Post menopausal breakouts, and other chronic breakouts.

Please help. I've been dealing with this for 2 years now. I've been told it's anxiety acne and menopause acne hormones. I break out on my chin line, top of shoulders, back, upper arms and chest area only. It was almost gone, but now it's back. And there's a lot of acne now. It's so embarrassing, and I'm so over it. I've tried creams, oral antibiotics and gone to two different dermatologists. I believe it's more hormonal. I'm done with menopause. Someone told me if I go back on birth control it will help me. I cannot take hormones because women breast cancer runs in our family. Thank you, needing advice bad.

I’m so glad you asked this! Because, many women suffer with post menopausal breakouts. It’s annoying and embarrassing. And sometimes breakouts can cause permanent discoloration (red or white), or scars! But here’s the interesting news: these are not always what you think. These “breakouts” might NOT be acne at all.

Chronic or post menopausal breakouts? Here’s what to do:

1. Get a bacterial culture. 

First, ask your primary care doctor or dermatologist to do a bacterial culture. There doesn’t need to be an open wound or pus to do this. The long, Q-tip like swab needs to be rubbed firmly and vigorously over the affected area. Why? Sometimes staph or other bacteria are present, and have tracked down into the small hair follicles. This requires 1-4 weeks of an antibiotic to get rid of the bacteria. Your doctor can tell what is growing from the culture, and which antibiotics the bacterial is sensitive to.

2. Test your male hormones.

Your primary doctor can test your MALE hormones. Yes, all women have some androgens (male hormones). Testosterone and DHE are the most commonly tested ones. In some women, these are too high and can cause breakouts. Your doctor can help you with how to treat this, if your androgen levels are too high

3. Consider your female hormones.

Your hormones may need to be adjusted, if you are getting any kind of female hormone replacement. Progesterone is often the culprit, or testosterone.

4. Reassess your steroids. 

Steroids, especially oral steroids like prednisone, can cause breakouts. Injected steroids are the same. For example, a steroid like kenalog in a knee or hip injection. Talk to your doctor about a plan to get you off these steroid injections or oral steroids slowly.

5. Get a yeast biopsy.

A form of yeast called Pityrosporum can cause breakouts in these areas . Unfortunately, a culture can’t be used to diagnose this. A small biopsy with a special stain (PAS) is required. Oral medications like fluconazole can treat Pityrosporum. Creams generally don’t work, because they don’t penetrate deeply enough. So what can you do? Take good quality probiotics; and avoid sugar and junk food. Build up your gut biome by eating more vegetables. Especially raw ones.

6. Get your blood sugar tested. 

Diabetes can contribute to all sorts of problems! Please get your blood sugar tested, if you haven’t had this done in a while.

Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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