Why do you suddenly start getting pimples again around age 45?

You might have thought you'd left this chapter behind long ago. Pimples, troubled skin, painful spots on your chin or jawline... that was for your teenage years, wasn't it? And yet, you're standing in front of the mirror again, thinking: why am I getting pimples again at my age?

Many women around 40 or 45 experience acne again due to hormonal fluctuations during perimenopause. In this phase, estrogen, progesterone, and androgens change. This can lead to hormonal pimples, often on the chin or jawline.

It feels confusing for many women. Your skin suddenly seems to react differently. Perhaps you're not only experiencing pimples on your face at an older age but also drier or more sensitive skin. This combination makes it even more frustrating.

But actually, this is a very recognizable story. Many women experience impure skin later in life due to hormonal changes.

In this blog, I'll calmly explain:

• why pimples can appear around age 45

• what hormonal changes occur in your body

• why hormonal pimples often appear on the chin

Read more: How to recognize menopausal acne?

45 years old and pimples: is that normal?

If you suddenly notice you're getting pimples again around age 45, it can feel very unexpected. Many women think acne is something from their teenage years. Yet, many women experience acne again later in life.

This is often due to the phase before menopause, perimenopause. During this period, hormones start to fluctuate more strongly. As a result, your skin may react differently than before.

Many women notice, for example, during this phase:

• pimples on the chin and jawline

• recurring subcutaneous pimples

• troubled skin due to hormones

• simultaneously drier or sensitive skin

This doesn't mean your skin has suddenly become "problematic." Often, your skin is simply reacting to hormonal changes that are part of this life stage.

What is perimenopause?

Perimenopause is the transitional period before menopause. In this phase, hormones slowly begin to change and fluctuate more strongly.

Menopause itself is only diagnosed when you haven't had a period for twelve months. The years leading up to that are called perimenopause.

During this period, women may experience various changes, such as:

• an irregular cycle

• hot flashes or sleep problems

• mood swings

• changes in the skin

Acne can also reappear.

Why do you get pimples again around age 45?

Many women literally search online for "45 years old and pimples." This is often because it comes unexpectedly.

The main reason lies in hormonal changes.

During perimenopause:

• estrogen gradually declines

• progesterone fluctuates more strongly

• androgens have relatively more influence

Androgens stimulate sebum production in the skin. This can make the skin greasier more quickly and pores can become clogged more easily. When pores become clogged and inflamed, hormonal pimples appear.

Why are hormonal pimples often on the chin?

With hormonal acne, we often see a typical pattern. The pimples mainly appear on:

• the chin

• the jawline

• around the mouth

• sometimes on the neck

This area is also called the U-zone. The skin in this zone is more sensitive to hormonal influences.

That's why many women notice that they primarily get pimples on their chin and jawline when hormones change. ( read more: zones of hormonal pimples )

These are often not small pimples, but:

• subcutaneous pimples

• painful inflammations

• pimples that keep recurring

Many women call these hormonal pimples on the chin, a pattern that is very typical for acne due to hormonal fluctuations.

What hormonal changes occur in your body?

To understand why acne can reappear, it helps to briefly look at the most important hormones. ( Read more: Hormonal acne explained: which hormones affect your skin).

Estrogen

Estrogen normally supports:

• skin hydration

• elasticity

• a strong skin barrier

When estrogen declines, the skin can become drier and more sensitive.

Progesterone

During perimenopause, progesterone can fluctuate significantly. This can contribute to skin that feels less stable.

Androgens

Androgens, such as testosterone, remain present in the body. When estrogen and progesterone decline, androgens have relatively more influence.

This can lead to:

• increased sebum production

• more easily clogged pores

• more inflammation

This is a major reason why women can get hormonal pimples again.

Why do you get dry skin and pimples at the same time?

Many women notice something that seems confusing: their skin feels both dry and impure at the same time.

It is common for women in this phase to experience dry skin and pimples simultaneously. ( read more: dry skin and pimples )

This is due to two processes happening at the same time:

1. The skin barrier weakens due to declining estrogen. This makes the skin lose moisture more easily.

2. At the same time, hormonal changes can increase sebum production.

The result is skin that:

• feels drier

• reacts more sensitively

• but can still develop pimples

This is therefore a very typical skin condition for women in perimenopause. (Read more: Dry skin and pimples simultaneously: how is that possible?)

What acne experts often see in women around 45

In practice, skin experts often see that acne in women around menopause is different from teenage acne.

Typical characteristics include:

• pimples on the chin and jawline

• deeper inflammations

• a more sensitive skin barrier

• slower skin healing

• higher chance of acne scars

Therefore, the classic approach for teenage acne often works less well for adult women. Skin in this phase usually needs a gentler and more targeted approach.

Why do you get pimples again around age 45? (brief summary)

Many women around 40 or 45 get pimples again due to hormonal changes during perimenopause.

When estrogen and progesterone decline, androgens have a relatively greater influence on the skin. This can lead to hormonal pimples, especially on the chin and jawline.

Typical signs include:

• pimples on the chin and jawline

• subcutaneous pimples

• troubled skin due to hormones

• dry skin and pimples at the same time

This type of acne is often called hormonal acne.

Frequently asked questions about pimples around age 45

Is it normal to get pimples around age 45?

Yes. Many women at this age get pimples again due to hormonal changes during perimenopause.

Why are pimples often on the chin?

The chin and jawline react more sensitively to hormonal fluctuations. That's why hormonal pimples often appear in this area.

Can you have dry skin and pimples at the same time?

Yes. During perimenopause, the skin barrier can weaken while hormonal changes affect sebum production.

Do hormonal pimples go away on their own?

For some women, they diminish over time as hormones stabilize. An adapted skincare routine often helps to calm the skin.

Summary

If you get pimples again around age 45, it is often related to hormonal changes during perimenopause.

Declining estrogen and fluctuating hormones can cause your skin to:

• become more sensitive

• feel drier

• develop pimples more easily

That's why many women in this phase get hormonal pimples, especially on the chin and jawline.

The most important thing to remember is that this is a very recognizable phase. Your skin is reacting to changes in your body, and with the right approach, it can calm down again.

Author: Sofie Dewitte

Sources:

1. Harper JC, et al. “Emerging Issues in Adult Female Acne.” Journal of Clinical and Aesthetic Dermatology, 2024.

2. Rocha M, Bagatin E. “Adult female acne: Clinical characteristics and factors related to disease severity.” Australasian Journal of Dermatology, 2018.

3. Del Rosso JQ, Kim G. “Adult female acne: A guide to clinical practice.” J Clin Aesthet Dermatol (review).