When Your Skin Starts to Change – What It Needs During Menopause

 “My skin suddenly felt dried out – no matter how much cream I used.” Many women describe their first skin changes during menopause in similar words. What used to feel soft, elastic, and easy to care for now feels dry, thinner, or more sensitive. Some notice small cracks, itching, or a feeling of tightness – often without immediately understanding the cause. What many don’t know: the skin is one of the organs that reacts particularly strongly to hormonal changes. Estrogen, in particular, plays a central role in the health and structure of the skin. As estrogen levels drop with the onset of menopause, a new phase also begins for the skin. If your skin changes, it’s not a sign of neglect – it’s the expression of a natural process. That’s why it’s all the more important to understand what’s happening in your body, the role hormones play, and how you can actively support your skin.

During menopause, hormonal balance shifts – most notably, estrogen levels steadily decrease. This change has far-reaching effects on the skin, as estrogen is involved in numerous processes that are essential for healthy, firm, and well-hydrated skin.

Collagen Loss and Skin Thickness

Estrogen stimulates the production of collagen – a structural protein that gives skin firmness and elasticity. Studies show that in the first five years after menopause, collagen content in the skin can decrease by up to 30%. The result: the skin becomes thinner, loses elasticity, and becomes more prone to minor injuries or irritation.

Moisture Loss and Skin Barrier

Estrogen also influences the production of hyaluronic acid and lipids – substances that help retain moisture in the skin and stabilize the skin barrier. A lack of estrogen leads to drier skin, a feeling of tightness, and itchiness. Many women also report increased sensitivity to skincare products or environmental stimuli.

Changes in Skin Structure

With hormonal changes, skin blood flow also decreases, and regeneration slows. The skin appears paler, duller, and less rosy. At the same time, pigmentation disorders, such as age spots, may increase – especially in women who had frequent sun exposure in the past.

Fat Distribution and Skin Appearance

Decreasing estrogen levels can also affect sebum production. Some women report drier skin, others experience sudden breakouts – a phenomenon reminiscent of teenage acne, but hormonally driven. The redistribution of body fat may also influence the skin’s appearance, for example, by causing increased dryness in the limbs or changes in the facial area.

These natural processes cannot be completely stopped – but they can be mitigated. In the next section, you’ll learn how to support your skin – from the inside and the outside.

The skin is not a passive protective shield, but a highly active organ – and one that is particularly sensitive to hormonal signals. Estrogen receptors – docking sites for estrogen – are found in almost all skin layers, especially in the face, legs, and genital area.

As long as enough estrogen circulates in the body, it exerts a series of beneficial effects:

• It promotes cell regeneration in the outermost skin layer and ensures a stable skin barrier.

• It stimulates the production of collagen and elastin – the main structural proteins for smooth, firm skin.

• It has anti-inflammatory and antioxidant effects – protecting the skin from environmental damage and free radicals.

• It supports moisture retention, among other things by regulating hyaluronic acid and ceramide-rich lipids.

As estrogen levels fall, this protective effect gradually declines: cell regeneration slows, the skin becomes more sensitive and dries out more easily. Small inflammations may also occur more frequently or heal more slowly. All of this explains why many women in perimenopause report a new, unusually “thin” skin sensation – even if they haven’t changed their skincare routine.

Not every woman experiences the same changes – but certain skin issues are especially common during menopause. They reflect the hormonal transition and its wide-ranging effects on moisture, regeneration, and the skin’s protective function.

Dry Skin (Xerosis)

A classic in menopause: the skin loses moisture more quickly, appearing rough, scaly, or dull. The shins, forearms, and face are particularly affected. Frequent moisturizing brings only short-term relief – long-term support is needed.

Itching (Pruritus)

Dry skin is more prone to irritation. Many women report sudden itching – without a visible cause. Sometimes, a warm shower or dry indoor heating is enough to trigger this uncomfortable sensation.

Thinning Skin and Slower HealingAs collagen decreases, the skin becomes noticeably thinner – small scratches or tears heal more slowly, and bruises form more easily. Skin elasticity also declines, which may lead to fine lines or a “loose” feeling.

