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I have had many patients say "how can I have wrinkles and pimples at the same time?" Well it seems that menopause plays some dirty little tricks on us including causing acne. During perimenopause and early menopause estrogen levels are declining while traces of male hormone remain. Male hormones stimulate the sebaceous glands to produce oils that promote acne. As for wrinkles, it the lack of estrogen again that is the culprit. Lower estrogen levels are known to promote collagen loss in the skin causing wrinkles.