During perimenopause and menopause, women often notice significant changes in their skin due to hormonal shifts. Common symptoms include increased dryness, thinning, reduced elasticity, more wrinkles, sagging, heightened sensitivity, itchiness, hormonal acne, a greater risk of rashes, and the appearance of dark spots such as hyperpigmentation and melasma. These changes are primarily linked to a decrease in estrogen levels, which weakens the skin barrier and reduces the production of oil (sebum), collagen, and hyaluronic acid.
Andrea Dale Maderal, M.D., a dermatologist with the University of Miami Health System, notes that sun protection remains one of the most effective strategies for preventing signs of aging. “Consider a tinted sunscreen to help minimize the appearance of pigmentation and signs of aging,” says Dr. Maderal. She emphasizes that even if daily sunscreen was not used earlier in life, starting in one’s 40s or 50s can still help prevent further wrinkles.
Hydrating serums and creams containing ingredients like hyaluronic acid and ceramides are also recommended for maintaining moisture. Dr. Maderal clarifies misconceptions about petrolatum-based products: “Petrolatum-based products, like Vaseline and Aquaphor, do not clog pores nor trigger acne,” she says. “These products can be very hydrating. They work best if you first apply a moisturizing cream. Then, Vaseline helps to lock in the moisturizer by occluding it into place.”
Regarding anti-aging creams and serums that claim to boost collagen or reduce wrinkles and dullness, Dr. Maderal points out that retinols are among the few topical treatments proven effective against photoaging: “Retinols and prescription retinoids are some of the best topical treatments that we have to prevent photoaging (skin sagging, sun spots, wrinkles, and dullness caused by sun exposure). However, no retinol can stop your skin from getting older.”
Flavia Fairbanks, M.D., Ph.D., a gynecologist with UHealth, discusses prescription estriol cream as another option: “According to current data, any topical estrogen — including the facial estriol cream or gel — can activate the beta-estrogen skin receptor. So it is helpful with partial restoring and collagen synthesis without a significant systemic hormonal effect,” she explains. Estriol may also improve hydration by increasing hyaluronic acid production while offering antioxidant benefits.
Dr. Maderal adds that niacinamide may assist with dark spots from sun damage: “Niacinamide can help with dark spots and other signs of sun aging.” She also recommends topical Vitamin C for reducing oxidative damage from pollution or sun exposure: “It can reduce signs of skin damage from external sources and can be particularly helpful for reducing hyperpigmentation.” On ferulic acid’s role in skincare formulations containing Vitamin C: “Ferulic acid is often used for its function in stabilizing topical Vitamin C but on its own is not a top cream,” she says.
Some dietary supplements are marketed for improving skin health during menopause; however, evidence varies regarding their effectiveness. “The benefits of collagen supplements are controversial but the data leans towards it being beneficial,” Dr. Maderal states about oral collagen products. In contrast: “While Biotin may be beneficial for nails it has consistently demonstrated no benefit for hair,” she adds.
Peptides found in both supplements and topical applications claim various benefits such as boosting collagen or healing wounds but require more research before firm conclusions can be drawn: “We need a lot more data on the effectiveness of peptides on the skin,” Dr. Maderal says.
Healthy lifestyle habits remain important for supporting skin health through menopause:
– Eating nutrient-rich foods high in antioxidants
– Getting sufficient sleep (about nine hours nightly)
– Drinking at least two liters of water daily (“You should also drink at least two liters of water per day to help your internal hydration,” says Dr. Fairbanks.)
– Avoiding smoking
– Limiting alcohol consumption
– Managing stress
– Maintaining physical activity through cardiovascular exercise or weight training
– Keeping a healthy weight
Red light therapy devices—available both professionally or at home—may provide some benefit according to existing studies: “These devices can be helpful as data demonstrates some benefit,” Dr. Maderal notes.
Dermatologists recommend twice-daily moisturizing routines using gentle fragrance-free products during this period when skin is especially vulnerable.
Women experiencing persistent inflammation or dryness unresponsive to moisturizers should consult with dermatologists specializing in menopausal skin care.
For appointments at UHealth Dermatology call (305) 243-6704 or request an appointment online.
