Why at 50 is my Face Breaking out

I am 50 yrs old and on chin I get these red pimples what could be the cause?

Doctor Answers 5

Acne at 50? Life really is unfair sometimes, isn't it?

Hi Mrs Mac.  Frequently I see women aged 20-55 with breakouts continuing well into middle years, starting again after a period of clear skin, or first occurring in the 30’s and 40’s. Often these same women are starting to see signs of aging and say  "Seriously, this is ridiculous--wrinkles and acne?"

Acne in adult women is strongly hormonal, combined with an inherited tendency and additional triggers of stress, heat, sweat and cosmetics which plug pores. It predominantly occurs on the chin and jaw line, areas where oil glands are most hormonally influenced. Stimulation of oil glands by male hormones, called androgens, is a key factor. Symptoms of hormonal imbalance with excess androgens are irregular menstrual cycles, acne, excess hair growth and infertility. Some women have normal androgen levels but oil glands that are more sensitive. 

Certain birth control pills, progestin containing IUD's, and the birth control shot have androgenic activity that aggravate acne. Menopausal women taking estrogen-testosterone for libido, or DHEA supplements may develop acne, facial hair growth and balding. Under stress--emotional, physical, sleep deprivation or a hectic life--adrenal glands release stress hormones; worsening acne, and increasing stress even more.

Cosmetics alone don't cause acne, but may worsen it by plugging oil glands. Long-wearing "all day coverage" foundations, oil-based foundations, covering pimples with concealer, or using a brush to apply mineral powder may plug or irritate pores and worsen acne. Look for moisturizers, foundations and powders that are non-comedogenic and non-acnegenic. Mineral powder applied with a sponge or liquid oil-free foundations are best. Hair styling products, heat, sweat, oil and friction (sweaty workout clothes, cell phones and touching your face etc) should be reduced.

To treat, we start with a skin care and surface retinoid program that both targets acne and is the mainstay of an anti-aging program. Antibiotic pads after workouts, light chemical peels, blue light treatment, and in certain patients, medical microdermabrasion are helpful. Oral antibiotics are often needed for larger, deeper cysts.

Getting hormones straightened out is essential, but complicated. For patients needing birth control or with hormonal imbalance, birth control pills such as Ortho Tri-Cyclen, Estrostep, Alesse, Yasmin, Yaz, Mircette, Ortho-Cept, and Desogen  improve acne. Dosages of estrogen-testosterone or DHEA may need to be reduced.

A related problem, perioral dermatitis, occurs as a pimply rash around the mouth. Your dermatologist can determine whether you have adult acne or perioral dermatitis.

Luckily, many of our acne therapies are also effective as anti-aging treatments, which is fair. So see your dermatologist for help. Good luck.

Amarillo Dermatologist

Have a question? Ask a doctor

Do You Really Have Acne?

Not everything that looks like acne actually is.
That's the problem in answering questions on a forum like this.

You might have Rosacea, or it's first cousin Perioral Eczema.

Both are treated with similar medications at times, but there are differences in both the problems and some of the medications used.

Michael A. Greenberg, MD
Elk Grove Village Dermatologist
5.0 out of 5 stars 2 reviews

Acne Occurs at All Ages, Caused by Hormones and Genetics

Adult acne is not as uncommon as one thinks. And comments from patients that they want their acne treated and wrinkles gone happens in dermatologists offices all the time. Acne is genetic and hormonal so at 50, most likely there is a hormonal influence at work here — but most all hormonal studies will be normal so we do not usually do much with them. Dermatologists will pick the best treatment routine with medicines and perhaps lasers and light sources to work with the acne and the wrinkles to make a bad situation into a good fix.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.5 out of 5 stars 10 reviews

Adult Acne at 50

Adult acne can strike at anytime; it is not unusual to experience acne in your 40's and 50's, even if you have not had acne in the past.  Your dermatologist will help you to find the best treatment regimen.  A common cause of acne in adults is a hormonal influence, particularly when women begin to have acne on their lower face and chin.  

Eric Schweiger, MD
New York Dermatologic Surgeon
3.5 out of 5 stars 11 reviews

Adult Acne

Twelve percent of women above the age of 24 will either continue to have teen acne or develop new acne lesions in their adult years. The typical causative factors are stress, inappropriate selections of make-up and hormonal imbalance. The lower third of the face often breaks out because of the latter. Especially at 50, the peri-menopausal years, supplementation with bio-identical hormone replacement therapy might solve more than just just the issue of acne. Other peri-menopausal issues such as night sweats and hot flashes would also be expected to improve.

Pamela Carr, MD
Sugar Land Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.