Mature Skin and Acne (#2)
Here is a good general rule when deciding on acne treatment options.
The more superficial the acne, the more likely topicals are to be effective. The deeper the acne (as in the small tender cysts), the more likely you are to need something to take orally, either alone or in combination with topicals.
If you have mostly the deeper cysts, topical treatment won’t help much because the creams, lotions, etc can’t really get down to the level of the problem.
For more information on skin care and menopause, see Dr. Irwin’s article Menopause and Your Skin