POSTED: 12 Jul 2023

Menopause Skin Changes & How to Treat Them

Menopause is a natural physiological change that usually occurs between the ages of 45 to 55. It is caused by a change in hormone levels and signals an end to a woman’s menstrual cycles. This has a number of effects on a woman’s health including skin changes. Menopause ski” represents a collective term for the various skin changes that occur due to the hormonal shifts linked with this. In this article we are going to explore how menopause skin changes lead to problems like itching, dryness and acne and how you can treat them.

What Happens to Your Hormones During Menopause?

Menopause occurs when a woman’s ovaries stop producing eggs. As a result, the levels of the hormones oestrogen and progesterone decline. These two hormones play a number of important roles in the body. There is also a change in FSH and LH which are hormones that are produced by the pituitary gland. They stimulate the ovaries to produce eggs and release hormones. During menopause, FSH and LH levels increase as the ovaries become less responsive to them. This contributes to the typical menopause symptoms and risks that some people may experience.

Oestrogen is the primary female sex hormone. It is responsible for a number of bodily functions, including regulating the menstrual cycle, maintaining bone health and protecting the heart. Progesterone is a hormone that is produced by the ovaries. It works with oestrogen to regulate the menstrual cycle and prepare the uterus for pregnancy. That’s why at menopause, periods may become irregular or stop altogether. The decline in oestrogen and progesterone levels during menopause can cause well known menopause symptoms like hot flashes, night sweats, sleep problems, vaginal dryness and mood swings. It can also increase the risk of osteoporosis which puts you at risk of fractures and heart disease.

These symptoms can vary from woman to woman. As such, menopause effects may be more or less severe depending on the individual. This is important to consider when looking for the best treatments.

How Menopause Affects Your Skin

Oestrogen, is a key player in skin health, promotes the production of collagen and elastin . These two proteins are responsible for making your skin plump, firm and elastic. Oestrogen also regulates the skin’s moisture balance and barrier function. Progesterone on the other hand, controls oil production, promotes new skin cell growth and blood vessel formation. It also has wound healing and anti-inflammatory properties.

The reduction in these hormones gives rise to a variety of skin problems including itching, dryness, skin ageing, acne and discolouration. These are together known as “menopause skin”.

Menopause Skin Itching, Dryness & Sensitivity

As oestrogen and progesterone levels go down, so do collagen, elastin and natural oils. As such, your skin may become dry, flakey and itchy. This may also be exacerbated by the decline in progesterone which has anti-inflammatory effects. The reduced oestrogen levels also weaken the skin’s protective barrier. This leads to increased skin sensitivity, inflammation, redness and irritation.

Accelerated Skin Ageing

The reduced collagen and elastin production can speed up and worsen the appearance fine lines and wrinkles as well as loss of face volume. Collagen gives the skin its strength and plumpness. When collagen levels decline, the skin becomes thinner and more prone to wrinkles. This means that the skin is less able to bounce back after being stretched. This can make the skin appear sagging or wrinkled. Elastin and collagen maintain the skin’s elasticity. When these are reduced, it means that the skin is less able to bounce back after being stretched and can give the appearance of sagging.

Acne Breakouts During Menopause

The hormonal imbalance during menopause can trigger sebum over production which leads to clogged pores and acne breakouts. Oestrogen and progesterone normally help to regulate the oil glands under the skin. When the levels of these drop, the body may produce more androgens in their place. Androgens are a type of male hormone that is normally present in women in smaller amounts. Excess androgens stimulate the oil glands in the skin which leads to an increase in oil production. The increased oil or sebum can clog pores which then become infected or inflamed and result in acne.

Additionally, other menopausal symptoms like stress, poor sleep and dietary changes can also lead to acne. Stress increases cortisol which is another hormone that can cause the skin to produce more oil. Poor sleep and dietary changes can also cause changes in the skin’s physiology and exacerbate acne.

Facial Redness & Flushing

Hot flashes are a common menopause symptom. They are sudden and transient periods of intense warmth and flushing that spread over the body, particularly concentrated in the face, neck and chest. When hot flashes occur, they cause the blood vessels in the skin to dilate (vasodilation). This is your body’s attempt to cool down and results in temporary skin redness and flushing.

Frequent hot flashes can lead to persistent redness and broken capillaries. This redness looks similar to that seen in rosacea. Furthermore, when capillaries break they give rise to to a network of tiny, red, web-like lines under the skin’s surface. These are called telangiectasia or ‘spider veins’ and can become a permanent feature on the skin.

Rosacea and Menopause

Rosacea is a chronic skin condition that causes redness and visible blood vessels in the face. It may also give rise to small, red, pus-filled bumps that are better known as acne rosacea. The exact cause of rosacea is unknown, but it is thought to be due to a combination of hereditary and environmental factors. The connection between menopause and rosacea is not yet fully understood. Menopause is thought to exacerbate rosacea but it is not thought to cause it.

During menopause, the levels of the hormones oestrogen and progesterone decrease significantly. This decline in hormones can lead to various physical changes, including hot flashes. Hot flashes are sudden feelings of warmth, which are usually most intense over the face, neck, and chest. This sudden increase in body temperature can cause dilation of the blood vessels in the face, which can trigger a rosacea flare-up.

Moreover, decreased levels of oestrogen can make the skin thinner and more sensitive, potentially exacerbating the symptoms of rosacea. Dry and thin skin can get irritated easily, and such irritation can trigger rosacea symptoms.

It’s also worth noting that stress is a well known trigger for both hot flashes and rosacea. The changes and symptoms that occur during menopause can cause significant stress and anxiety, which could possibly lead to more frequent or severe rosacea flare-ups.


