Anonymous
Post 11/06/2025 16:26     Subject: Acne in middle-aged
Anonymous wrote:
Anonymous wrote:Spironolactone is the only thing that helped me. I’ve taken it for years and recently tapered from 100mg to 50mg daily. I’m 42.


+1
This is the answer. I recently tapered from 50 mg to 25.


I hate to tell you, but 25 mg isn't really therapeutic. My derm tapered me to that and I got a ton of cysts a couple months later once the dose settled. I ended up clearing with salicylic acid and quitting the spiro altogether.
Anonymous
Post 11/06/2025 16:12     Subject: Acne in middle-aged
Anonymous wrote:
Anonymous wrote:Spironolactone is the only thing that helped me. I’ve taken it for years and recently tapered from 100mg to 50mg daily. I’m 42.


+1
This is the answer. I recently tapered from 50 mg to 25.


Spironolactone did not work for me, and because I already have low blood pressure, it made me lightheaded and increased my fainting.
Anonymous
Post 11/06/2025 16:05     Subject: Acne in middle-aged
Anonymous wrote:Spironolactone is the only thing that helped me. I’ve taken it for years and recently tapered from 100mg to 50mg daily. I’m 42.


+1
This is the answer. I recently tapered from 50 mg to 25.
Anonymous
Post 11/06/2025 15:45     Subject: Re:Acne in middle-aged
Products with salicylic acid. I’ve always had oily skin though, so same old same old, just with less intense products.,
Anonymous
Post 11/06/2025 14:35     Subject: Acne in middle-aged
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I started with tretinoin, stuck with it, and finally figured out how to make it work for me (sandwiching).


This! I have always had clear skin. But once 36 hit I started getting those super deep and painful pimples (cystic acne?). It would just be one, but it would takes weeks to resolve, then leave an ugly red mark for MONTHS. As soon as the dark spot mostly faded, another painful pimple would start again. I felt like I was always in this cycle of having a painful pimple or faded the mark it left behind.

Tretinoin plus azelic acid did the trick. I haven’t had a pimple in years!

Good lord, I just turned 36 and am having the worst breakout of my life! What the heck 36, some sort of cursed age


35-40 I had really bad mood swings correlated to my cycle, much heavier periods, and acne. It was like a horrible second adolescence- perimenopause!!!
Anonymous
Post 11/06/2025 13:34     Subject: Acne in middle-aged
Are you female? (Sorry, I missed it if you said.)

my OBGYN said it's part of the whole "going into menopause" process. I had a brief period with acne maybe about 8-10 years before menopause. "It's your hormones, all over again" she also said.

Fantastic...

Anonymous
Post 11/06/2025 13:31     Subject: Acne in middle-aged
Anonymous wrote:
Anonymous wrote:I started with tretinoin, stuck with it, and finally figured out how to make it work for me (sandwiching).


This! I have always had clear skin. But once 36 hit I started getting those super deep and painful pimples (cystic acne?). It would just be one, but it would takes weeks to resolve, then leave an ugly red mark for MONTHS. As soon as the dark spot mostly faded, another painful pimple would start again. I felt like I was always in this cycle of having a painful pimple or faded the mark it left behind.

Tretinoin plus azelic acid did the trick. I haven’t had a pimple in years!

Good lord, I just turned 36 and am having the worst breakout of my life! What the heck 36, some sort of cursed age
Anonymous
Post 11/06/2025 13:28     Subject: Acne in middle-aged
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Is it cystic acne? Or regular acne? Cystic acne is nightmarish and I had to change my diet and get rid of dairy to make it go away. Regular acne you can just use salicylic acid.


What helped you? I think I'm going to need to give up dairy to get back to clear skin


Yeah, I had to change my diet for a few years. Can still have milk in my coffee but no cheese!


I seem to be the opposite. I think I'm okay with hard cheeses but if I have cream in my coffee or a matcha latte or whipped cream I get these huge cystic welts.


LOL! Sometimes it feels like my body does nothing but betray me...

I think Tretinoin has helped with this issue as well? I have not been as careful with diet but since I started tretinoin I have not gotten cystic acne.
Anonymous
Post 11/06/2025 12:04     Subject: Acne in middle-aged
A dermatologist prescribed me a low-dose Accutane, and it cleared up within weeks. Plus, I don't have to use tretinoin anymore because it would be redundant, so I can moisturize at night, and my skin looks so much better. I think it's also helping with wrinkles, texture, and pigmentation.
Anonymous
Post 11/06/2025 12:00     Subject: Acne in middle-aged
It depends on what kind it is. But I do remember a derm telling me that something like half of all women she sees in their 30s-40s are on spiro for hormonal acne.
Anonymous
Post 11/06/2025 10:34     Subject: Acne in middle-aged
Anonymous wrote:I got cystic acne in my 50s and found it was directly caused by inflammation from food allergies. The food allergies were new. I changed my diet and my skin, joints and mood all improved instantly.

Go on an elimination diet to see if your acne improves, (dairy, gluten, sugar, etc.). It's a simple cheap test.


I’ve found this too. Cottage cheese and anything oat related is the worst for me. I’ll get cystic acne all over my body after eating those. Yogurt OK in moderation, same w hard cheeses and ricotta. Lots of foods we are told are healthy (and are) can be really bad for your skin too.
Anonymous
Post 11/06/2025 10:28     Subject: Acne in middle-aged
I got cystic acne in my 50s and found it was directly caused by inflammation from food allergies. The food allergies were new. I changed my diet and my skin, joints and mood all improved instantly.

Go on an elimination diet to see if your acne improves, (dairy, gluten, sugar, etc.). It's a simple cheap test.
Anonymous
Post 11/06/2025 10:20     Subject: Acne in middle-aged
Went keto.
Anonymous
Post 11/06/2025 10:18     Subject: Re:Acne in middle-aged
When I was young (early 20s) I had terrible cystic acne and only Accutane worked. Now I'm old (upper 40s) and I get hormonal acne but it's surface-level. I treat it with OTC acids and drying agents. Being on or off birth control didn't change much for me.
Anonymous
Post 11/06/2025 09:53     Subject: Acne in middle-aged
Depends on what the cause is. Do you have more with your menstrual cycle? Is it hormonal? I've been on tretinoin for years and it isn't helping, the only thing that helps is birth control, which sucks because I'm over 35.