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Perimenopause vs Menopause: How Hormonal Changes Affect Skin Health (and What to Do About It)

Close-up of ageing facial skin highlighting texture, hydration, elasticity and signs of perimenopause and menopause
As we age, our skin naturally changes - but for many women, the most dramatic and confusing changes occur during perimenopause and menopause.

As a highly qualified beauty and aesthetics practitioner | educator with over 25 years’ experience, I regularly see clients who feel frustrated, unheard, or unsure why the skincare and treatments that once worked suddenly no longer do.

This article is designed to help you understand:

  • The difference between perimenopausal and menopausal skin health

  • The key hormonal factors affecting skin health

  • How skincare, treatments, and routines should be adapted at each stage

What Is Perimenopause and How Does It Affect Skin?

Perimenopause is the transitional phase leading up to menopause and can begin in your late 30s to mid-40s. Hormone levels, particularly oestrogen and progesterone, begin to fluctuate rather than decline steadily.

Common Perimenopausal Skin Changes

During this stage, skin concerns often feel inconsistent and unpredictable:

  • Adult acne or flare-ups.

  • Increased oiliness combined with dehydration.

  • Sensitivity and inflammation.

  • Pigmentation and uneven skin tone.

  • Early collagen loss.

  • Slower healing and compromised barrier function.

💡 Key point: Skin in perimenopause is often reactive, not yet depleted, so overly aggressive treatments can worsen symptoms.

Menopause and Skin Health: What Changes?

Menopause is diagnosed once you’ve gone 12 consecutive months without a period. At this stage, oestrogen levels decline more permanently, leading to more structural skin changes.

Common Menopausal Skin Changes

  • Significant loss of collagen and elastin.

  • Thinning of the skin (especially around eyes and jawline).

  • Dryness and chronic dehydration.

  • Increased laxity and sagging.

  • Dullness and loss of radiance.

  • Delayed wound healing.

By menopause, the skin’s ability to retain moisture, repair itself, and protect against environmental stress is significantly reduced.

The Role of Hormones in Skin Ageing

Oestrogen plays a critical role in:

  • Collagen production.

  • Skin thickness.

  • Hydration and lipid balance.

  • Blood flow and nutrient delivery.

Research shows that women can lose up to 30% of their skin’s collagen in the first five years post-menopause. This is why a proactive, skin-health-focused approach is essential, not just “anti-ageing” treatments.

How Skincare Should Change in Perimenopause vs Menopause

Perimenopausal Skincare Focus

✔ Strengthen the skin barrier✔ Support hydration without clogging pores✔ Reduce inflammation

Recommended ingredients:

  • Niacinamide (barrier repair & oil regulation).

  • Ceramides.

  • Hyaluronic acid (multi-weight).

  • Gentle exfoliating acids (mandelic, lactic).

  • Retinoids used cautiously.

🚫 Avoid harsh peels, over-exfoliation, and stripping cleansers.

Menopausal Skincare Focus

✔ Restore lipids and hydration✔ Stimulate collagen safely✔ Protect compromised skin

Recommended ingredients:

  • Rich ceramides and cholesterol blends.

  • Peptides and growth-factor support.

  • Phytoestrogens (where appropriate).

  • Retinal/retinoids (tailored and supervised).

  • Broad-spectrum mineral SPF (daily, non-negotiable).

Treatments to Consider (and Adapt)

Suitable Treatments During Perimenopause

  • Skin needling (with conservative depth).

  • LED light therapy.

  • Chemical peels.

  • Barrier-repair facials.

  • Acne-safe rejuvenation treatments.

Suitable Treatments During Menopause

  • Advanced skin needling (medical protocols).

  • Chemical Peels.

  • Regenerative treatments (Skin Boosters, Polynucleotide's).

  • LED for inflammation and healing.

  • Bespoke corrective facials.

⚠️ Important: Treatment plans must consider skin resilience, healing capacity, and hormone-related sensitivity, not just age.

Why Professional Skin Education Matters

One of the biggest mistakes I see is clients blaming themselves, or their skincare when the real cause is hormonal change. Understanding what’s happening internally allows us to work with the skin, not against it.

A well-educated practitioner will:

  • Adjust treatments seasonally and hormonally.

  • Modify active ingredients.

  • Support long-term skin health, not quick fixes.

  • Educate rather than oversell.

Final Thoughts: Skin Health Is Not One-Size-Fits-All

Perimenopause and menopause are not skin “failures” they are biological transitions. With the right education, professional guidance, and tailored approach, skin can remain healthy, strong, and confident at every stage of life.

If your skin suddenly feels unfamiliar, reactive, or unresponsive, it’s not you. It’s hormones.


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