Melasma is a condition that causes dark coloured patches on the skin. It is usually found on the face. Although it can affect anyone, melasma is more common in women. It is particularly likely to occur during times of significant hormonal shifts such as pregnancy or menopause.

Oestrogen and progesterone, have been linked to melanin production. Melanin is the pigment responsible for the colour of our skin, hair and eyes. It is produced by melanocytes, the pigment producing cells in the skin, which are affected by oestrogen and progesterone. When these hormones decrease, as they do during menopause, the melanocytes may over react and produce excess melanin in certain areas. This results in the dark patches characteristic of melasma. Furthermore, melasma is also often exacerbated by sun exposure. This is because UV light from the sun can also stimulate melanocytes. During menopause, as the skin thins and loses some of its natural sun protection, it can become more susceptible to the effects of UV light, which can further exacerbate melasma.

Treatments for Menopause Skin Changes

Menopause Skincare

The most effective way to treat menopause skin changes is with a consistent and personalised skincare routine. Your menopause skincare routine should firstly address the accelerated skin ageing that occurs with menopause. It should also be designed to target specific menopause skin problems like menopause skin itching, acne, redness and rosacea and melasma if you have them.

The foundations of a good anti-ageing skincare routine will contain:

You will also need to consider active products to address skin concerns. Tretinoin and other retinoids treat wrinkles, build up collagen and elastic as well as fade hyperpigmentation. They will also treat acne, smooth your skin and give a brighter complexion. Exfoliating acids and Vitamin C can also help improve skin texture and radiance. Azelaic acid and Tretinoin can also help with rosacea and facial redness.

Professional Skin Treatments

If you wish to augment your menopause skincare routine, professional skin treatments can potentially help. Chemical peels can help with skin ageing, acne and melasma. Laser therapy can help with wrinkles, texture and telangectasia. Microneedling, RF Microneedling and Profhilo can help improve collagen and elastin production to improve the appearance of crepey and sagging skin. Injectables like Botox anti-wrinkle injections and dermal fillers can improve the appearance of lines, wrinkles and loss of face volume.

Medicines for Menopause Skin

Topical oestrogen creams, can combat moderate menopause skin changes. These creams deliver oestrogen directly to the skin. If you use them regularly, they can improve skin elasticity and increase moisture levels.

Hormone Replacement Therapy (HRT) can help with severe skin changes due to menopause. HRT replaces oestrogen and sometimes progesterone throughout the body. This can help manage a wide range of menopause symptoms such as hot flashes, night sweats, mood changes and skin changes. By restoring hormone levels, HRT can help improve skin thickness, elasticity and hydration. It may also help with menopause associated redness, rosacea exacerbation and melasma.

Healthy Lifestyle

Regardless of which treatments options you choose, lifestyle choices play a pivotal role in managing menopause skin changes. A healthy diet, regular exercise and adequate sleep will support your overall skin health.

Healthy Diet

Your diet can significantly influence your skin’s health. Consuming antioxidant rich foods such as fruits and vegetables (especially those with deep colours like berries, spinach, and bell peppers) helps combat free radicals that cause cellular damage and accelerate skin aging. Foods rich in omega-3 fatty acids, like fish, walnuts, chia seeds and flax seeds, can help enhance skin elasticity, add hydration and reduce inflammation. In addition to this, include lean proteins in your diet to boost collagen production. This is crucial for skin quality and firmness. Increasingly, studies also show that eating fermented foods or probiotics can support gut health. Scientific studies have found a link between the gut microbiome to skin health. Furthermore, try to limit your intake of processed foods, sugars and alcohol. This can help maintain hormonal balance and reduce inflammation.

Hydration is also key to maintaining skin moisture and addressing dryness which is a common menopausal skin issue. Drinking sufficient water throughout the day can significantly improve your skin’s hydration.

Regular Exercise

Regular physical activity improves blood circulation which helps to deliver oxygen and nutrients to your skin. Exercise can also help manage stress which can worsen skin problems. Furthermore, it helps maintain bone density and muscle mass, which indirectly supports your face and skin structure.

Adequate Sleep

Sleep is essential for skin health. Your skin repairs and renews itself during sleep. Lack of sleep can lead to higher levels of stress hormones in the body that may increase the extent of inflammatory skin conditions and accelerate the ageing process. Aim for 7-9 hours of quality sleep per night.

Quit Smoking & Limit Alcohol

Smoking accelerates skin aging by damaging collagen and elastin. As you know by now, these are the proteins that give your skin its strength and elasticity. Quitting smoking can improve your skin tone, texture and reduce wrinkles. Alcohol can dehydrate your skin, leaving it dry and more prone to wrinkles. Limiting your alcohol intake can improve your skin’s hydration and overall health.

You can manage menopause skin changes sucessfully with a little patience and consistency. Its important to understand the hormonal and physiological changes your body is going through and how these are affecting your skin. This will allow you to take a personalised approach to treating menopause skin. An anti-ageing skincare routine targeted towards menopause changes is key to improve the look and feel of your skin. You should also incorporate healthy lifestyle habits as these can go a long way to manage menopause skin changes and your overall well-being. Remember that each woman’s menopause journey is unique. The best treatment for you will depend on your specific symptoms, medical history and lifestyle. Consult with a healthcare professional to provide you with advice and treatment options tailored to you. This is especially important if you are considering medical options.

We offer a number of skincare treatments that can help treat menopausal skin. Check out our online skin clinic which offers prescription-strength skincare treatments for skin ageing and other skin concerns like melasma, acne and hyperpigmentation.  Book a virtual consultation with one of our doctors or fill in our online consultation form to take your first step towards better skin.


Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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