Navigating the impact of perimenopause & menopause on skin health

It’s been a couple of years since I have written a blog post on the menopause and skin health and with World Menopause Day approaching, I thought it was worth exploring this topic again, since many of you are probably approaching or living this period of your life.

If your skin has started behaving differently - drier than it used to be, feeling tight, more reactive, suddenly prone to breakouts or sensitivity you've never experienced before - and you're in your 40s or beyond, there's a good chance hormones are at play.

As the founder of Apothaka®, I've experienced first-hand how perimenopause can affect our bodies for several years now. I’m really glad to see more open conversations about this phase of life, though this has sadly led to a lot of brands taking advantage of women through menowashing i.e. pushing “menopause-specific products” (more on that later!). My goal here is to cut through the noise and give you practical, straightforward guidance on what's actually happening to your skin, and what actually helps. As a skin health expert and cosmetic formulator, I’m going to stay in my lane and focus specifically on the impact of skin - though perimenopause and menopause have much broader effects on our bodies (and minds!).

What is menopause and perimenopause, and when do they happen?

Perimenopause is the transitional phase leading up to menopause, during which hormone levels, particularly oestrogen and progesterone, but also testosterone begin to fluctuate and gradually decline. It typically begins in the mid-to-late 40s, though for some women it can start as early as the late 30s, and it can last anywhere from a few months to over ten years. When I look back at the various symptoms I’ve experienced, I can trace the start of my perimenopause to the age of 41 – I’m now 50 and I’m still in perimenopause (cries!). Importantly, many of the skin changes associated with "menopause" actually begin during perimenopause, so if you're noticing shifts in your skin before your periods have stopped, that's likely why.

Menopause itself is defined as the point at which a woman has not had a period for 12 consecutive months. The average age in the UK is 51, though early menopause (before 45) and premature menopause (before 40) do occur. The years following i.e. post-menopause, bring their own ongoing changes as hormone levels stabilise at their new, lower baseline.

What happens to skin and why?

Oestrogen plays a crucial role in skin health, among other things. It supports collagen and elastin production, stimulates sebum production, helps the skin retain moisture and contributes to the skin's barrier function. As oestrogen declines in perimenopause, all of these processes are affected.

The key changes you might notice include:

• Dryness and dehydration - reduced sebum production makes skin feel drier and a weakened skin barrier means the skin loses moisture more easily (increased transepidermal water loss or TEWL), leading to tightness, flakiness and a dull appearance. Oestrogen also plays a role in hyaluronic acid production, so its decline compounds this further, whilst also affecting how hydrated and plump the skin looks
• Weakened skin barrier - think of a healthy skin barrier as a robust wall without any cracks or holes. As the wall (barrier function) weakens, cracks appear causing increased moisture loss, but it also allows unwanted substances to get into our skin, leading to skin irritation and inflammation. This in turn impacts the skin’s healing ability and contributes further to skin ageing
• Loss of firmness and elasticity - collagen production drops significantly in the years leading up to menopause. Collagen is the scaffolding of your skin, it provides structure, so declining collagen leads to sagging and the deepening of fine lines. Elasticity refers to the pliability of your skin – it holds your skin taut across the face. Imagine a rubber band when it’s overstretched repeatedly and doesn’t return to its original size. This is how loss of elasticity shows on your face (the classic “puckering” of the skin in front of your ears is a key example of this). These are perhaps the most noticeable and well-documented skin changes associated with this transition
• Slower cell turnover - oestrogen helps maintain active epidermal cells; as levels drop, cell turnover slows, causing skin to look dull, flaky and uneven
• Changes in pore size and texture - the shift in hormone balance, with androgens becoming more dominant together with falling collagen, can cause pores to look more visible and skin texture to change
• Breakouts - some women experience adult acne for the first time during perimenopause, particularly around the chin and jawline, again driven by the relative dominance of androgens, though breakouts can often be caused by irritation and a weakened skin barrier from declining oestrogen
• Hyperpigmentation - fluctuating hormones can trigger increased melanin production, causing age spots or uneven skin tone. Melanin is just part of the story here, because as we age, our reduced ability to clear cellular waste under the skin surface can also contribute to age spots (this may be why skin doesn’t respond as well to topical pigment inhibitors as we age).

Why does skin become more sensitive and reactive?

A compromised skin barrier is strongly linked to (peri-)menopausal skin sensitivity. When the barrier is functioning well, it keeps moisture in and irritants out. When it's weakened, through declining oestrogen, the skin becomes more permeable, meaning irritants, allergens and environmental aggressors get through more easily.

This can manifest as redness, stinging, itching, or reactions to products that previously caused no issues at all. You may develop rosacea or dermatitis. You may only notice irritation on certain areas, typically the eyes, neck and decolletage. The skin is much thinner in these areas, so much more susceptible to irritation. It's also why women who have never had sensitive skin before can find it suddenly becoming a concern during perimenopause and beyond. The solution isn't more products - it's careful choice of the right formulations, at the right strengths, at the right frequency for your skin.

