Spironolactone, week 12 | 72% |
| Placebo, week 12 | 68% |
| Spironolactone, week 24 | 82% |
| Placebo, week 24 | 63% |
Pooled data point the same way, with caveats. A meta-analysis of 5 randomized trials and 563 patients found an odds ratio of 6.59 for objectively assessed improvement vs placebo, but no significant difference on subjective assessment (Ghanem et al., 2025). Menstrual irregularities and breast enlargement weren't significantly increased, and the authors declared no conflicts. A second meta-analysis reported an odds ratio of 2.51 for treatment success vs placebo or doxycycline, with trial numbers and funding not reported in the abstract (Kow et al., 2025).
| Santer et al., BMJ, 2023 | 410 women randomized | 24 weeks | Oral spironolactone vs placebo (prescription; doses not listed here) | Reported improvement at week 24: 82% vs 63% |
| Dréno et al., Acta Derm Venereol, 2024 | 133 women | 6 months (doxycycline active for the first 3 months only), then further 6-month continuation for those treated successfully | Spironolactone plus benzoyl peroxide for 6 months vs doxycycline plus benzoyl peroxide for 3 months, then placebo plus benzoyl peroxide (prescription; doses not listed here) | Spironolactone more successful at month 6 (p=0.007) |
| Bomfim et al., Clin Cosmet Investig Dermatol, 2024 | 40 women aged 25-44 | 6 months | Azelaic acid 15% gel vs oral spironolactone (dose not listed here) | Quality of life improved in both; no difference between groups |
| Lessner et al., J Drugs Dermatol, 2014 | 41 women aged 19-57 | 2 to 102 months | Spironolactone plus topical tretinoin or adapalene (doses not listed here) | 85.4% rated good, excellent or clear |
| Bagatin et al., J Eur Acad Dermatol Venereol, 2023 | 53 women | 16 weeks | Myrtle extract plus azelaic acid product vs light moisturizer | Relapses 3 vs 8; severity score difference not significant |
| Tran et al., Indian J Dermatol Venereol Leprol, 2025 | 58 women completed | 6 months | Adapalene 0.1% cream vs no added treatment | Skin Ageing Score difference -5.40 (p<0.001) |
Santer et al., BMJ, 2023
Result: Reported improvement at week 24: 82% vs 63%
Double-blind RCT, mean age 29.2. NIHR-funded. Evidence: Limited for perimenopause; age does not match.
Dréno et al., Acta Derm Venereol, 2024
Result: Spironolactone more successful at month 6 (p=0.007)
Double-blind RCT in moderate acne. No conflicts declared. Evidence: Limited.
Bomfim et al., Clin Cosmet Investig Dermatol, 2024
Result: Quality of life improved in both; no difference between groups
Randomized study. LEO Pharma donated the medicines. Evidence: Limited.
Lessner et al., J Drugs Dermatol, 2014
Result: 85.4% rated good, excellent or clear
Retrospective chart review of cyclical acne. Funding not reported in abstract. Evidence: Early / preliminary.
Bagatin et al., J Eur Acad Dermatol Venereol, 2023
Result: Relapses 3 vs 8; severity score difference not significant
Exploratory, investigator-blinded maintenance RCT. Pierre Fabre Dermo-Cosmétique funding, with company-affiliated authors. Evidence: Limited.
Tran et al., Indian J Dermatol Venereol Leprol, 2025
Result: Skin Ageing Score difference -5.40 (p<0.001)
Single-center aging trial, not an acne trial. Funding not reported in abstract. Evidence: Limited.
None of these studies enrolled perimenopausal women specifically. Prescription doses are left out on purpose; those decisions belong with your doctor.
The highest age stated in our abstracts comes from the retrospective chart review above, which included women up to 57 and had no described comparison arm (Lessner et al., 2014). The head-to-head FASCE trial gave spironolactone plus benzoyl peroxide for 6 months, while the doxycycline arm got doxycycline plus benzoyl peroxide for 3 months, then placebo plus benzoyl peroxide for 3 months. Spironolactone was 1.37 times more successful at month 4 and 2.87 times more successful at month 6; the abstract reports a statistically significant difference only at month 6 (p=0.007) (Dréno et al., 2024).
Treatment choices can depend on your health history, so ask your clinician about any hormonal option. A 2021 review says acne drugs should be chosen with pregnancy plans, pregnancy or breastfeeding in mind (Bagatin et al., 2021). The abstract doesn't mention perimenopause, but this may still apply if pregnancy remains possible. The abstracts we reviewed don't cover menopausal hormone therapy and acne, so we can't say whether it helps or worsens breakouts. For a different question about topical hormones, see estrogen cream for the face. Never start, stop or change a medication, contraceptive or hormone therapy on your own. Evidence: Well-established in adult women generally; no direct evidence in perimenopausal women.
How long does perimenopause acne take to improve?
