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Five Common Skin Problems Experienced in Perimenopause & How To Cope

Five Common Skin Problems Experienced in Perimenopause & How To Cope

Your skin changes throughout your lifetime, showing signs of aging that can affect its appearance and behavior. For women, however, the skin's reliance on reproductive hormones can lead to significant changes in skin health.

Perimenopause is often when these changes occur, as the rapid fluctuations in hormones can manifest as various skin problems.

Estrogen: The Powerhouse of Hormones

Estrogen, also known as estradiol, is a hormone closely associated with the female reproductive system and its organs. But it also impacts the body in various ways. For example:

  • During puberty, estrogen plays a crucial role in the growth of long bones and the fusion of growth plates. Estrogen also protects bones throughout life by regulating the osteoblast cells that maintain bone density and prevent osteoporosis.[1]
  • During puberty and pregnancy, estrogen encourages the growth of mammary ducts.[2]
  • Vaginal epithelial mucosal cells take their direction from estrogen, providing lubrication and moisture.[2]
  • Cardiovascular function benefits from estrogen, which reduces LDL (β€œbad cholesterol”) and increases HDL (β€œgood cholesterol”).[2]

Along with these essential activities, estrogen plays a vital role in maintaining skin suppleness, elasticity, and smoothness.

How Do Estrogen Levels Affect Skin?

Women often associate perimenopause with hot flashes, night sweats, hair loss, and mood swings, but the skin is another organ profoundly affected by hormonal upheaval. While progesterone, estrogen, and testosterone all play roles in skin physiology, estrogen exerts the most significant influence. During perimenopause, rapid declines and sharp swings in estrogen levels can disrupt the skin’s structure and behavior.[3]

Because estrogen supports so many aspects of skin health, including collagen integrity, lipid barrier function, inflammatory balance, and cellular repair, a sudden drop or fluctuation in its levels during perimenopause can trigger:

  • Dryness & Thinning: Reduced collagen and oil production thins the dermis and compromises moisture retention.[4]
  • Acne & Breakouts: Imbalanced sebum regulation and inflammatory dysregulation may lead to clogged pores and flare-ups.[5]
  • Delayed Wound Healing: Lowered estrogen levels diminish growth factor activity, slowing the repair process.[6]
  • Increased Sensitivity & Reactivity: A weakened barrier heightens susceptibility to irritants and environmental stressors.[4]

It’s not just absolute hormone concentrations that matter, but also their relative balance. Sudden estrogen swings disrupt the body’s homeostasis more profoundly than gradual declines, making perimenopausal skin particularly vulnerable. As estrogen levels fluctuate, women may experience a spectrum of skin changes as the skin struggles to adapt to its new hormonal environment.

What Does Perimenopausal Skin Look Like?

Perimenopausal skin changes can look different depending on your existing skin health, lifestyle factors, and genetic history. Here are some of the most common perimenopause skin problems that women experience:

#1: Sagging Skin

Skin loses a significant amount of its collagen content every year, a process that's accelerated by hormonal changes during perimenopause and the menopausal transition. This is due to estrogen's role in the biosynthesis of collagen.[7]

Within the first five years of menopause, your skin loses approximately 30% of its collagen. Afterward, you could expect a 2% collagen reduction each year for the next two decades. Yet, while the most significant changes occur during menopause, this process of collagen loss begins during perimenopause. [6]

The significant loss of collagen reduces skin elasticity and resilience, making it prone to sagging and wrinkles. It’s not just the loss of collagen that causes these visible signs of skin aging. Perimenopausal women also begin to lose some of the structural fat and muscle that keep the skin plump and supple. This gives the skin a more sullen look, and with less structural integrity, the skin wrinkles and sags, especially in the neck and jawline areas.[8]

The OS-01 peptide significantly improves collagen production in skin, helping it resist the losses associated with perimenopause. Found in every one of OneSkin's topical supplements and SPFs, these products may help prevent and even reverse some of the initial signs of sagging skin and wrinkles.[9] Due to the underlying structural changes under the skin, however, not all sagging skin can be slowed with topical products.[8]

#2: Dry & Flaky Skin

While both men and women's skin thins with age, women's skin undergoes a much more sudden loss of skin thickness during perimenopause, primarily due to its lowered collagen levels. This thinner barrier means less protection against external threats, but perhaps more importantly, an impaired ability to retain moisture.[7]

