Menopause Skin Changes: What to Expect and Why It Happens

Menopause and Skin Changes: What to Expect and Why It Happens

During menopause and perimenopause, the skin becomes drier, thinner and less firm. This happens because the body produces less oestrogen, the hormone that plays a central role in keeping skin hydrated, plump and structurally supported. Research suggests that collagen levels can decline significantly in the first years after menopause, which is why the changes to skin firmness and texture can feel so pronounced in a relatively short period.

For many women, these changes feel sudden, as if the skin shifted overnight. In reality, the process begins gradually during perimenopause, often years before periods stop, as hormone levels start to fluctuate.

This guide explains what menopause does to the skin, why it happens, what to expect at each stage, and how to approach skin health during this time.

What Menopause Does to the Skin

The menopause skin changes that most women notice are a direct consequence of declining oestrogen. Oestrogen receptors are found throughout the skin, and when oestrogen levels fall, the effects show up in several distinct ways.

• Collagen loss: Oestrogen plays a key role in stimulating collagen production. As levels fall, the skin loses structural support. It becomes thinner, less firm, and more prone to the fine lines and sagging that many women notice accelerating during this period.
• Reduced moisture retention: Oestrogen supports the skin’s ability to retain water. Lower levels mean the skin loses moisture more quickly, leading to dryness, tightness and in some cases itchiness, particularly on the face, neck and body.
• Loss of elasticity: Elastin, which gives skin its ability to bounce back, is also affected by the hormonal shift. Skin that was once resilient can begin to feel less springy and more prone to crepey texture, particularly around the neck, chest and under the eyes.
• Changes in skin tone and pigmentation: Hormonal fluctuations can trigger increased melanin production in certain areas, leading to new patches of hyperpigmentation or uneven skin tone. Some women also notice their skin appears duller or less luminous than before.
• Sensitivity and reactivity: The skin can become more reactive during menopause, with some women noticing increased flushing, redness or sensitivity to products that their skin previously tolerated well.

According to the NHS, skin changes including dry and itchy skin are among the recognised symptoms of menopause and perimenopause. These changes are a normal part of the hormonal transition, not a sign of a skin condition.

Perimenopause Skin Changes: When It Starts and What to Expect

Perimenopause skin changes often begin earlier than most women expect. This transitional phase, which can start in the early to mid-forties, is when oestrogen levels begin to fluctuate before eventually declining. The skin often reflects these fluctuations before periods become noticeably irregular.

Common perimenopause skin changes include:

• Dryness and a feeling of tightness, particularly in areas that were not previously dry
• Increased sensitivity or reactivity to skincare products
• A change in skin texture, often described as feeling less smooth or more rough to the touch
• A loss of the glow or luminosity the skin previously had
• New or worsening pigmentation, particularly if UV exposure has been a factor
• Early signs of laxity, particularly around the jaw, neck and under the eyes

These perimenopause skin changes can be subtle at first. Many women notice that their skin feels different before any visible changes become obvious. The skin often becomes less forgiving, requiring more support from skincare to maintain the same level of hydration and comfort it previously maintained naturally.

Perimenopause Skin Problems: The Concerns Women Notice Most

Beyond the general changes in texture and tone, there are specific perimenopause skin problems that bring many women to seek clinical advice. Understanding what is driving each concern is important, because it determines the most appropriate way to address it.

Skin Laxity and Loss of Firmness

The combination of collagen loss, reduced elastin, and the redistribution of facial volume that comes with hormonal change leads to visible laxity. The jawline softens, jowls may begin to form, and the neck and chest can develop a crepey quality. This is one of the most common concerns women notice during perimenopause and the early postmenopausal years.

Dryness and Dehydration

Skin that was previously balanced or even oily can become noticeably dry during perimenopause. This is not a superficial hydration issue. It reflects a change in the skin’s barrier function and its reduced ability to retain water at a deeper level. Topical moisturisers can help at the surface, but they do not address the underlying cause.

Pigmentation and Uneven Skin Tone

Hormonal fluctuations during perimenopause can trigger or worsen melasma and other forms of hyperpigmentation. Women who have always been vigilant with SPF may still find that new pigmentation appears during this time. Sun exposure remains the most significant external trigger, but the hormonal environment is what makes the skin more susceptible to it.

Hair Thinning

While not a skin concern in the traditional sense, hair thinning is closely connected to the hormonal changes of perimenopause and menopause. Falling oestrogen levels affect the hair follicle cycle, often resulting in finer strands, reduced density and a widening part. This is one of the perimenopause skin problems that many women find most distressing.

Skin Spots and New Lesions

Perimenopause skin spots are a common concern. Age spots, sun-damage-related lesions and small skin tags can all appear or increase in visibility during this period. These are largely a consequence of cumulative UV exposure becoming more visible as skin quality changes, combined with the hormonal shift affecting pigment cell behaviour.

Menopause and Skin: Why Sun Protection Matters More Than Ever

At every stage of life, daily SPF is a non-negotiable part of skin health. During and after menopause, its importance increases. Skin that has become thinner and more susceptible to pigmentation changes is more vulnerable to UV damage than it was before.

Daily SPF applied every morning, regardless of the weather, is the single most effective step anyone can take to slow the visible progression of menopause-related skin changes and protect against new pigmentation.

It will not reverse the hormonal changes that are already underway. But it will significantly influence how quickly those changes become visible, and how much additional pigmentation and texture damage accumulates during the transition.

When to Consider a Clinical Skin Assessment

Not all skin changes during menopause require clinical intervention, and some will respond well to a considered approach to skincare and sun protection. But for women who are noticing significant laxity, persistent dryness that skincare alone is not addressing, new pigmentation, or a more general shift in skin quality that is affecting how they feel, a clinical skin assessment is a sensible next step.

A qualified practitioner can evaluate what is happening in the skin, identify which changes are most affecting quality of life, and advise on whether clinical options are appropriate and which are most likely to be effective for that individual.

If you are experiencing menopause-related skin changes and would like to understand your options, a consultation with a qualified skin practitioner is the right place to start.

Conclusion

Menopause and perimenopause skin changes are a normal part of the hormonal transition. They are driven primarily by falling oestrogen levels and their effect on collagen, elastin, hydration and skin barrier function. Knowing what to expect, and why it is happening, is often the most useful starting point for anyone navigating this stage.

Amanda Azzopardi Aesthetics offers skin consultations for women navigating perimenopause and menopause who would like clinical guidance on their skin health.

MEET THE AUTHOR

Amanda Azzopardi, an Advanced Nurse Practitioner and Aesthetic Medicine Prescriber, specialises in ageing-related changes. With a Masters in Advanced Clinical Practice, she's trained at the renowned Harley Academy in London and the Level 7 accredited Derma Medical Academy. Boasting over 15 years of global experience in acute medical settings and extensive aesthetic insurance, Amanda combines care, skill, and professionalism to ensure your treatments are in trustworthy hands.