I’ve been thinking about the phrase “menopausal skin”.
It’s a term I use myself, usually as shorthand for skin that is changing through perimenopause, menopause and the years that follow. An umbrella term, really, that acknowledges the influence changing hormones can have on our skin through midlife.
So I don’t have a problem with the term “menopausal skin”, but I do have a problem with treating it as a skin type.
Because going through the same physiological stage of life doesn’t mean our skin will behave in the same way.
One woman may find her skin becoming noticeably drier or more sensitive. Another may suddenly be dealing with breakouts again, perhaps alongside skin that also feels dry or dehydrated. Skin that was once fairly predictable may become more reactive, or stop tolerating products that have been used happily for years. And some women will notice relatively little change.
The hormonal transition may be something we share. How it shows up in our skin is different for all of us.
Sometimes those changes are gradual. Sometimes they seem to arrive almost overnight. You can look in the mirror and wonder when your skin became so different from the skin you thought you knew.
That was certainly part of my experience, and one of the reasons I became so interested in what was actually happening rather than simply looking for something to make my skin look younger.
That distinction is important, because when we talk about “menopausal skin” as though it describes a particular type of skin, we can overlook what an individual woman’s skin is actually doing and what it needs.
Perimenopause is part of the story too.
One of the problems with the phrase “menopausal skin” is that it can make it sound as though these changes begin at menopause.
Menopause itself is technically a point in time, a day. For someone reaching menopause naturally, it is generally identified after 12 consecutive months without a menstrual period. Perimenopause is the transition leading up to it, when ovarian function and hormone patterns are already changing. That transition can last for years.
So the relationship between our hormones and our skin doesn’t suddenly change on the day we reach menopause. Skin may already have been responding to a changing hormonal environment during perimenopause, often before we have connected what we are seeing in the mirror with what is happening elsewhere in the body.
This is certainly closer to my own experience. By the time I really noticed changes in my skin, other changes had already been happening for quite some time.
What do hormones actually have to do with our skin?
Quite a lot, particularly when we look at oestrogen.
Our skin is responsive to oestrogen, with oestrogen receptors found in different skin cells. Oestrogen is involved in processes that influence collagen and the extracellular matrix, skin thickness and elasticity, water content and wound healing.
During perimenopause, oestrogen does not simply decline in a neat, straight line. Hormone levels fluctuate as ovarian function changes. After menopause, ovarian oestrogen production is substantially lower.
Progesterone and androgens are part of this changing hormonal picture too, although the direct research into progesterone and menopausal skin is much less developed than the evidence around oestrogen.
So there are good physiological reasons why skin may behave differently through perimenopause and after menopause.
But that still doesn’t create one “menopausal skin type”.
Midlife skin and menopausal skin aren’t quite the same thing either.
There is another distinction worth making.
Not every change we notice in our skin during midlife can be attributed to menopause.
Hormonal change is happening alongside chronological ageing. Our skin also carries the cumulative effects of UV exposure and environment, as well as the influence of genetics, health, medication and our skincare history. All of these things can overlap.
So while menopause may be an important part of the reason skin starts behaving differently, it is rarely useful to make hormones responsible for every line, patch of pigmentation, change in texture or moment of sensitivity that appears in midlife.
Menopause can be part of the story without being the whole story.
The same transition. Different skin.
This is perhaps the part I find most interesting.
If hormonal change automatically created one particular skin type, we might expect women moving through perimenopause and menopause to experience broadly the same thing. But we don’t.
Our starting skin is different. Our genetics are different. We have different histories of sun exposure, health, medication and skincare use. Some women take HRT and others don’t. And hormonal change is happening alongside the ordinary process of getting older.
Changes in the balance between oestrogen and androgens can also influence sebaceous glands and hair follicles, which may be one reason the picture can be more complicated than simply skin becoming dry.
You can be experiencing breakouts while your skin feels drier than it used to. You can have oily areas and sensitivity. You can become more reactive without necessarily becoming particularly dry.
And perhaps one of the most disconcerting changes isn’t simply how skin looks, but how it behaves.
Products that were once fine can suddenly feel uncomfortable. Skin may seem less forgiving when we over-exfoliate or introduce several strong actives at once.
When that happens, it makes sense to pay attention to what our skin is tolerating, rather than continuing with a routine simply because it worked for us before.
This is why “menopausal skin” works better as an umbrella term than a skin type. It describes a range of changes that can happen to skin through the menopausal transition. What varies is how much we experience them, and in what combination.
What if you take HRT?
This adds another layer.
Not every woman in perimenopause or after menopause is experiencing the same hormonal environment.
Some women don’t use hormone replacement therapy. Others use systemic oestrogen as a patch, gel, spray or tablet, with progesterone or another progestogen where appropriate.
Research suggests menopausal hormone therapy can influence some characteristics of the skin. A systematic review and meta-analysis found improvements in skin elasticity, thickness and collagen content in women using menopausal hormone therapy, although it did not find a statistically significant improvement in skin dryness.
The research isn’t perfect, and individual studies don’t always agree. HRT is also a medical treatment, with individual benefits and risks, rather than something I would ever suggest taking for cosmetic reasons.
But its relevance here is interesting.
If two women are both postmenopausal but one is using systemic oestrogen and the other isn’t, even their hormonal environments aren’t identical.
Another reason why the word “menopausal” alone cannot tell us what their skin needs.
So what does this mean for skincare?
For me, it comes back to paying attention to the skin in front of us.
When skin changes, there can be a temptation to find something to correct it. Stronger actives, harsher treatments, and adding another product to the routine.
But if skin has become drier, more sensitive or less tolerant, perhaps the answer isn’t to push it into submission. Maybe we need to change the way we care for it too.
That might mean gentler cleansing, replenishing the lipids and moisture it needs for healthy barrier function, or removing unnecessary sources of irritation. Most importantly, it means being willing to adapt our routine to what our skin is telling us, rather than what we’ve been told skin of a particular age should be using.
That doesn’t require a special “menopause routine”. It means understanding that skin can change as we change, and adapting how we care for it.
Perhaps that is the most useful way to think about “menopausal skin”.
Not as a skin type, but as skin responding to the hormonal changes of midlife, in different ways and to different degrees.
Understanding why our skin may be changing gives us context. Paying attention to our own skin tells us how to care for it.
Sources & further reading
NICE, Menopause: identification and management.
NHS, Treatment for menopause and perimenopause.
Pivazyan L et al., Skin Rejuvenation in Women using Menopausal Hormone Therapy: A Systematic Review and Meta-Analysis, Journal of Menopausal Medicine, 2024.
Thornton MJ, Estrogens and aging skin, Dermato-Endocrinology, 2013.
Kamp E et al., Menopause, skin and common dermatoses. Part 2: skin disorders, Clinical and Experimental Dermatology, 2022.
Gasser S et al., Impact of progesterone on skin and hair in menopause: a comprehensive review, Climacteric, 2021.
A note on skincare and health
This article is intended for general information and skincare education, not as medical advice. If your skin is persistently sore, swollen, itchy, broken, weeping or reacting in a way that is unusual for you, please seek advice from your GP, pharmacist or dermatologist.
If you're introducing a new skincare product, particularly if your skin is sensitive or reactive, it's sensible to patch test first. A patch test can help identify some reactions, although it cannot guarantee that a product won't cause irritation.