However, skin thickness isn't the only factor involved in keeping your skin hydrated. Estrogen is a key ingredient in the biosynthesis of skin-smoothing and moisturizing oils. As estrogen levels drop, a loss of nourishing oils occurs. For perimenopausal women, that means more trans-epidermal water loss and drier, flakier skin.[7]

Skin with a weakened skin barrier allows more external sources of inflammation to enter, which can spread throughout the body and contribute to overall aging through a process called inflammaging. Use OS-01 BODY to improve hydration and strengthen the skin barrier. It's clinically validated to boost skin barrier function by up to +41% and even reduce circulating inflammatory biomarkers.[9,10]

#3: Acne Breakouts

Acne during perimenopause can be frustrating and confusing. After all, most people associate acne outbreaks with their teen years. There are many causes of perimenopausal acne, but hormonal imbalance is usually the culprit.

As estrogen diminishes, the balance of androgen hormones (testosterone) to estrogens becomes disrupted. This imbalance can result in an overexpression of androgens, leading to the hormonal acne sometimes experienced during perimenopause.[11]

Along with the imbalance of hormones, lifestyle factors, diet, stress, and genetics are other factors that lead to perimenopausal acne. Many women may experience occasional minor acne outbreaks during menopause. Others may find themselves with severe bouts of acne that require intervention.[11]

Furthermore, women experiencing perimenopause lack the robust collagen and healing factors they once had. Compared to teenage acne, perimenopausal acne can take longer to heal and lead to scarring if not properly managed. During perimenopause, incorporating skin care products that promote skin barrier repair whilst remaining non-comedogenic is essential. Choose a product like OS-01 FACE, which is clinically validated to do both.[9]

#4: Eczema

Atopic dermatitis, also known as eczema, causes itchy skin, scaly patches, blisters, and dry skin. Although eczema can occur at any time, perimenopause can create the perfect conditions for eczema symptoms to appear:[12]

  • Weakened Skin Repair Mechanisms: Hormone imbalance is the primary cause of eczema during perimenopause. Diminished estrogen levels cause the skin to thin and dry out while losing the ability to heal as quickly as it used to, resulting in persistent eczema symptoms.[7]
  • Increased Skin Reactivity: Perimenopausal skin can become sensitive and less resilient, resulting in facial rashes or eczema. Fabrics, dyes, and perfumes that may have once been tolerated by skin can induce reactions much more quickly during perimenopause.[12]
  • Skin pH: The pH level of perimenopausal skin begins to change when a woman nears 50 years of age, potentially disrupting the delicate skin microbiome. This may allow β€œbad” bacteria to outcompete the β€œgood” bacteria responsible for maintaining your skin's health. While this won't directly cause eczema, it can promote species that weaken the skin barrier, exacerbating eczema. In extreme conditions, it can even cause bacterial infections in skin weakened by this condition.[13,14]

Therefore, women with a previous history of eczema may experience a significant recurrence of their symptoms, especially during menopause.

While not specifically designed to treat eczema, the National Eczema Association has validated all of OneSkin’s products as safe for individuals with eczema. Additionally, by enhancing skin repair mechanisms and fortifying the skin barrier, OneSkin’s topical supplements may help eczema-prone skin better defend against symptoms like dryness and flaky skin.[15]

#5: Hyperpigmentation & Discoloration

Hyperpigmentation is a highly complex process regulated by several hormones and external factors. One of the primary ways that hyperpigmentation can be triggered during perimenopause is through fluctuations in estrogen.

Estrogen plays a central role in regulating melanogenesis, the process by which melanin is produced in the skin. During periods of elevated or fluctuating estrogen levels, such as pregnancy or perimenopause, this hormone can stimulate melanocytes via estrogen receptor pathways. In perimenopause, even though estrogen is overall decreasing, it doesn’t do so steadily. Sharp rises and falls in estrogen levels can mimic the pigmentary changes associated with pregnancy-related melasma, particularly in sun-exposed areas of the skin.[16]

At the same time, progesterone, another sex hormone that decreases pigment production in melanocytes, also declines during perimenopause. This means that your skin's ability to regulate its melanin production is impaired at the same time that melanin production may be increasing.[16]

While these are primary sources of changes in pigmentation, other factors associated with aging, such as cellular senescence, can also trigger hyperpigmentation in perimenopausal women. Add products clinically validated to reduce the appearance of hyperpigmentation to your routine, like OS-01 FACE and OS-01 EYE.[9]

#6: Slower Wound Healing

As you enter perimenopause, your skin just doesn’t bounce back like it used toβ€”and that includes healing from cuts, scrapes, or other wounds. This is because estrogen plays a crucial role in every step of the healing process, helping to regulate inflammation, support collagen production, and stimulate the growth of new skin cells and blood vessels. When estrogen levels drop, research indicates that these healing processes slow down.[6,17]