How to support your skin during this time

The good news is that you may not need a dramatic overhaul of your routine - it depends on where you're starting from and the degree of changes you're noticing. Here's what I recommend:

Skincare

• Prioritise barrier support (before changing anything else!) - I cannot emphasise this enough: be gentle with your skin (that means gentle cleansing, suitable moisturiser for hydration, daily sunscreen, careful use of actives, minimal products), including barrier-supporting ingredients like ceramides (multiple ceramides in a synergistic complex to restore the barrier, rather than single ceramides), niacinamide and fatty acids that help reinforce the skin's protective barrier and lock in moisture. A strong barrier allows you to better tolerate actives if you need them
• Layer your hydration - use products containing humectants like glycerin, hyaluronic acid and Natural Moisturising Factors (NMF) / amino acids to draw moisture to the skin, followed by something more occlusive (dimethicone in moisturisers is great for this) to seal it in and reduce water loss
• Consider a retinoid - Vitamin A (retinoid) supports healthy ageing through regulating cell turnover and increasing collagen production over time, and there is a lot of science to support usage. Start with a low concentration and introduce gradually (I personally prefer retinal as it offers the best efficacy with minimised side effects out of the cosmetic retinoid options). Not everyone can tolerate retinoids, in which case, signalling peptides like Matrixyl 3000 are a very good, non-irritating alternative. Note, not all peptides are the same - they offer differ benefits and not all have solid data behind them, so you need to look beyond “a peptide” serum!
• Add antioxidants - think of them as the safety net to your sunscreen, providing an extra layer of defence against free radical damage which damages/ages the skin. Whilst ascorbic acid is the best known antioxidant, it’s a notoriously unstable ingredient and can be quite irritating for sensitive skin, so I tend to recommend a Vitamin C derivative as a gentler alternative, ideally combined with other antioxidants for more comprehensive protection
• Introduce gentle exfoliation to target dull skin - as cell turnover slows, regular but non-aggressive exfoliation helps to resurface and brighten. Enzyme-based exfoliants are particularly well suited to (peri-)menopausal skin as they work gently without the irritation risk of stronger acids. Frequency is key here, once or twice a week is sufficient (especially if you’re also using a retinoid!)
• Be fragrance-aware - with increased sensitivity, fragranced and essential-oil-containing products are more likely to cause reactions; opting for fragrance-free formulations reduces that risk considerably. If you are dealing with rosacea then I strongly recommend ensuring all your skincare is fragrance/essential oil free (or at least free of known fragrance allergens, which must be listed on all products if present)
• Use sunscreen daily, every day - with thinning skin and increased hyperpigmentation risk, broad-spectrum sun protection is non-negotiable. Don't rely on SPF in makeup - you won't get the stated level of protection from the amount you apply (you need half a teaspoon for your face and neck)
• Be extra careful with areas of thinner skin - eyes, neck, decolletage are all areas that are more susceptible to irritation / sensitivity. If you’re using any kind of actives (retinoids, exfoliators, ascorbic acid etc) in those areas and noticing reactions, avoid those areas and allow the skin to heal. Focus on applying very basic, nourishing / barrier repairing moisturisers. You may be able to reintroduce actives once the skin is fully healed, but you may need to dilute / buffer actives in these areas (and / or reduce frequency of use in those areas)
• Don’t forget your body! - declining oestrogen can also cause intensely itchy skin. This can happen on various parts of the body. For me it’s my lower legs, but I know ears is another common one! For itchy skin on the body, I highly recommend a urea-based cream. Believe me, I have tried everything and this is what gives me the most relief topically. I do sometimes take oral antihistamines as these reduce itching (please speak to your doctor about this!). For ears, I don’t have personal experience of this but I have been advised that applying a small amount of steroid nasal spray like beclametasone or fluticasone on a cotton bud and swiping it gently in your ear may help reduce the itching and inflammation (again, please do check with your doctor or pharmacist!).

Professional treatments

We need to be realistic about what topical skincare can do and where its limitations lie. I see topical skincare as highly supportive in terms of providing hydration and protection, and the inclusion of retinoids for example can also support ageing well (from a prevention standpoint mostly). But if you’re looking to address skin sagging and collagen production, then this is where professional treatments come into play. Treatments that stimulate collagen production - such as professional microneedling, radiofrequency, LED therapy and gentle peels - can be particularly beneficial at this stage. I've personally found a combination of at home LED masking, professional microneedling and superficial peels to be really positive for my own skin, though I have noticed my skin takes a little longer to recover than it used to, so this is worth bearing in mind if you’re considering professional treatments. Microcurrent has been helpful for maintaining muscle tone, which is another aspect affecting how your facial skin looks. I haven’t seen as much benefit from at home radiofrequency but professional RF may be more effective (I’m considering a course of RF + microneedling for my neck at some point if my budget allows, as this combined modality helps with skin tightening). I recommend finding a reputable and knowledgeable skin health/aesthetics practitioner who can guide you through this based on your skin concerns and understands the impact of working with (peri-)menopausal skin.