Expect a timeline of months, not weeks. A 2021 review says improvement in adult female acne is noticeable only after 3 months, whichever treatment is used, and no study in our sources measures this in perimenopausal women.
When adult acne and retinoid studies saw changes
- Month 2Retinoid side effects settle
Most stinging and dryness improved after 2 months in an adapalene aging trial (Tran).
- Month 3Improvement becomes noticeable
A 2021 review places visible improvement after 3 months (Bagatin 2021). The median trial in a 221-trial analysis ran 12 weeks (Huang).
- Month 6Larger gaps appear in oral drug trials
Differences favoring spironolactone were greater at week 24 than week 12 (Santer).
- YearsMaintenance
An expert guide says maintenance treatment is usually required for years (Bagatin 2019).
The 2021 review also names lesion picking as an aggravating habit to discuss with patients (Bagatin et al., 2021). Our sources don't show whether perimenopause acne fades once hormones settle, because none of the abstracts we reviewed reports following women through that transition; the 1991 description calls postmenopausal acne long-smoldering (Kligman, 1991). Evidence: Limited.
Where the evidence stops
- No perimenopause trials. No randomized trial in our sources enrolled perimenopausal women specifically; adult-female trials enrolled women 18 and up (SAFA) or 25 to 44 (Bomfim).
- Age mismatch. Mean ages were 20.4 in the network meta-analysis, 29.2 in SAFA and 32.7 in the azelaic acid comparison.
- Weak pattern data. The only abstract-level description of how acne around menopause looks dates from 1991 and isn't a trial.
- Thin azelaic acid data. Its key comparisons rest on 1 trial each, with study quality limited by bias and imprecision.
- Unknown tolerance. No study here tests benzoyl peroxide or azelaic acid specifically in aging skin.
- Hormone therapy. The abstracts we reviewed don't address its effect on acne.
FAQ
What causes perimenopause acne?
Reviews link perimenopause acne to declining estrogen and relative androgen excess, along with inflammation, skin barrier impairment and microbiome shifts. Androgens can enlarge oil glands and increase oil output, but they are considered necessary rather than sufficient on their own.
What do perimenopause pimples look like?
The abstracts we reviewed don't describe perimenopause pimples as a separate pattern, though a 2019 review calls menopausal acne a special subtype. A 1991 description of postmenopausal acne reported low-grade, long-lasting acne dominated by small closed comedones with a few small inflamed bumps, but that was an observational account, not a trial.
Do I need hormone tests for perimenopause acne?
That is a decision for a doctor. A 2019 review says most menopausal women with a few isolated lesions have normal androgen levels and do not need extensive investigation, though it calls baseline tests including total testosterone useful, and a 2019 paper notes that no dermatology guideline defines when endocrine testing is needed.
Is azelaic acid or benzoyl peroxide better for perimenopause acne?
No trial in our sources compares them in perimenopausal women. In one 351-person trial in a Cochrane review, azelaic acid was probably less effective than benzoyl peroxide, while most participants across that review were 12 to 30 years old.
Can a retinoid treat acne and aging skin at the same time?
Each use has its own evidence, but no trial in our sources tests both goals together in perimenopausal women. Retinoids beat vehicle for acne in a systematic review, and adapalene 0.1% improved the Skin Ageing Score over 6 months in a separate randomized trial with 58 completers.
Does spironolactone work for perimenopause acne?
Spironolactone improved acne in adult women in randomized trials, but those trials did not enroll perimenopausal women specifically, and the SAFA trial had a mean age of 29.2. It is a prescription medicine, so whether it suits you is a question for a doctor.
Does hormone therapy help or worsen perimenopause acne?
The abstracts we reviewed don't cover menopausal hormone therapy and acne, so we cannot say whether it helps or worsens breakouts. Ask your clinician, and never start, stop or change hormone therapy on your own.
How long does perimenopause acne treatment take to work?
A 2021 review of adult female acne says improvement is noticeable only after 3 months, whichever treatment is used. A 2019 expert guide says maintenance treatment is usually required for years, although neither paper focused on perimenopausal women.