As a result, cuts or scrapes may take longer to heal, the skin may become weaker, and scarring can be more noticeable, underscoring the importance of hormone balance in maintaining healthy skin during midlife.[6,17]

OneSkin’s topical supplements, OS-01 FACE and OS-01 BODY, are scientifically validated to enhance epidermal thickness, thereby boosting your skin's resilience.[9] While we haven't directly studied the effects of OS-01 FACE on a healing wound, OS-01 FACE is scientifically proven to improve a key biomarker of cell proliferation associated with wound healing.[18,19]

Additionally, many customers have reported that our topical supplements help their skin bounce back from injuries during the healing process. For perimenopausal women experiencing fragile, slow-healing skin, targeted topical interventions like OS-01 FACE and OS-01 BODY may offer a valuable layer of biological support.[9]

Never apply skin care products to an open wound (only apply to closed wounds), and always consult a physician for proper wound care.

Does Perimenopause Change The Appearance of Your Face?

It may feel like the skin you’ve become familiar with throughout your life is changing almost overnight. And the skin treatments you’ve used for years may become ineffective.

The bone structure of the face changes during the menopausal transition, particularly around the eyes and jaw. Additionally, the muscles, fat, and connective tissue that attach to facial bones undergo an overhaul during perimenopause. Structural loss due to collagen and fat reduction, combined with perimenopausal skin conditions, can alter the appearance of your face.[8]

How Can Perimenopausal Skin Changes Be Slowed?

Perimenopause is a natural part of life. However, just because it's natural doesn’t mean you can’t slow the skin changes that occur. After all, your skin is a crucial part of your appearance and health, and often needs some extra TLC.

  • Use a Gentle Facial Cleanser: Harsh soaps and cleansers can strip your skin of beneficial oils. Instead, opt for gentle versions that have been tested on sensitive skin. We recommend our gentle enzyme cleanser, PREP, as it has been validated for use on sensitive and eczema-prone skin.
  • Moisturize Daily: Dry, unmoisturized skin ages faster and releases inflammatory markers that can exacerbate skin conditions like eczema. Moisturizing daily helps keep your skin hydrated, protecting it against some of the changes associated with menopause. Our topical supplements, OS-01 FACE, OS-01 EYE, and OS-01 BODY, have been clinically tested to improve skin barrier function and hydration.
  • Wear Sunscreen: Whether you’re 16 or 60, wearing sunscreen daily can help reduce sun damage, skin irritation, and skin cancer. In fact, UV radiation is responsible for up to 80-90% of the visible signs of skin aging. Don't settle for a simple chemical-based SPF, however. Choose a mineral-based option specifically designed to reverse signs of UV-induced aging, like OS-01 FACE SPF, OS-01 BODY SPF, and OS-01 LIP SPF. Adding a hat and sunglasses to your sun protection regimen provides an extra layer of defense against the UV rays.[20]

Your skin might feel like it’s changing overnight, but that doesn’t mean you’re stuck with the effects. With the right tools, such as science-backed skincare and some lifestyle adjustments, you can provide your skin with the care it truly needs. Midlife is just the beginning of a new chapterβ€”why not start it feeling great in your skin?

Key Takeaways

  • The sharp hormonal fluctuations of perimenopause, especially in estrogen, can significantly alter skin texture, hydration, and resilience.
  • Collagen loss starts in perimenopause, leading to sagging, fine lines, and structural changes in the face.
  • During perimenopause, declining estrogen disrupts skin hydration, sebum balance, pigment regulation, and repair processes, leading to dryness, adult acne, eczema, hyperpigmentation, and delayed wound healing.
  • Leveraging the power of the OS-01 peptide, OneSkin’s topical supplements target the cellular processes responsible for the visible and invisible signs of skin aging associated with perimenopause.

References

Last Updated June 23, 2025

Reviewed by

Alessandra Zonari

Alessandra Zonari

PhD, Chief Scientific Officer (CSO) and Co-Founder of OneSkin

Alessandra earned her Master’s degree in stem cell biology, and her PhD in skin regeneration and tissue engineering at the Federal University of Minas Gerais in Brazil in collaboration with the 3B’s Research Group in Portugal. Alessandra did a second post-doctoral at the University of Coimbra in Portugal. She is a co-inventor of three patents and has published 20 peer-reviewed papers in scientific journals.

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