Why is my skin 41 going on 14?

January 23, 2008 5:54 PM

Why am I, in my 40's, suddenly breaking out like a teenager?

In the past few weeks I have developed lots of acne. It's mostly clusters of pimples and blackheads on my jawline. But I also have whiteheads on my nose and around my mouth, which reappear the day after I squeeze them.

Some background - I am female and in my early 40's. I had a bad complexion when I was in my teens and early 20's, to the point that I was prescribed Accutane and the skin problems mostly subsided. The acne returned in my later 20's and I was prescribed Retin-A. I used it up until last year, when my dermatologist switched me over to Avage (which is a tazarotene .1% cream) because he thought it would be less drying than the Retin-A.

My skincare routine is simple - in the morning I wash with Cetaphil and use nothing on my face except for sunscreen (Neutrogena Dry Touch). At night I use the Avage. During the winter months I use a fairly heavy moisturizer because the dry/cold air dries out my skin so much that it flakes. I rarely wear makeup.

I am in good health, eat well, and take multivitamins and Omega-3 capsules daily. I am also using a no-estrogen birth control pill (Camila).

I am of Irish descent and my skin is fair. I get flushed when I exert myself or drink, and I got some significant sunburns when I was younger and have some sun damage (freckles and spots).

I have been, for the most part, pimple free, over the past 10-ish years. No part of my regimen/lifestyle has changed recently, except in positive ways - less stress and booze, no more smoking, and lots more sleep.

So what would cause this problem? I suspect it might be the heavy moisturizer, so could anyone recommend something that won't make me break out?

posted by anonymous to health & fitness (10 comments total)

Kind of an obvious guess, but menopause? Serious hormonal changes etc.
posted by rokusan at 6:08 PM on January 23, 2008

seconding the hormones. also, are you exfoliating your skin? that's a huge culprit. if you use lip balm overnight, it might be smearing a bit on your face as you move in your sleep.

also: it sounds weird, but wipe down your phone every day with rubbing alcohol. once i started doing that, i noticed many fewer jawline zits.
posted by thinkingwoman at 6:23 PM on January 23, 2008 [1 favorite has favorites]

Also seconding hormones as the culprit. Acne is not uncommon while going through menopause or perimenopause.
posted by LoriFLA at 6:41 PM on January 23, 2008

Definitely hormones, but not necessarily menopause. I sympathize - I developed adult-onset acne in my early 30s. It's hormonal, in my case due to PCOS rather than menopause.

My acne has also been closely tied to what type, if any, of oral contraceptive I have taken (OCs are a common treatment for PCOS, so I've tried a number of them). Some made it really bad, some alleviated it. How recently did you start taking Camila? When I was on a progesterone-only pill, my skin was terrible - cystic acne all over my chin/jawline and back. Can't remember exactly when it happened, but it wasn't right away - many a few cycles after I started taking it. A couple of others, including Ortho Tri-Cyclen, were equally awful. Yazmin made my skin nearly perfect, but made me a nervous wreck! They are definitely *not* all the same.
posted by chez shoes at 6:41 PM on January 23, 2008

Uh, that should have been *maybe* a few cycles. Long day, sorry.
posted by chez shoes at 6:42 PM on January 23, 2008

2nding PCOS & high androgen levels. Certain OCs help, but spironolactone helps too.
posted by ick at 7:37 PM on January 23, 2008

Could you be pregnant?
posted by InnocentBystander at 7:38 PM on January 23, 2008

I am pretty sure my mom had some premenopause-caused breakouts (not as bad as what you're describing, but it sounds like you're more pre-disposed) in her early to mid-40s; your hormones start changing, so that might be it.
posted by SoftRain at 1:30 AM on January 24, 2008

2nding the pregnant. Right before I found out I was pregnant, I looked like a 16-year-old again. Still do, as a matter of fact, but it's improving as the Munchkin grows.
posted by tigerjade at 5:28 AM on January 24, 2008

Your story sounds similar (although not identical) to mine, and my stepfather the Board-certified dermatologist in private practice says rosacea, not hormones. It's probably worth seeing a dermatologist, since there are several approaches depending on specific presentation + what you are willing to do. Even just minor changes in your skincare regimen could help, and derms are the fastest navigators around all the snake-oil out there.
posted by caitlinb at 12:26 PM on January 24, 2008