Woman taking hormone replacement pill

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Fluctuating Hormones

You may not be a teen, but your hormones may still be riding a roller coaster all the same as an adult. One common time is during perimenopause and menopause. "Estrogen is declining, which is protective against acne," says integrative dermatologist Cybele Fishman, MD. However, ovaries continue to make testosterone, and the imbalance brings about breakouts.

It's the estrogen in birth control pills that helps clear skin, so if you've been on hormonal birth control for years and just get off, you may also see pimples pop up again, adds Deirdre O'Boyle Hooper, MD, of Audubon Dermatology in New Orleans. She often suggests patients take a testosterone-blocking Rx called spironolactone. "It's the most-refilled drug in my office. That's how you know people like it," she says. You may be able to take it for three to six months and then taper off your dose.