Understanding the menopause and perimenopause skin changes

Table of Content:
Why does skin change? | What skin changes can occur? | What hair changes can occur? | What skin changes can occur in the vaginal or anal area? | How can menopause affect the inside of your mouth? | Can a dermatologist help? | How to get a prescription? | FAQ

What is the difference between menopause and perimenopause?

Dr. Anne Allen, board-certified dermatologist offering care to patients via Miiskin, says that menopause is the natural phase in your life when your menstrual periods permanently stop, marking the end of your reproductive years, typically occurring around age 51. It’s officially diagnosed after you’ve gone 12 months without a period. 

Perimenopause is the transitional period leading up to menopause, which can start several years earlier, usually in your 40s. During perimenopause, your hormone levels, especially estrogen and progesterone, fluctuate, leading to symptoms like irregular periods, hot flashes, mood changes, sleep disturbances, and vaginal dryness. 

According to Dr. Allen, during perimenopause and menopause your skin and hair are also affected. Your skin may become drier, thinner, or more prone to itching and wrinkles, while hair can become finer, drier, or begin to thin, especially around the crown or temples. These symptoms can vary widely from person to person and may last for several years, even after menopause is reached.

Why does skin change during menopause and perimenopause?

According to Dr. Allen, skin changes during menopause and perimenopause happen mainly because of declining estrogen levels. Estrogen helps maintain your skin’s thickness, hydration, and elasticity by supporting collagen production and oil gland function. As estrogen drops, collagen levels decrease, leading to thinner, less elastic skin and more visible fine lines or wrinkles. Reduced oil production can cause dryness and itchiness, while slower skin cell turnover may make your skin appear dull. Blood flow to the skin also decreases, affecting its overall tone and healing capacity. These hormonal shifts can also lead to increased sensitivity, acne flare-ups, or conditions like rosacea.

What skin changes can occur during perimenopause and menopause?

According to Dr. Allen, menopause and perimenopause can bring noticeable changes to your skin, hair, intimate areas, and even inside your mouth. Partnering with a board-certified dermatologist can help you navigate these changes and support the health and appearance of your skin over time. 

• Acne – Hormonal fluctuations during perimenopause and menopause, especially an increase in androgens, can trigger new breakouts or worsen existing acne. This may occur even in women who didn’t have acne earlier in life, often presenting along the jawline or chin.
• Rosacea – This chronic skin condition can flare during menopause due to increased skin sensitivity and hormonal shifts. It may cause redness, flushing, visible blood vessels, and bumps, often mistaken for acne but requiring different treatment.
• Dark “age” spots – Hyperpigmentation or sun spots become more visible due to years of sun exposure and thinner, more fragile skin.
• Skin thinning – As estrogen declines, your body produces less collagen and elastin, resulting in thinner, more fragile skin that bruises more easily and heals more slowly.
• Sagging or loss of plumpness – With less collagen, fat, and elasticity, skin can sag—especially around the cheeks, jawline, and neck—creating a more hollow or aged appearance.
• Pruritus (itching) – Chronic itching becomes common due to drier, thinner skin and hormonal shifts. It can be generalized or localized, sometimes severe enough to disturb sleep or quality of life.
• Xerosis (dry skin) – A very common symptom, xerosis causes rough, flaky, or cracked skin due to decreased oil production and a weakened skin barrier.
• Eczema (dermatitis) – Skin becomes more reactive and prone to inflammation. Eczema may newly develop or worsen during menopause, often due to dryness or irritation.
• Impaired wound healing – Reduced estrogen slows the skin’s natural repair process, meaning cuts, abrasions, or irritations may take longer to heal and be more prone to infection.
• Hot flushes – Sudden episodes of heat and flushing that can leave the skin red, sweaty, and temporarily irritated, commonly affecting the face, neck, and chest.
• Hyperhidrosis (excess sweating) – May accompany hot flushes or occur independently, often affecting the underarms, palms, feet, or entire body.

What hair changes can occur during perimenopause and menopause?

• Hair loss or female pattern hair thinning – A gradual reduction in hair density, especially along the crown or part line, due to hormonal imbalance affecting hair follicles.
• Hirsutism (unwanted facial hair) – Increased androgen activity can cause coarse hairs to appear on the chin, upper lip, or jawline.

What skin problems or changes can happen in the vaginal or anal area during perimenopause and menopause?

• Lichen sclerosus – A chronic, inflammatory skin condition often affecting the vulva and anal area. It causes thin, white, itchy, or crinkled skin, and can lead to scarring and painful intercourse if untreated.
• Lichen planus – An inflammatory condition that can affect the genital mucosa, leading to red or purple lesions, pain, and potential scarring. It may also affect the mouth or skin elsewhere.
• Hemorrhoids –  Hormonal shifts during perimenopause and menopause can contribute to hemorrhoids, often due to increased constipation or pelvic floor changes. They may cause itching, discomfort, or bleeding and can usually be managed with simple treatments.

How can perimenopause and menopause affect the inside of your mouth?

• Lichen planus (oral) – Appears as white lacy patches, redness, or painful ulcers inside the mouth. It may cause discomfort with eating or speaking.
• Burning mouth syndrome – A sensation of burning, tingling, or pain in the tongue, lips, or entire mouth without visible signs. This is believed to be linked to hormonal changes and nerve sensitivity.
• Xerostomia (dry mouth) – Decreased saliva production can lead to a dry, sticky feeling in the mouth, difficulty swallowing, altered taste, and increased risk of cavities and oral infections.

Can a dermatologist help me address one or several of the skin changes mentioned?

Yes, absolutely. Dr. Allen emphasizes that a board-certified dermatologist is well-equipped to help manage skin changes that occur during perimenopause and menopause. Whether you’re dealing with dryness, wrinkles, acne, pigmentation, or sensitivity, a dermatologist can create a personalized treatment plan, often combining prescription skincare, lifestyle guidance, and targeted therapies, to improve both how your skin looks and feels.

How to get an online prescription via Miiskin?

Miiskin connects you with board-certified dermatologists, who may prescribe FDA-approved generics or personalized compounded medications.

If you are interested in a customized formula, simply select Foothills as your pharmacy and place your medication order directly in the Miiskin platform. Foothills will send you a payment link, and once payment is completed, your medication will be shipped free via UPS delivery.

Transparent pricing: A consultation is typically around $59, and medication refills are around $39. The price of most Foothills formulas via Miiskin is $48.99 with a few exceptions being priced at $58.99 and some hair growth formulas priced at $68.99. You will not be enrolled in an automatic subscription, you will only purchase medication when you need it.

Important Disclaimer: Compounded medications are not reviewed by the FDA for safety or efficacy.

References:
https://my.clevelandclinic.org/health/diseases/21841-menopause
https://my.clevelandclinic.org/health/diseases/21608-perimenopause
https://www.dermcoll.edu.au/wp-content/uploads/2022/05/ACD-FAQs-Perimenopausal-skin-April-2022-.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC10092853/

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