What Menopause Does to Your Skin — and What Actually Helps
Published 2026-02-27 • Summer House Editorial Team
Menopause is often described as a single event, but for skin it's a years-long process that begins in perimenopause and continues well after. If your skin suddenly feels like it's changed the rules — drier, thinner, more reactive, or developing new spots — that's not imagination. Estrogen does a significant amount of work in the skin, and its decline is visible. Here's what's actually happening and what helps.
Dryness, Thinning, and Barrier Changes
Estrogen plays a direct role in maintaining skin hydration and barrier function. It stimulates production of hyaluronic acid in the skin, supports sebaceous gland activity, and influences the proteins that hold skin cells together. When estrogen declines, all of these processes slow: skin becomes drier, less able to retain moisture, and more sensitive to products that previously caused no irritation. This is why menopausal skin often can't tolerate the same routine that worked for years.
Skin thinning is the other major physical change. Estrogen supports collagen production; its decline accelerates the natural age-related drop in collagen and elastin. The result is skin that looks and feels more fragile, bruises more easily, and shows fine lines that weren't there before. This is not a skincare-product problem — it's a structural change that requires either hormonal intervention or professional treatments to address meaningfully.
Melasma, Pigmentation Shifts, and New Spots
Melasma — the brown, patch-like discoloration often associated with pregnancy — can also appear or worsen during perimenopause due to hormonal fluctuation. It tends to appear on the upper lip, cheeks, and forehead. Unlike sun spots, melasma is hormonally driven and is notoriously difficult to eliminate permanently; treating it effectively requires both topical management and careful sun avoidance, because UV exposure is the trigger that activates existing melanin overproduction.
Pigmentation changes unrelated to melasma also accelerate after menopause, partly because estrogen normally has some protective effect on melanocyte regulation. Clients who managed sun spots successfully for years may find they progress more quickly after menopause. This is the window where adding a professional-grade retinoid and SPF 50 to a daily routine produces the most protective benefit.
Medspa Treatments Worth Considering
For skin thinning and laxity, radiofrequency microneedling (Morpheus8) is one of the most effective non-hormonal options available. It stimulates collagen formation by delivering controlled heat into the dermis, partially compensating for the decline in estrogen-supported collagen production. Results build over months and hold well. For the dryness and barrier disruption, professional-grade hyaluronic acid boosters — injected as a hydration treatment rather than a structural filler — can restore a level of skin hydration that topicals can't reach.
IPL and laser treatments address the pigmentation that accelerates after menopause. For melasma specifically, treatment requires a careful approach — some laser wavelengths can worsen melasma if not chosen correctly — so provider experience with this condition matters. A combination of professional topicals (tranexamic acid, azelaic acid, niacinamide) and IPL, managed carefully around sun exposure, produces the best outcomes for most patients.
FAQ
Should I wait until after menopause is fully complete before starting treatments?
No — and waiting often means more change to address later. Treatments during perimenopause can support the skin through the transition rather than trying to correct accumulated change afterward. The one caveat is melasma: if your hormones are still fluctuating significantly, some pigment treatments may produce inconsistent results. Your provider should know you're perimenopausal so they can calibrate their approach.
Will medspa treatments interact with hormone replacement therapy (HRT)?
Generally no — most medspa treatments are safe alongside HRT. Some patients on HRT find their skin responds better to treatments because estrogen levels are better supported. Disclose your HRT regimen (including topical hormones) at your consultation. The main interaction to be aware of is increased sensitivity in some patients — a conservative starting point for any new treatment is sensible.
Need help now?
If your skin has changed significantly in the last few years, book a skin consultation at Summer House Medspa — we treat a lot of menopausal skin and can build a realistic plan.