References
- Parkinson H. Adult and perimenopausal acne and the nurse's role in management. Br J Nurs. 2026. Review; author listed as GP and aesthetic doctor at Dr Hazel Skin Solutions; no interests declared. https://pubmed.ncbi.nlm.nih.gov/41636006/
- Zeichner JA, et al. Emerging Issues in Adult Female Acne. J Clin Aesthet Dermatol. 2017. Expert review; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/28210380/
- Khunger N, Mehrotra K. Menopausal Acne - Challenges And Solutions. Int J Womens Health. 2019. Review; no conflicts reported. https://pubmed.ncbi.nlm.nih.gov/31754313/
- Bagatin E, et al. Adult female acne: a guide to clinical practice. An Bras Dermatol. 2019. Expert consensus guide, 5 experts; 1 author is a Bayer medical consultant. https://pubmed.ncbi.nlm.nih.gov/30726466/
- Bagatin E, et al. Treatment challenges in adult female acne and future directions. Expert Rev Clin Pharmacol. 2021. Literature review; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/33957838/
- Tan AU, et al. A review of diagnosis and treatment of acne in adult female patients. Int J Womens Dermatol. 2018. Review; La Roche-Posay covered publication costs (no role in content per the authors); authors declared no conflicts. https://pubmed.ncbi.nlm.nih.gov/29872679/
- Zaenglein AL, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016. Evidence-based guideline; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/26897386/
- Santer M, et al. Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial. BMJ. 2023. Double-blind RCT, n=410 randomized, 24 weeks; NIHR-funded; 1 author disclosed ties to Almirall, Eucerin, Galderma, GSK, La Roche-Posay, LEO Pharma, L'Oréal, Mylan, Origimm and Procter & Gamble. https://pubmed.ncbi.nlm.nih.gov/37192767/
- Kow CS, et al. Spironolactone for the Treatment of Moderate to Severe Acne in Adult Women: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Australas J Dermatol. 2025. Meta-analysis; number of trials and funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/39912292/
- Ghanem L, et al. Efficacy and Safety of Oral Spironolactone for Women With Acne Vulgaris: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials With Trial Sequential Analysis. J Cosmet Dermatol. 2025. Meta-analysis, 5 RCTs, 563 patients; no conflicts declared. https://pubmed.ncbi.nlm.nih.gov/40823723/
- Dréno B, et al. Efficacy of Spironolactone Compared with Doxycycline in Moderate Acne in Adult Females: Results of the Multicentre, Controlled, Randomized, Double-blind Prospective and Parallel Female Acne Spironolactone vs doxyCycline Efficacy (FASCE) Study. Acta Derm Venereol. 2024. Double-blind RCT, n=133, 6 months plus continuation; no conflicts declared. https://pubmed.ncbi.nlm.nih.gov/38380975/
- Bomfim DP, et al. A Prospective Randomized Trial Comparing Quality of Life in Adult Female Acne Treated with Azelaic Acid 15% Gel versus Oral Spironolactone. Clin Cosmet Investig Dermatol. 2024. Randomized study, n=40, 6 months; LEO Pharma donated the medicines. https://pubmed.ncbi.nlm.nih.gov/39444646/
- Liu H, et al. Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne. Cochrane Database Syst Rev. 2020. Systematic review, 49 trials, 3,880 participants; authors declared nothing; clinical referee disclosed advisory, consulting or investigator roles with Allergan, Almirall, Cipher, Galderma and Valeant. https://pubmed.ncbi.nlm.nih.gov/32356369/
- Huang CY, et al. Comparative Efficacy of Pharmacological Treatments for Acne Vulgaris: A Network Meta-Analysis of 221 Randomized Controlled Trials. Ann Fam Med. 2023. Network meta-analysis, 221 trials, 65,601 patients, median 12 weeks; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/37487721/
- Kolli SS, et al. Topical Retinoids in Acne Vulgaris: A Systematic Review. Am J Clin Dermatol. 2019. Systematic review, 54 trials; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/30674002/
- Bagatin E, et al. The usefulness of a dermocosmetic containing Myrtus communis extract and azelaic acid for maintenance phase of adult female acne: Results from a randomized exploratory investigator-blinded comparative study. J Eur Acad Dermatol Venereol. 2023. Investigator-blinded RCT, n=53, 16 weeks; Pierre Fabre Dermo-Cosmétique funding, with company-affiliated authors. https://pubmed.ncbi.nlm.nih.gov/36729399/
- Telkkälä A, et al. Etiology of Adult Female Acne-Systematic Review. Health Sci Rep. 2025. Systematic literature review, 20 articles; no conflicts declared. https://pubmed.ncbi.nlm.nih.gov/40309637/
- Lessner E, et al. Spironolactone and topical retinoids in adult female cyclical acne. J Drugs Dermatol. 2014. Retrospective chart review, n=41, 2 to 102 months; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/24509960/
- Bienenfeld A, et al. Androgens in women: Androgen-mediated skin disease and patient evaluation. J Am Acad Dermatol. 2019. Continuing education review; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/30312644/
- Kligman AM. Postmenopausal acne. Cutis. 1991. Observational description, not a trial; n and funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/1831742/
- Tran QT, et al. Effectiveness and tolerability of adapalene cream 0.1% in the treatment of female skin ageing: A randomised controlled trial. Indian J Dermatol Venereol Leprol. 2025. Single-center RCT in skin aging, not acne, 58 completed, 6 months; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/40990960/
Disclosure: This article is for general information only. It is not medical advice. Peptide Skincare has no affiliate links in this article and received no payment from any manufacturer mentioned. Hormonal and prescription acne treatments need a doctor; never start, stop or change any medication or hormone therapy on your own.