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[mking12]

About 10 years ago I went on Roaccutane for terrible acne, when I started the perimenopause.  My doctor could not help me so I had to go private to have this treated.

2 years ago I got prescribed HRT by a private clinic, and this stopped my terrible night sweats and hot flashes, but about 6 months ago my terrible acne started again and steadily got worse.  I decided to come off the HRT to see if it was causing it, and after about 10 days, my acne totally vanished.  The problem was 2 months later the night sweats came back, as did the hot flashes, but much worse this time, leaving me unable to sleep.

I have now gone back on the HRT, 2 weeks so far, and the night sweats have gone, and the hot flashes are much less.   I can see small spots appearing on my face and I am really worried it is going to get worse again.  I don't know whether to see a dermatologist or go back to the private menopause specialist first.  I am going to have to pay as the GP is useless at skin issues, the menopause nurse takes weeks to see, and from past experience, they are not good with acne.  I have suffered with it for years on and off, and all the normal treatments you can be prescribed via the GPdo not work, hence seeing the private dermatologist 10 years ago.

I wondered from other peoples experience who to see first, since It will cost me a lot of money I don't want to pay to see the wrong specialist. 

[CLKD]

Hi!  did U suffer with spotty skin during your teens?   I believe that antibiotics can help but it's a long course.  It certainly seems that something in the HRT triggers spots!

Which HRT have you been prescribed this time?  There are anti-depressants which may ease hot flushes.  A dermatologist would be my way to go.

U will probably be aware of the waiting lists so paying out is important to get this under control.  Will be interested to see what other Members suggest.

[mking12]

Thanks for the reply

Unfortunately, I have done the antibiotics, I suffered from spots from my teens.  I don't want to go down the antidepressant route, as I am not depressed and not suffering any mental health issues.

I did not mention the HRT I am on, I take one Utrogestan tablet every day and Oestrogel two pumps a day. I'm 48 and have been on the progesterone-only pill for many years to stop my periods due to endometriosis.

[CLKD]

I'm not suggesting that you have mental health issues, simply that with many medications which are designed to help 1 complaint, a few ADs have been found to help hot flushes. 

Which route would you think suits you the best?

[mking12]

I suppose I don't want to spend money seeing a menopause specialist, only to find they then recommend a dermatologist and vice versa, as I am looking at a lot of money being based just outside of London.  I wondered if anyone else had had the same thing happen and which specialist sorted the problem out. 

I would prefer to keep taking HRT as the only issue I have had is the acne.

[Sprat_Jax]

Hi - I've been on HRT for almost 3 months and have been getting the occasional spot from it. I did a bit of googling and from what I could tell - it could be progesterone that's the culprit for the acne? My plan for if the spots got worse (I had bad acne in my teens/early 20s) was to try using the progesterone vaginally as you halve the dose there and I am not sure if it quite gets into your system as compared to taking it orally. This is complete layman guesswork on my behalf - you could try running it past a doctor?

[Dierdre]

My DIL can't take the contraception pill as it caused acne and nothing would stop it. It stopped as soon as she stopped taking it.

[Violetta808]

Hi. I sympathise as I had miserable ‘adult’ acne myself and finally took a course of Roaccutane when I was 31. It worked wonderfully well but I still get the occasional breakout, even nearly 25 years later.

I am only guessing, but as yours seems to be hormonal acne (as most is) a dermatologist would likely just say stop the hormones that’s triggering it. Which is not much use when you want to take HRT. So a menopause specialist might be more appropriate to find you a skin-friendly regime.

It could indeed be the progestogen that needs tweaking as Sprat says. Long long ago I was on a combined Pill for a while called Dianette with the progestogen cyproterone acetate, which blocks testosterone receptors. I don’t know if that is available separately (or how safe it is these days).

I found my skin became less greasy therefore improved as I went through menopause. I’m pretty sure it’s testosterone that triggers my skin (I have zero libido but much better skin these days 🙄)

Ironically my skin became flawless on same dose of HRT as you - we are all so different in our responses. I am off HRT for now and have noticed a spot or two return.

So I don’t have an answer but just wanted to say you are not alone.

[CLKD]

   violetta808

[mking12]

Thanks to everyone, some great ideas there.  I think I will book an appointment with the menopause specialist as it could well be progesterone causing the problems.

Unfortunately due to migraine with aura, the only contraceptive pill I can take is progesterone only, and not the combined.

[Sprat_Jax]

I hope you can get it sorted. I've struggled with acne on and off my adult life so I know how awful it can be. Let us know how you go.

[Banjo1973]

Hi mking12,

As you said you were on a prog only contraceptive, I was wondering whether you could replace your Utrogestan with a progesterone with something more similar to what you seemed to tolerate better.

What pill was it?

[mking12]

I am on desogestrel, and have always tolerated it very well.  This is something I could ask my GP or practice nurse.

I am going to try the Utrogestan vaginally, as looking at info online this could solve the problem.

[Sgtvhilts]

Hi ,
Probably quite late in the day to come in on this, but the word ACNE caught my eye.
I too have suffered with horrendous acne, needing roaccutane x2 over the years, along with all the ‘other’ stuff doled out. Does hrt cause an increase in/ flare up acne?? In my experience YES . Particularly my old friend progesterone. I am in the process of ‘re evaluating’ my own hrt after going on conti and not really getting on with the constant progesterone, but what I do very much have is a nice dose of inflamed ‘spots’ one right in my eyebrow at this moment and my usual places cheeks and around side of nose-HOW at my age (54) grrrr.
I didn’t have it this bad when I was on sequi, hardly any ‘nonsense’at all- only difference there was progesterone free for 14 days.
So for me that was and still is no 1 suspect and culprit.
If you need to be on it- what about another course of roaccutane? Has its own ‘delights’, but would no doubt cure it. I also used retin-A for years and that was really effective, but of course some ‘helpful’ person has taken it off the market in UK. I discovered that it is still available to buy from India.
I hope you find a solution, I feel your pain xx

[mking12]

Just thought I would post an update. 

I switched GP, and was able to see someone to discuss my HRT issues within a day rather than the 6 weeks that my previous GP would take, which was amazing.

They put me on Femoston 1/10, I am halfway through my second month, and no acne whatsoever, and my skin looks great.  No night sweats either which were horrendous, and I have not felt this well in years.