You survived teenage acne. Then your 40s said, just kidding.
If you are suddenly breaking out on your chin and jaw in your late 30s, 40s, or 50s, while also fighting fine lines in the same mirror, this episode is for you. Dr. Arti Thangudu, triple board-certified endocrinologist and founder of Complete Medicine, breaks down the zits-and-wrinkles combo nobody put in the brochure. She hears about it constantly from her own patients, and she has watched too many women get handed another cleanser when what they needed was a hormone conversation.
🔍 This episode explores:
• 🧩 Why estrogen starts "ghosting you" in perimenopause, riding up and down like a roller coaster while androgens stick around, and why that ratio shift lands on your chin, jaw, and neck
• 🧩 The three patterns of adult acne in women (persistent, late-onset, postmenopausal), why persistent acne can travel with PCOS (or PMOS, the newer name Dr. Arti prefers), and which pattern deserves an androgen workup
• 🧩 Why treating hormonal acne with skincare alone is like mopping the floor while the faucet is still running
• 🧩 Spironolactone: how a decades-old blood pressure medication became a well-studied, dermatology-recommended tool for hormonal acne
• 🧩 The honest side effect conversation, including the potassium question, period changes, and why pregnancy is a hard no while taking it
• 🧩 Who is the best candidate for spiro, and when a dermatologist should be leading your acne care
👩 This episode is for you if:
-Your breakouts came back (or showed up for the first time) after 35
-The same pimple returns to the same spot on your chin every few weeks
-Your flares track with your cycle, or got worse as your cycle changed
-You have tried every topical and still feel like you are losing
-You want to walk into your next appointment knowing exactly what to ask
⚖ The bottom line
Perimenopause acne is real, incredibly common, and not your fault. It is not a face-washing problem. It is a hormone transition, and there are real tools that treat it at the root cause. You deserve to be taken seriously, and you deserve clear skin at every age.
🎙 About the Host
Dr. Arti Thangudu is a triple board-certified physician in Internal Medicine, Endocrinology, and Obesity Medicine, and the founder of Complete Medicine, a direct-care practice built around time, transparency, and evidence. She is also a mom who understands that midlife health does not happen in a vacuum.
📚 Resources Mentioned
-American Academy of Dermatology guidance on spironolactone for hormonal acne
(discussed in episode)
-Complete Medicine: https://www.sacomplete.com
-This episode is sponsored by Complete Medicine and Hey Healthy
🔗 Learn More / Connect
🩺 Complete Medicine → https://www.sacomplete.com | Direct care with a doctor who actually has time for you
📩 Newsletter + Blog → https://www.sacomplete.com/complete-medicine-blog | Weekly, plain-language hormone breakdowns
🎙 Podcast → Endocrine Matters, new episodes every Wednesday on all major platforms
📲 Instagram → https://www.instagram.com/drartithangudu | Daily myth-busting and real talk
▶ YouTube → https://www.youtube.com/@drartithangudu | Full episodes and shorts
Subscribe, leave a review, and share this episode with a friend who is also fighting the zits-and-wrinkles combo.
🎙 About Endocrine Matters
Endocrine Matters is a weekly podcast where endocrinologist Dr. Arti Thangudu breaks down hormones, metabolism, and the healthcare system in plain language. No hype. No misinformation. No "heal your hormones naturally" shortcuts.
⏱ Chapters
00:00. Welcome and the zits-and-wrinkles combo
01:00. What is actually going on with your hormones
05:00. Can't I just use skincare?
07:00. Enter spironolactone
11:00. Side effects and safety, honestly
14:00. Who spiro is for, and when to see a dermatologist
16:00. The bottom line