Skin in menopause and what helps

Falling estrogen makes the skin thinner and drier. What happens biologically during menopause and which measures have evidence behind them.

Why estrogen matters for skin

Skin is a hormone-responsive organ. Fibroblasts, the cells that produce collagen and elastin, as well as keratinocytes and sebaceous glands carry estrogen receptors. Estrogen supports collagen production, the skin’s ability to hold water, and the formation of hyaluronic acid in the dermis. When estrogen levels fall during perimenopause and menopause, these supporting signals decline, and many women notice changes in their skin within a few years.

What changes

The best-known data on collagen come from studies by Brincat and colleagues from the late 1980s onwards: skin collagen declined markedly in the first years after menopause, by up to about 30% in the first five years, followed by a slower decline of roughly 2% per year. Skin thickness decreased in parallel. These studies were small, and later work showed that chronological age and time since menopause are difficult to separate, but the direction is consistent across studies.

Change	What you may notice
Less collagen	Thinner skin, more fine lines, less firmness
Less elastin and hyaluronic acid	Reduced elasticity, a drier feel
Weaker barrier	Dryness, sensitivity, slower recovery from irritation
Slower wound healing	Small injuries and irritation take longer to settle
Hormonal shifts	In some women, adult acne or increased facial hair

Intrinsic aging and sun damage continue alongside these hormonal changes. The general mechanisms are described in The mechanisms of skin aging.

Hormone therapy

Studies have shown that systemic menopausal hormone therapy can increase skin collagen and thickness. However, hormone therapy is prescribed for menopausal symptoms such as hot flushes, not for skin, and its benefits and risks depend on personal and family history. Gynecological societies do not recommend it for skin aging alone. If you are considering it, the decision belongs with your gynecologist.

The basics with the strongest evidence

Daily sun protection: UV light breaks down collagen; a skin with less collagen production can afford that loss even less. Daily SPF is the foundation.
Retinoids: the topical class with the best evidence for stimulating collagen. Thinner, drier skin often needs a slower start (see Retinoids).
Barrier care: moisturizers with ceramides, glycerin and fatty acids reduce water loss and sensitivity.
Gentle cleansing: less stripping, fewer foaming products, lukewarm water.
Not smoking, enough sleep, enough protein: unglamorous, but relevant for collagen.

Regenerative treatments

Where skin quality has declined, regenerative injections aim to stimulate the skin’s own repair processes rather than to fill. PRP for the full face uses platelet growth factors from your own blood, and polynucleotides for the full face are DNA fragments intended to support fibroblast activity and hydration. Both have encouraging data on skin quality in general, but specific studies in women after menopause are few. They work gradually, are usually given as a series, and do not replace the basics above.

Infusions such as the Skin Rejuvenation infusion provide antioxidants and micronutrients such as vitamin C, which is essential for collagen synthesis. Whether intravenous delivery improves skin beyond an adequate diet has not been established in controlled studies, which is why we describe infusions as a supporting measure.

Realistic expectations: menopause is a natural phase. Skin care in these years aims to support the barrier, collagen production and the comfort of the skin.

When to seek advice

Sudden severe dryness, persistent itching, new acne or rapidly increasing hair growth can have causes beyond menopause and are worth a medical check. Which treatments make sense for your skin is decided in a physician consultation, ideally with your gynecological history in mind.

References

Thornton MJ. Estrogens and aging skin. Dermatoendocrinol. 2013;5(2):264-270. PMID 24194966.
Brincat M, Moniz CJ, Studd JW, et al. Long-term effects of the menopause and sex hormones on skin thickness. Br J Obstet Gynaecol. 1985;92(3):256-259. PMID 3978054.
Brincat M, Moniz CF, Kabalan S, et al. Decline in skin collagen content and metacarpal index after the menopause and its prevention with sex hormone replacement. Br J Obstet Gynaecol. 1987;94(2):126-129. PMID 3828252.
Affinito P, Palomba S, Sorrentino C, et al. Effects of postmenopausal hypoestrogenism on skin collagen. Maturitas. 1999;33(3):239-247. PMID 10656502.
Brincat MP, Baron YM, Galea R. Estrogens and the skin. Climacteric. 2005;8(2):110-123. PMID 16096167.
Viscomi B, Muniz M, Sattler S. Managing Menopausal Skin Changes: A Narrative Review of Skin Quality Changes, Their Aesthetic Impact, and the Actual Role of Hormone Replacement Therapy in Improvement. J Cosmet Dermatol. 2025;24 Suppl 4(Suppl 4):e70393. PMID 40847905.
Lampridou S, Bassett S, Cavallini M, et al. The Effectiveness of Polynucleotides in Esthetic Medicine: A Systematic Review. J Cosmet Dermatol. 2025;24(2):e16721. PMID 39645667.
Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin Health. Nutrients. 2017;9(8). PMID 28805671.