Pigmentation Changes and Melasma

Hormonal changes also affect the regulation of melanin – the skin’s pigment. This can lead to uneven pigmentation – especially in women with significant past sun exposure. Typical signs include melasma or age spots: brown, well-defined patches that appear on sun-exposed areas such as the forehead, cheeks, upper lip, and back of the hands. Sun exposure worsens these changes – making consistent UV protection especially important during this stage of life.

Increased Sensitivity

What used to be well tolerated suddenly causes redness or burning. The altered skin barrier reacts more sensitively to fragrances, preservatives, or certain fabrics.

The good news: even though hormone-related skin changes can’t be completely “creamed away,” there are many effective ways to support the skin. A holistic approach is key – from external care to internal support.

a) Skincare: What Really HelpsAs estrogen levels drop, the skin especially needs more support in retaining moisture and maintaining its protective barrier.

• Lipid-replenishing, fragrance-free products are well tolerated and help stabilize the skin’s lipid film.

• Humectants like urea or glycerin bind water in the skin – especially important for dry, flaky skin.

• Sun protection should be part of your daily routine – not just to prevent skin cancer but also to reduce pigment spots and premature aging.

• Gentle cleansing instead of harsh surfactants: lukewarm water, pH-neutral products, and minimal application help protect the skin barrier.

b) Local Hormone TherapyA lesser-known but well-documented option in research is the use of estrogen-containing creams – especially with estriol, a weak estrogen with low systemic absorption.

• Topical estriol can improve skin density, elasticity, and moisture content – particularly in sensitive areas like the face.

• While no such skincare products are currently approved in Europe, the U.S. already has facial creams with low-dose estriol available.

• Progesterone-containing creams are occasionally offered alongside estrogen creams, but their effect on the skin is less well documented – partly due to lower skin absorption.

c) Nutrition and MicronutrientsWhat we eat affects our skin – especially when it comes to antioxidant protection and cell regeneration. But during menopause, nutrient absorption and metabolism change, so some additional support may be helpful:

• Omega-3 fatty acids (e.g. from flaxseed or fish oil) have anti-inflammatory effects and support the skin barrier.

• Antioxidants like vitamins C and E help neutralize free radicals.

• Zinc and selenium are important for wound healing, immune protection, and enzyme function.

• Vitamin D is also essential for skin health – and deficiency is widespread in Central Europe.

If you have symptoms or risk factors, micronutrient testing through your GP or gynecologist may be useful.

Skin is more than just an organ – it reflects our inner state. When it changes, this often affects body image. Many women report no longer feeling “comfortable in their skin” when they experience tightness, redness, or visible changes.

Especially in a life phase of major transition, it’s important to treat yourself with care. Rather than self-criticism and perfectionism, this time calls for a loving and realistic understanding of what your body is going through. Skincare can become more than routine – it can be a conscious ritual of self-care. A moment of calm, appreciation, and connection with yourself.

If skin changes are unsettling or burdensome, it can help to seek professional support – for example, from an experienced dermatologist. They can identify potential causes and recommend suitable treatments. Conversations with menopause experts, other women, or practicing relaxation techniques like mindfulness or meditation can also help improve well-being.

Because ultimately, it’s not about perfection – it’s about feeling at home in your own skin again.

Sources

Weidlinger, S. et al. Die Menopause und ihre Auswirkungen auf Haut und Haare. Gynäkologische Endokrinologie 21, 290–297 (2023). https://doi.org/10.1007/s10304-023-00526-1.

Gasser S. et al.. Impact of progesterone on skin and hair in menopause - a comprehensive review. Climacteric. 2021 Jun;24(3):229-235. doi: 10.1080/13697137.2020.1838476. Epub 2021 Feb 2. PMID: 33527841.

Rzepecki AK, Murase JE, Juran R, Fabi SG, McLellan BN. Estrogen-deficient skin: The role of topical therapy. Int J Womens Dermatol. 2019 Mar 15;5(2):85-90. doi: 10.1016/j.ijwd.2019.01.001. PMID: 30997378.

Patriarca MT et al. Effects of topical estradiol on the facial skin collagen of postmenopausal women under oral hormone therapy: a pilot study. Eur J Obstet Gynecol Reprod Biol. 2007 Feb;130(2):202-5. doi: 10.1016/j.ejogrb.2006.05.024. Epub 2006 Jun 23. PMID: 16797821.