Your Skin During the Season of Perimenopause and Menopause

When hormones shift, your skin follows. Here’s what’s unfolding beneath the surface and how to meet it with intention.

Perimenopause and menopause are often spoken about in terms of internal change, shifting hormones, disrupted sleep, changes in mood
and energy. Yet for many women, the transition begins to reveal itself through the skin. Your complexion may feel less balanced, more
sensitive, drier or less resilient. Tone can appear uneven, fine lines more defined, and your go-to products that once delivered predictable results may no longer perform in the same way. These changes rarely exist in isolation; they reflect the broader physiological transition unfolding beneath the surface.

As women’s natural health and hormone expert Nat Kringoudis, founder of The Pagoda Tree, explains, “As hormones start to decline, so does collagen, hydration and that natural elasticity in the skin … this is an inside-out rather than an outside-in situation.”

Rather than viewing these changes as something to correct, this transition calls for a deeper understanding of how the skin is responding to
internal changes. It is not simply about ageing, but about adaptation, as the body moves into a new hormonal landscape, one that requires a reframe in how the skin is cared for and understood.

The changing architecture of the skin

From a clinical perspective, the changes seen in the skin during perimenopause and menopause are both structural and functional. Dermatologist Dr Katherine Armour, founder of Bespoke Skin Technology, describes this period as one “primarily mediated by declining oestrogen and relative androgen excess”, alongside the accumulation of changes from external factors in the environment that disrupt the skin, such as UV exposure, pollution and cigarette smoke. As the skin’s structure and function evolve, so too do the concerns that present during this stage of life. Some may emerge for the first time, while others become more pronounced.

“These shifts can manifest as thinning and fragility of the skin, barrier impairment, dryness, sensitivity, easy bruising and changes to pigment, while some women also experience acne and increased facial hair,” says Dr Armour.

At a deeper level, oestrogen plays a central role in maintaining the skin’s architecture. As levels decline, there is a measurable reduction in collagen production, alongside decreased synthesis of glycosaminoglycans, the molecules responsible for retaining water within the dermis. The result, as Dr Armour explains, often “means a loss of plumpness and hydration”.

Elasticity, the skin’s “bounce”, is also affected. Reduced oestrogen compromises the integrity of elastin fibres, contributing to a progressive loss of firmness and structural support. These changes are further compounded by cumulative environmental exposure, particularly ultraviolet radiation, which accelerates collagen breakdown and deepens visible ageing.

Equally significant is the effect on the skin’s barrier. “A reduction in oestrogen results in less production of ceramides and sebum, and other natural moisturising factors,” explains Dr Armour, impairing the skin’s ability to retain moisture and defend against external irritants. This is often experienced as dryness, roughness and increased sensitivity, even in those who have not previously had reactive skin.

For some women, inflammatory conditions may also emerge or intensify. According to Dr Armour, “This may also exacerbate underlying skin conditions such as eczema, while rosacea can become more pronounced, influenced by barrier impairment and the vasomotor instability commonly experienced during menopause.”

These changes can feel complex, even contradictory. Yet they reflect the interplay between hormonal shifts, structural decline and the skin’s changing capacity to regulate and repair itself.

More than skin deep

While these structural changes are well understood, their appearance does not tell a simple, isolated story. The skin is responding not only to hormonal decline, but to a wider network of internal processes that become more pronounced during these phases of life.

As Kringoudis explains, “Hormones don’t just influence your cycle … they interact with your nervous system, metabolism, immune system and
detox pathways.”

This interconnectedness helps explain why changes can feel sudden or, at times, inconsistent. It is not only the decline in oestrogen, but the way this shift amplifies underlying imbalances, from stress and blood sugar fluctuations to liver function and inflammatory load.

“Suddenly, the things you used to get away with… they just don’t land the same way,” she notes. In this context, the skin becomes less forgiving.
Repair processes slow, resilience is reduced, and the visible effects of internal strain can begin to surface more readily.

This transition invites a more expansive perspective than simply understanding the cascade of hormone driven skin changes that perimenopause and menopause bring. It calls for a deeper consideration of the conditions shaping how the body looks, feels and functions as a whole, not only how the skin behaves. Hormones remain central, yet they are only one part of an intricate internal picture and, according to Kringoudis, “Some of the biggest internal drivers are blood sugar balance, stress and nervous system load, liver function and gut health.”

When these systems are under strain, the effects can become visible. Blood sugar fluctuations can contribute to infl ammation and accelerate collagen breakdown, while ongoing stress elevates cortisol, impairing the skin’s ability to repair.

Lifestyle factors take on greater significance here. As Kringoudis notes, “They aren’t just ‘nice to have’; they’re often the difference between skin that feels resilient and skin that suddenly feels reactive.”

Nurturing your internal landscape

Rather than adding layers, this stage often invites a return to what is foundational. Nutrition, sleep, stress regulation and gentle movement all influence the skin’s ability to repair and maintain balance. “This phase doesn’t need a complete life overhaul,” says Kringoudis. “Start with the basics.”

Protein-rich meals that support stable blood sugar, adequate protein intake and consistent hydration all play a role in maintaining skin structure. Sleep, as the body’s primary window for repair, becomes equally influential, while chronic stress can disrupt these processes through elevated cortisol.

Gentle movement such as walking and strength training, plus anything that supports the nervous system (think breathwork, time in nature and slowing down the pace of your everyday life), can all make a meaningful difference. There is also value in restraint and intention. As Kringoudis reflects, “It’s less about doing more, and more about doing what actually supports your body now … learning to work with your body instead of against it.”

In this way, as you move through perimenopause and menopause, skin health becomes less about isolated intervention and more about nourishing the conditions that allow your whole being to thrive.

Adapting your skincare ritual

Even with a supportive lifestyle foundation, as the skin’s needs evolve with hormonal changes, so too must the way it is cared for topically. The focus shifts towards maintaining barrier integrity, protecting against environmental stressors, and supporting the skin’s natural regenerative processes.

As Dr Armour explains, “The key principles in skin longevity still apply … protect the skin barrier, microbiome and DNA, and aim to stimulate the skin’s own biological processes such as collagen production.”

Hydration sits at the centre of this approach. Ingredients such as ceramides and glycerol help reinforce the barrier and retain moisture, while
daily sun protection and antioxidant support remain essential in defending against further damage. Actives that promote renewal can still play a role, though often with a more considered application.

“Retinoids, bakuchiol and AHAs are useful to promote collagen production and improve elastin quality,” says Dr Armour. Sensitivity, however, may require adjustment. “During menopause, women often find that retinoids and vitamin C are too irritating … that’s why alternatives such
as bakuchiol and astaxanthin can be beneficial.”

Similar to lifestyle practices, skincare becomes less about intensity and more about alignment, gently tending to the skin’s changing capacity rather than pushing against it.

Working with a new rhythm

The skin is highly intelligent; it does not change without reason. It reflects what is shifting beneath the surface, responding to hormones, environment and the rhythms of the body itself. During perimenopause and menopause, these signals become more visible, not as a sign of something going wrong but as a passage of womanhood, which offers an invitation to deeper self-connection.

“The reframe here is that this stage isn’t just about decline … it’s an opportunity for recalibration,” Kringoudis reflects. “It’s often the moment women start to truly understand their bodies, rather than override them.”

To meet these changes with awareness rather than resistance is to recognise the skin for what it is, not something to control, but something to embrace and care for, even when it sends visible signals.

This process asks us to trust that the body knows what to do when given the right conditions. Your role is to create those conditions, so the skin can continue to thrive through perimenopause, menopause and beyond.

This article is featured in Wellbeing Magazine 224