Many women tell me the same thing: their skin seemed to change almost overnight. Products that worked for years suddenly sting. Skin feels drier and thinner, make-up sits differently, and some women get spots again for the first time since their teens.
It isn’t in your head, and it isn’t just “getting older”. Hormones play a big part, and once you understand what’s happening, it’s much easier to know what will help.
Why menopause affects your skin
Your skin is full of oestrogen receptors. Oestrogen helps keep skin thick, firm and hydrated. It supports collagen production, helps the skin hold on to hyaluronic acid and water, and keeps the barrier lipids that lock moisture in topped up.
In perimenopause, which often starts in your 40s, oestrogen levels begin to fluctuate and then fall. The average age of menopause in the UK is 51. As oestrogen drops, the effect on skin can be marked. Studies by Brincat and colleagues found that women lose around 30% of their skin collagen in the first five years after menopause, and then roughly 2% a year after that.
The changes you might notice
- Dryness and dehydration. Less oil and fewer barrier lipids mean skin loses water more easily.
- Thinning and loss of firmness. Falling collagen makes skin less plump and more crepey, particularly on the neck, jawline and around the eyes.
- New sensitivity. A weaker barrier lets irritants in. Products you’ve used for years may suddenly sting.
- Breakouts. As oestrogen falls, the relative effect of androgens (male-type hormones) rises, which can trigger spots around the jaw and chin.
- Pigmentation. Existing sun damage often becomes more visible as skin renewal slows.
- Slower healing. Skin repairs more slowly, which is worth knowing before any treatment.
What helps: your daily skincare
Menopausal skin needs a routine that repairs as well as treats. The principles I give patients:
1. Cleanse gently. Swap foaming cleansers for a cream or oil cleanser. Tightness after washing means your cleanser is too harsh. There’s more on this in our guide to cleansing.
2. Rebuild the barrier. Look for moisturisers with ceramides, fatty acids and hyaluronic acid. Obagi Rebalance Skin Barrier Cream and Medik8 Advanced Night Restore are both good choices.
3. Keep vitamin A, but go gently. Retinoids are still the best-evidenced skincare ingredient for collagen, but menopausal skin is less tolerant. Start with a low strength two or three nights a week. Retinal, such as Medik8 Crystal Retinal, is effective at low strengths. Read our retinal vs retinol guide first.
4. Use vitamin C in the morning. It supports collagen and helps with pigmentation. Oil-soluble forms such as C-Tetra Luxe tend to suit drier skin better.
5. Wear SPF every day. UV is still the biggest single driver of skin ageing. Protecting the collagen you have matters more than ever.
What helps: in-clinic treatments
Skincare works at the surface. When collagen loss is the main issue, treatments that stimulate the deeper layers can make a much bigger difference.
- Profhilo is designed to hydrate deeply and support collagen and elastin production. It’s one of the treatments I recommend most for menopausal skin that has become dry and lax.
- Polynucleotides help thin, crepey skin, especially under the eyes and on the neck. See our guide to polynucleotides vs Profhilo.
- Microneedling triggers the skin’s own repair response, which encourages new collagen and can improve texture.
- Sculptra is a collagen stimulator that gradually restores structure where volume and firmness have been lost.
- Chemical peels can help with pigmentation and dullness, with the strength adjusted for more sensitive skin.
Because skin heals more slowly at this stage of life, we plan treatments carefully and space them out. We’ll also adjust your home routine around each treatment.
Where hormones and HRT come in
Some studies suggest hormone replacement therapy (HRT) may affect skin thickness and hydration, but the evidence is mixed and HRT isn’t used to treat skin. If menopause symptoms are affecting you, talk to your GP about the options.
On testing: if you’re over 45 with typical symptoms, menopause is usually diagnosed from your symptoms, and NICE advises that blood tests aren’t needed to diagnose it. Blood tests are useful, though, when symptoms start earlier, or to check for other causes of similar problems, such as thyroid issues, low iron or low vitamin D, which can also affect skin, hair and energy. We offer hormone and wellness blood testing in clinic if another cause needs ruling out.
Frequently asked questions
Is it too late to start retinoids after menopause?
No. Skin still responds to vitamin A at any age. Start slowly and build up.
Why am I getting spots in my 50s?
Falling oestrogen changes the balance of hormones in your skin, which can trigger breakouts, often around the jawline. Gentle exfoliation and retinal can help. Persistent or painful spots are worth getting checked.
Which treatment should I start with?
It depends on your main concern. For overall dryness and loss of bounce, Profhilo is a good starting point. For under-eye crepiness, polynucleotides. We’ll recommend a plan after seeing your skin.
Book a consultation
If your skin has changed and your usual routine isn’t keeping up, come and see us. I’ll assess your skin, talk through what’s realistic, and build a plan that combines the right skincare with treatment where it will help. Book your free consultation.
Dr. Ommid
This article is for general information and isn’t a substitute for personal medical advice.
References: Brincat MP, Baron YM, Galea R. Estrogens and the skin. Climacteric 2005;8(2):110–123. NICE guideline NG23: Menopause.