Lifestyle

There are no magic tricks or “hacks” to helping through (peri-)menopause. In fact, most of my tips are probably very “boring” and apply to all life stages, but are generally underrated. And the good news is, you don’t need to waste money on expensive “menopause” supplements!

• A balanced diet rich in wholefoods/fibre, protein, healthy fats, and antioxidants (all the colours of the rainbow!) supports skin health from the inside - the link between gut health and skin health is very strong!
• Omega-3 fatty acids (oily fish, flaxseed) and phytoestrogens (soy, chickpeas) are worth including. I swear by oily fish for glowing, healthy skin! If you aren’t a fish fan, this is one of the few situations I recommend a supplement (omega 3)
• Prioritise sleep - skin repairs itself overnight, and 7-8 hours makes a meaningful difference, though this is often a challenge when declining oestrogen commonly causes night time waking and poor sleep quality
• Move your body – do not underestimate the impact of movement on overall health and skin health. Walking is ideal for most people and gentle on joints, but I also do resistance training with weights at home, as there is evidence to suggest resistance training improves skin health as well as physical health
• Manage/reduce stress where you can (easier said than done, am I right?!) to support overall health, as there is evidence that chronic stress can exacerbate inflammatory skin conditions
• HRT - for some women, Hormone Replacement Therapy has a genuinely positive effect on skin as well as other menopausal symptoms (I’m not talking life changing, but certainly it’s allowed me to keep functioning as a human!). I started HRT 3 years ago for a number of other symptoms (palpitations, night time waking, brain fog and poor concentration), and the skin improvements have been a welcome bonus (reduced sensitivity, increased hydration), plus my improvement in sleep have had a positive impact on my skin health. It's not for everyone, but worth discussing with your GP (ideally one with an interest in women's health) or a menopause specialist

What to avoid

• Over-cleansing - using a cleanser that strips the skin or cleansing too frequently disrupts the skin barrier. If your skin is dry and sensitive, opt for oil and cream-based cleansers
• Aggressive use of actives - high concentrations of active ingredients, overuse / over-exfoliation are particularly problematic for (peri-)menopausal skin. Less is always more
• Product overload - a simple, thoughtfully-chosen routine will serve your skin better than a ten-step one
• Sun exposure - UV damage is responsible for the majority of premature skin ageing; avoid sun tanning and sun beds
• "Menopausal skincare" marketing - contrary to what some brands would have you believe, there are no magic ingredients exclusive to menopause skincare ranges. It's largely an opportunity to charge a premium at a vulnerable time in our lives. The ingredients that support menopausal skin are the same ones that support healthy skin at any age, which means you have plenty of options!

Apothaka products for menopausal and perimenopausal skin

These are my recommendations for building a routine that supports your skin through this transition (you don't need all of these, but these are the most popular amongst my perimenopausal customers):

• Golden nectar jelly balm cleanser: a decadent gelled oil cleanser without the heaviness of a solid balm cleanser. Great for a facial massage, this breaks down make up and impurities, and rinses off with water to leave the skin feeling clean and nourished
• Velveteen cloud cleanser: This gentle water-based creamy gel hybrid cleanser with a high glycerin content effectively removes impurities without stripping the skin, leaving it feeling hydrated and comfortable after cleansing
  
• Barrier support serum - 5% niacinamide, hyaluronic acid and a ceramide complex to hydrate and reinforce the skin barrier; ideal for tight, dehydrated perimenopausal skin
• Skin quenching essence - a lightweight extra layer of hydration for dehydrated skin; particularly useful during the drier months
• Barrier defence AOX serum – a comprehensive blend of multiple antioxidants to protect and brighten skin tone
• Barrier renew retinal serum - a thoughtfully formulated retinoid with encapsulated retinal, signalling peptides, ceramides and licorice to support healthy ageing without irritation
• Face oils - adding a few drops of oil to your moisturiser at night can make a noticeable difference to how skin feels by morning; choose the fragrance-free comforting oil booster for sensitive skin
• Gentle enzyme exfoliant - a leave-on overnight milky serum with fermented pineapple and papaya enzymes and a multi-fruit acid complex. Gently resurfaces and brightens without the irritation risk of stronger AHAs — ideal for skin that's become more reactive
• EVY sunscreens - weightless, robust broad-spectrum protection that you'll actually want to wear every day (also doubles as a make up primer!)

Navigating menopause and perimenopause can feel overwhelming at times - but your skin doesn't have to be another thing to worry about. With the right knowledge, a simplified routine, and a little patience, healthy, radiant skin is absolutely achievable at every stage. Remember, this is about ageing on your own terms, not chasing impossible skin goals around perfection. As always, if you have any questions or would like personalised advice on building a routine that works for you, don't hesitate to get in touch – I’m always here to help!