Menopause skin changes with Dr Meg Minasian
What often changes in perimenopause and menopause
Skin changes in menopause can feel sudden. Common issues include more laxity (especially around the eyes and jawline), eye bags, jowls, and a general drop in skin quality. Skin can look dull, feel dry, become more sensitive, and seem more inflamed. Redness can appear for the first time, or older problems like acne and rosacea can flare. Pigmentation is also common.
What’s happening under the surface
These changes are linked to hormonal shifts, not just “normal ageing”.
Collagen loss is a big one. Up to 30% can be lost in the first five years of menopause, then about 2% each year after that. This affects firmness, definition, and barrier function.
Elastin declines, so skin has less recoil.
Hyaluronic acid drops, so skin holds less water and can look less bouncy.
The epidermis thins, which weakens the barrier and can make skin more fragile.
Oil (sebum) production reduces, which adds to dryness and sensitivity.
The basics that make the biggest difference
A routine does not need to be complicated.
Moisturiser: menopausal skin usually needs more hydration, even if breakouts are a worry. Better hydration supports the barrier and can calm inflammation.
Daily SPF: UVA is present even on grey days and is linked with ageing, inflammation, and non-melanoma skin cancers. Daily SPF 30 or 50 is a core step.
Retinol: alongside SPF, it has some of the strongest evidence for skin benefit. It supports collagen by boosting production and reducing attrition. It needs a careful start. One application can act for up to 72 hours, so spacing it out matters.
Other ingredients with evidence for benefit include vitamin C, vitamin E, alpha hydroxy acids (gentle exfoliation plus hydration), and anti-inflammatory options like niacinamide and azelaic acid.
Cleansing also matters. Foaming or gel cleansers can be too stripping. Creamy, hydrating cleansers are often a better fit. Examples such as Cetaphil and CeraVe.
In-clinic options (with an evidence focus)
Three main treatment areas:
Botulinum toxin: beyond lines and wrinkles, it’s described as anti-inflammatory in skin. Injecting it intradermally (“microtoxin”) is presented as a way to improve skin health and quality.
Light treatments (IPL/BBL): used for redness, pigmentation, acne, and also laxity. A pilot study was described where regular light therapy shifted the behaviour of around 1200 ageing-related genes to act 5–10 years younger. Light can treat multiple concerns in one go, often without needles and with no downtime.
Polynucleotides (PDRNs): used in therapeutic medicine for years and more recently in aesthetics. They’re described as regenerative and anti-inflammatory, useful around the eyes, mouth, jawline, and neck. They can involve downtime: visible bumps for 24–48 hours and small bruises.
What to be cautious about
Dermal fillers: can be effective when used selectively and by highly skilled practitioners, but they carry risks and are not a universal answer.
“New” treatments: lack of long-term data is a real issue. “Clinically proven” is often used loosely.
Oestrogen cream on the face: interesting, but cautioned due to possible pigmentation and concerns about non-melanoma skin cancer risk. Retinol was positioned as a more established option.
Safety checks before any procedure
Avoid being rushed, expect a cooling-off period between consultation and treatment, ask about credentials and experience, and ask directly about complications and how they’d be managed. A detailed medical history matters, including medications that could affect light treatment safety. For injectables, check product provenance, including seeing the product and confirming it’s licensed for injectable use.
The main takeaway
A slower, step-by-step approach was recommended: start with what can be done at home (hydration, SPF, careful retinol use, gentle routine), then consider in-clinic options if needed, keep a strong focus on evidence and safety.
