Ep #7: 15-Minute Consult: Acne and Facial Hair in Perimenopause & Menopause with Dr. Melissa Mauskar

As a board-certified OBGYN, I’m the first to admit: while I’m an expert in hormones and menopause, I am not a dermatologist. Yet, my patients come to me every day with skin concerns that feel like “cruel and unusual punishment.” You’re already dealing with hot flashes and night sweats—why are the cystic acne and chin hairs back too?

To give you the answers you deserve, here is a “15-minute consultation” with my go-to expert and dear friend, Dr. Melissa Mauskar.

Dr. Mauskar is a double-threat: a Dermatologist and Associate Professor in both the Departments of Dermatology and OBGYN at UT Southwestern. She is the Director of Genital Dermatology and Women’s Health and a leading expert in vulvar dermatoses.

In this episode, we dive into the “Big Three” of menopausal skin:

1. The Return of the Adult Acne

Why are we getting “teenager” pimples in our 50s? Dr. Mauskar explains the “hormonal dance” of perimenopause—specifically the relative androgen excess that happens when estrogen dips.

• The Gold Standard: Why retinoids (like Tazarotene) are the “heavy hitters” for both acne and aging.
• The Spironolactone Debate: We discuss why this anti-androgen is a first-line treatment for skin, but why I, as a sexual health expert, have some serious reservations about its impact on libido.

2. The “Wisdom” Hairs (Chin Beards & Upper Lips)

Dr. Mauskar breaks down why terminal hairs start popping up on the chin and why you need to act before they turn white if you want laser hair removal to work. (Plus, I share a quick story about why chin hairs are actually a sign of wisdom in Sub-Saharan Africa!)

3. The Widening Part: Hair Thinning

It is incredibly frustrating to see your hair density drop just as your hormones shift. We discuss:

• Topical vs. Oral Minoxidil: Which one is right for your hair-washing routine?
• The 6-Month Rule: Why patience is the most important ingredient in any hair growth protocol.
• Red Light Caps: Are they worth the investment, or should you stick to the basics?

Connect with Dr. Melissa Mauskar

• Professional Profile: UT Southwestern Medical Center – Dr. Melissa Mauskar
• Specialty: Genital Dermatology, Lichen Sclerosis, and Women’s Health.

Key Resources Mentioned

• Tazarotene: A potent retinoid Dr. Mauskar prefers over traditional Tretinoin for better tolerance.

Spironolactone: A common oral medication for hormonal acne (use with caution regarding sexual side effects!).