Here’s What Happens To Your Skin During Menopause

Menopause — the natural biological process in which the ovaries stop producing the ‘female hormones’ (i.e. estrogen and progesterone) and stop releasing eggs — comes with many unwelcomed side effects, like hot flashes, mood swings, trouble sleeping, and weight gain to name a few. While menopause is the point when a woman no longer has menstrual periods for at least 12 months, symptoms can start months or even years before during the transitional time known as perimenopause. In the United States, the average age women enter this next stage of life is 51.

One of the side effects of menopause that doesn’t get much attention compared to the others is aging skin. Enter a huge, disappointing sigh… From a loss of collagen and elasticity to dryness, women experience skin changes in their forties and fifties as a result of hormone fluctuations. But, with the proper adjustments to your skincare regimen and a good relationship with a cosmetic dermatologist, you can lessen the impact.

What Happens to the Skin During Menopause

“When it comes to your skin, estrogen is the hormone that’s responsible for many of the things we associate with youthfulness,” explains Morgan Rabach, MD, a board certified dermatologist and co-founder of LM Medical in New York City. Beginning in your twenties, women start to lose collagen (the building blocks of amino acids that give structure to the skin), but within the first few years of menopause, women can lose 20 to 30 percent due to the lack of estrogen, she says.

The result? Deeper lines and wrinkles, sagging skin, hollowing under the eyes, crepiness in the neck area and hands, as well as more visible blood vessels. Since estrogen also plays a role in oil production, the decrease leads the skin to become much drier and thinner. But that’s not all. As the so-called ‘female hormones’ decrease, the ‘male hormone’ (read: testosterone) increases. That shift can lead to acne and body hair on the cheeks, chin, neck, and chest.

We know this can be a lot to take in, but don’t fret. From at-home lifestyle changes to in-office procedures, there are an array of beauty and wellness treatments that can slow the aging process.

How to Care for Your Skin At-Home During Menopause

By the time you enter perimenopause, you’ve most likely found a skincare regimen that works for you. But, due to the fluctuation of hormones, there are some adjustments you may want to make in order to keep your complexion healthy and youthful. You’ll be hard pressed to find a dermatologist who doesn’t extoll the virtues of sunscreen and retinol. Oh, make sure you treat your hands, neck, and chest the same way you treat your face. Below are some skincare swaps to consider:

1. Sunscreen

As we’ve covered extensively, you should already be using a broad-spectrum sunscreen with SPF 30 or higher, all day, every day, rain or shine. Not only will it help to prevent skin cancer, but it’ll also help to reduce signs of aging like hyperpigmentation, fine lines, and wrinkles. During perimenopause (at the earliest), upgrade your SPF to one that includes antioxidants for an extra boost (we like the ISDIN Eryfotona Ageless, which also contains vitamin E). The added protection will “punch away” environmental aggressors like smoke, pollution, and other free radicals, Dr. Rabach explains.

2. Retinol

If you’re not already using a vitamin A derivative like retinoids or retinol, now’s the time to add it to your skincare routine. If you’ve been using the same formulation for years, then now may be a good time to switch it up. “You won’t be able to use the same retinol you used as a teenager with acne because your skin will be less oily,” Dr. Rabach notes.

Treating everything from acne to wrinkles, over-the-counter retinols and prescription-strength retinoids help ‘wake up’ the skin by increasing collagen and elastin production in the dermis and exfoliating the top layers of dead skin that can lead to dullness. “When collagen and elastin rev up, they hold your pores closed and help to keep them looking clean,” Dr. Rabach says. Retinol and retinoids come in various forms and strengths. Since your skin becomes drier during menopause, a cream-based formulation that adds moisture can be a good multitasking option. Our pick? SkinMedica Retinol Complex .25.

3. Moisturizers

“After menopause, your skin loses the ability to hold water,” says Cheryl Karcher, MD, a board certified dermatologist and co-founder of Center Aesthetic & Dermatology in NYC. “This makes proper moisturization an essential part of your regimen.” Hyaluronic acid (HA) is a powerhouse ingredient that can hold over 1,000 times its weight in water. Try using a serum with HA, like SkinCeuticals Hydrating B5 Gel, before your moisturizer for a hydrating boost. Another tip? Skip lightweight gel and lotion formulations in favor of richer creams. The Olay Regenerist Micro-Sculpting Cream, for example, contains hyaluronic acid and vitamin B3. If you’re still feeling dry (and not breaking out), consider adding a few drops of face oil, like the Beuti Skincare Beauty Sleep Elixir, into your moisturizer or patting it on top.

