What Dermatologists Say About How Menopause Affects Skin

By 2030, an estimated 1.2 billion women around the world will be menopausal or postmenopausal, and roughly 47 million will reach menopause each year. The hormonal transition can start years earlier during perimenopause, bringing shifts in sleep, mood, skin texture, firmness and hydration. Although these stages are discussed more openly now, many women still feel unprepared for how they affect skin and appearance. Industry experts are working to close that gap.

Experts say the message is simple: women deserve clearer information about what is happening to their skin, why it is changing and what can be done. For some, a consistent skin-care routine helps. For others, in-office treatments may make a bigger difference. In either case, understanding the changes is the first step.

Below, experts explain the treatments worth considering and the daily habits that matter just as much.

Featured Experts

• Doris Day, MD is a board-certified dermatologist in New York
• Ellen Marmur, MD is a board-certified dermatologist in New York
• Adelle Walker is chief marketing officer for Revance
• Tara Capalbo is head of U.S. Aesthetics at Galderma

The Skin Changes Can Seem Abrupt

“Usually, around 45, you’re almost by definition in perimenopause, and by around 50, you’re generally menopausal,” says New York dermatologist Ellen Marmur, MD. “You can still have your period and be hormonally menopausal. It’s not always measurable, and it’s not black-and-white science.” For many women, the earliest signs of perimenopause do not immediately read as hormonal.

“In my own practice, what I see is women coming in and saying things like, ‘One day my face just fell apart. Why is my skin dry and itchy? Why am I breaking out like a teenager?’” says New York dermatologist Doris Day, MD. She often connects those concerns with other shifts, including sleep, mood, joint discomfort and menstrual changes, so patients can recognize that they may be entering perimenopause.

The knowledge gap is not just anecdotal. At a recent event in New York, Tara Capalbo, head of U.S. Aesthetics at Galderma, discussed research based on a survey of more than 4,300 women across nine countries and five continents. The findings suggested that many women only learn about skin changes after they experience them. In fact, 90 percent of respondents said they had never been taught about menopause.

Dr. Day says the lack of awareness also extends to clinicians. “They’re not having the discussions with their doctors,” she says. “GYNs don’t seem to want to own the space. Primary care physicians don’t seem to want to have that conversation. Women are kind of told, like, ‘You’ll power through, you’ll be fine.’ And they’re not satisfied with this answer.”

For Dr. Marmur, menopause has become a routine part of patient conversations, especially for women trying to make sense of several changes at once. She sees the dermatologist’s office as a place where patients can ask questions they may not have known how to raise elsewhere. The goal, she says, is to make those conversations easier and help patients understand their options.

A separate Revance study found that 50 percent of perimenopausal women were unaware of how menopause would affect their skin and appearance when the transition began. “We also asked them whether they would want formal health care and aesthetics in the same place, and surprisingly, 68 percent said yes,” says Adelle Walker, chief marketing officer for Revance. “When we heard that, we thought, ‘Wow, what can we do as a medical aesthetics company?’ We have great products, including regenerative treatments, injectables and skin care. How can we bring those together so women can get this care in one place?”

What Happens to Skin During Perimenopause and Menopause

Estrogen is important for skin health, and hormonal changes can influence hydration, elasticity and collagen. The result may be a mix of fine lines, wrinkles, dullness, dryness and reduced firmness rather than one isolated issue.

Dr. Day points to research suggesting that women may lose up to 30 percent of their collagen in the first five years after menopause, followed by about 2 percent annually after that. “Changes are influenced by several factors, including declining estrogen, cumulative sun exposure, genetics and skin-care products that may be too aggressive for the skin’s needs,” she explains. “Those collagen-building cells—the fibroblasts—are simply exhausted and depleted. This is one reason why I focus on supporting skin quality rather than treating lines or volume changes alone. No single treatment can address every concern.”

Dr. Marmur also encourages women to look beyond wrinkles. “Skin texture, laxity and the appearance of the neck, chest and upper lip can become more noticeable during this stage, and these areas may not respond well to simply adding volume,” she says. In her view, treatment should consider the entire face and the way it moves.

In-Office Treatments That May Help

As women learn more about menopause-related changes, interest is rising in treatments that prioritize skin quality rather than only volume or expression lines. “Patients often want to look refreshed without taking on significant downtime, making regenerative approaches such as microneedling part of the conversation,” Dr. Marmur says. “Everyone wants to glow, right? And that’s what they say. ‘My face is starting to look a little dull. I’m not sleeping as much. I’m taking care of other people, and I don’t have any downtime.’”

One option is SkinPen, a microneedling device. “SkinPen uses mechanical microneedling to create controlled microchannels in the skin, supporting the body’s natural regenerative processes,” says Dr. Marmur. “It can help improve the appearance of texture and dullness. The neck and the hands are amazing areas for SkinPen, in addition to the under-eyes.”

For women concerned about volume loss, fillers, including hyaluronic acid and biostimulatory options, can help restore balance. “It’s important to choose a formulation suited to the treatment area to preserve natural movement, particularly around the mouth, where the skin is highly dynamic,” says Dr. Marmur, who favors the RHA Collection of fillers: RHA Redensity, RHA 2, RHA 3 and RHA Dynamic Volume. “You need something that’s gonna move with you—a really delicate enhancer.”

Dr. Day says her focus is on supporting skin health and structure over time. “For some patients, that might involve using a combination of neuromodulators, hyaluronic acid fillers like Restylane, microneedling and energy-based devices. For others, it may mean a collagen-stimulating treatment such as Sculptra,” she explains. “I’ve said for the longest time that my Sculptra patients are my happiest patients because they love the change in their skin texture. They love the way that it’s restoring their body’s own natural collagen.”

Capalbo says about 85 percent of aesthetic patients are women, making it important to understand how treatments perform during different stages of women’s lives. “As part of Galderma’s effort to address the research gap, we’re incorporating menopausal status into our injectable aesthetics clinical trials. We’re also collaborating with dermatologists, plastic surgeons and gynecologists to develop a consensus paper intended to provide guidance on treatment approaches for women during these stages of life.”

Aesthetic Care Is Only One Piece of the Puzzle

In-office procedures can help with certain concerns, but daily habits remain important too: sun protection, a steady skin-care routine, nutrition, exercise and sleep. “Nothing looks more beautiful in your 50s than sun protection in your 20s,” says Dr. Day.

Because skin changes can be part of a broader transition, hormone therapy decisions should be made with a health-care professional who can take symptoms and medical history into account. “Be careful about treating online information as a substitute for personalized care,” says Dr. Marmur.

Ultimately, the point is not that every woman needs aesthetic treatment or that menopause should be treated as a problem to solve. The goal is for women to have the information and support they need to make choices that help them feel comfortable in their skin.

“I don’t want women to be caught off guard by menopause,” says Dr. Day. “Start learning about it in your 30s, pay attention to what’s happening in your 40s, and make these conversations part of your ongoing health care. I don’t think we become less beautiful with age. I think in many ways we become more beautiful. It’s just a different beauty. And that we have to learn to see.”