Dry skin doesn’t stop at the face. It occurs all over the body and can cause itchiness. To combat this, Dr. Rabach recommends using a gentle, conditioning cleanser, like Dove Body Wash Mousse with Argan Oil, in the shower and following it up with a thick moisturizer when your body is still damp. In the case of itchy skin, Dr. Karcher recommends applying a cool compress or taking a colloidal oatmeal bath to help calm and soothe the irritation.

Cosmetic Procedures to Consider During Menopause

If you’re not interested in surgery but are looking for ways to address skin concerns like sagging, hyperpigmentation, and unwanted hair, there are minimally invasive procedures that — when coupled with an at-home skincare routine — can rejuvenate the face and body.

1. Botox® & Filler

A combination of neurotoxin injections (i.e. Botox®, Dysport®, Jeuveau®, and Xeomin®) and dermal fillers can be a great way to restore fullness and reduce the appearance of wrinkles in menopausal skin. “I use small amounts in a way that replaces lost volume, as opposed to adding to a feature that wasn’t there before,” Dr. Rabach says. “This way, the patient feels better about aging without looking like they’ve gotten something done.” Filler can also be used to rejuvenate the hands.

2. Chemical Peels

Chemical peels have a bad reputation thanks to that one Sex and the City episode in which Samantha’s face turns bright red and scaly. Truth is, they’re misunderstood and can be one of the simplest treatments to help get your skin through menopause. A series of light chemical peels using glycolic or beta hydroxy acids will improve skin tone and texture — jump starting collagen production and sloughing off dead skin cells to reveal a brighter and smoother complexion. Chemical peels are available in varying concentrations (from superficial to deep), so talk to your dermatologist about what peel is right for you. Oh, and they can be used to treat the face, neck, chest, and hands.

3. Hair Removal

You can thank testosterone for the pesky hairs popping out of your face. If you’re looking to get rid of them for good, laser hair removal and electrolysis are both options. The treatment you receive will depend on the color and type of hair you’re interested in removing. If you have dark, coarse hair, then lasers are appropriate. If your hair is grey or white, electrolysis is the way to go.

4. Microneedling

Microneedling is an in-office procedure that uses small needles to create micro-injuries in the skin. These tiny wounds set off signals underneath the surface of the skin to start repairing itself by creating new collagen. The result? Smoother and firmer skin. “My patients love this option because there’s very little downtime,” Dr. Rabach says. “They can go out the same night with a little makeup on and in two days they look completely normal.” A series of four to five treatments spaced four to six weeks apart is necessary for best results, with follow up maintenance sessions one or two times per year. Microneedling can also be combined with platelet-rich plasma (PRP) or radiofrequency for additional benefits.

5. Ultrasound Technology

Ultherapy® is the only non-invasive device approved by the United States Food and Drug Administration (FDA) to lift and tighten the skin. Ultrasound energy heats up the tissue under your skin so that it seizes up and shrinks, a process Dr. Rabach compares to heating an egg. “It’s great for people who aren’t into surgeries like a face or eye lift,” she says. Ultherapy® can tighten the neck, brows, and chin, and results last up to a year. Warning: This one’s a bit uncomfortable — but, to many, worth it.

Don't Forget: Your Pre-Perimenopause Lifestyle Is Important

If you’re reading this article and you’re in your twenties and thirties, congratulations — there are steps you can take now that will benefit your skin down the road. Perimenopause can set in some eight to 10 years (!) before menopause for some women, and how you take care of your body and skin matters even before that. Good habits in your twenties and thirties will pay dividends in your forties and fifties. “A healthy diet including omega 3 fatty acids and proper hydration will put you in a healthier position to start menopause,” Dr. Karcher says.

It goes without saying, but smoking, alcohol consumption, and sun exposure should all be limited, too. “If you protected your skin from the sun growing up and really took care of it, then going into menopause will be easier on the skin,” Dr. Rabach shares. When it comes to skincare, it’s always easier to prevent than to correct.

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