Menopause and skin changes: what's happening and what helps

Medically reviewed by Dr Matt Cullen MBBS, FRANZCP

Skin is one of the largest organs affected by oestrogen, and one of the more visible places where menopausal changes show up. Drier, more sensitive, slower to recover from a single late night. New breakouts in women who haven't had acne since their twenties. Itchy skin without an obvious cause. None of this is in your head. The biology has shifted, and so has what your skin needs.

Key facts at a glance

• Skin loses around 30 percent of its collagen in the first five years after menopause.
• Oestrogen supports skin moisture, elasticity and barrier function. As it declines, all three change.
• Sun protection is the single most evidence-supported intervention for skin in midlife.
• Retinoids, ceramides and adequate moisturisation have the strongest evidence among topical approaches.
• Persistent itchy skin, new pigmented lesions or non-healing patches warrant a GP review.

What menopause does to skin

Collagen and structure

Oestrogen plays a key role in collagen production. Collagen is what gives skin its firmness and resilience. In the years immediately after menopause, collagen loss accelerates. ^[1,2]

The result, over time, is thinner skin, more visible fine lines and looser texture. This is true even for women who have looked after their skin their whole lives.

Hydration and barrier function

Menopausal skin holds less water and the protective barrier (which prevents water loss and keeps irritants out) becomes less efficient.

^[1][3]

The same products and routines that worked at 35 may no longer feel adequate. Dryness, tightness and a duller surface are common.

Sensitivity and redness

Many women find their skin becomes more reactive in menopause. Products they used for years suddenly sting. Rosacea-like redness can appear or worsen. ^[4]

The threshold for irritation is lower because the barrier is more fragile.

Adult acne and hormonal breakouts

While oestrogen falls, the relative androgen contribution can become more dominant. For some women this triggers acne, particularly along the jawline and chin. It can happen in women who never had acne as teenagers.

Itch

Itchy skin without a rash, sometimes called menopausal pruritus, is more common than discussed.

^[3][5]

It can be linked to dryness and reduced barrier function, but can also exist independently. Vaginal pruritus is also a recognized component of genitourinary syndrome of menopause. ^[4]

What actually helps

Daily sun protection

The single most evidence-supported step. Daily broad-spectrum SPF 50+ on face, neck and hands does more to protect long-term skin appearance than any other intervention. UV exposure compounds the changes menopause brings to collagen and pigmentation. This should be a daily habit.

Menopausal skin changes are driven by biology, not neglect. Small, consistent choices matter more than expensive product routines.

Gentle cleansing

Switch to a gentle, non-foaming or low-foaming cleanser. Avoid hot water and harsh scrubs. Twice a day is plenty, sometimes once is enough if your skin is feeling reactive.

Moisturisation with the right ingredients

Look for moisturisers with ceramides, hyaluronic acid, glycerine, niacinamide or shea butter. These support the skin barrier and improve hydration. ^[6]

Heavier formulations are often appropriate at night. Apply to slightly damp skin to lock in moisture.

Retinoids

Retinoids (retinol over the counter, prescription versions through a GP or dermatologist) have the strongest evidence among topical anti-ageing ingredients. ^[7,8]

They stimulate collagen and accelerate cell turnover. Start low and slow, two or three nights a week, to allow skin to adjust. Always pair with daily SPF.

Vitamin C

Topical vitamin C, particularly L-ascorbic acid in stable formulations, may support collagen production and provides antioxidant protection, though evidence is less robust than for retinoids.

^[7][9]

Often used in the morning under SPF.

Protein and overall nutrition

Skin is built from protein. Adequate protein intake (around 1.0 to 1.2 g per kg of body weight per day for general health in midlife women), enough water, omega-3 fats and a varied diet all support skin from the inside. Severe restrictive eating tends to show up on the face.

Sleep, stress and alcohol

Poor sleep, chronic stress and alcohol all affect skin within days. Improving any of these often produces visible changes.

What's less proven

The skincare industry is large and the evidence varies. Some patterns to be wary of:

• Products promising dramatic results in days or weeks
• Elaborate, 10-step routines that mostly create irritation
• Collagen drinks and supplements: high-quality independent studies show no benefit for skin aging. Positive results come primarily from industry-funded, low-quality trials ^[7]
• Expensive products with the same active ingredients as cheaper ones
• Devices and treatments without proper evidence behind them

A simple routine, applied consistently, beats an elaborate routine applied haphazardly. The actives that work are well-established.

When to see a GP or dermatologist

Worth booking an appointment if:

• Itchy skin is persistent, severe or interfering with sleep
• A new pigmented lesion has appeared, or an existing one has changed
• A patch of skin isn't healing, is bleeding intermittently, or doesn't look right
• Acne is severe, scarring, or significantly affecting how you feel
• Rosacea-like redness is worsening despite gentle care
• Hair loss is accompanying skin changes (some autoimmune conditions affect both)

Australia has the highest rates of skin cancer in the world. Annual skin checks are a sensible habit from midlife onward.

Note on retinoid use

Retinoids are contraindicated in pregnancy. Women of reproductive age using retinoids should use reliable contraception. Discuss with a GP or dermatologist before starting.

A reasonable perspective

Menopausal skin isn't broken skin. It's skin that's working with a different hormonal environment. With sensible sun protection, a few well-chosen active ingredients, and care for the basics from the inside, most women find their skin can look healthy and feel comfortable through their 50s, 60s and beyond. The goal isn't to look 25 again. It's to have skin that's healthy, comfortable, and well-protected for the long term

If you'd like to talk to an Australian clinician about menopausal symptoms, including skin changes, the Chemist2U Menopause Program offers a private consultation with a partner clinician.

References

1. Menopause, Skin and Common Dermatoses. Part 2: Skin Disorders. Clinical and Experimental Dermatology. 2022. Kamp E, Ashraf M, Musbahi E, DeGiovanni C.
2. Menopause Induces Changes to the Stratum Corneum Ceramide Profile, Which Are Prevented by Hormone Replacement Therapy. Scientific Reports. 2022. Kendall AC, Pilkington SM, Wray JR, et al.
3. Physiological and functional changes in the stratum corneum restored by oestrogen in an ovariectomized mice model of climacterium. Experimental Dermatology. 2017. Chen Y, Yokozeki H, Katagiri K.
4. Skin Ageing and Topical Rejuvenation Strategies. The British Journal of Dermatology. 2023. Griffiths TW, Watson REB, Langton AK.
5. Topical and Systemic Skin Aging Interventions: Evidence, Pitfalls and Perspectives. Biochemical Pharmacology. 2026. Gürtler AL, Sirois JP, Heckenbach IJ, et al.
6. Management of Menopausal Symptoms. The Journal of the American Medical Association. 2023. Crandall CJ, Mehta JM, Manson JE.
7. Skin, Hair and Beyond: The Impact of Menopause. Climacteric : The Journal of the International Menopause Society. 2022. Zouboulis CC, Blume-Peytavi U, Kosmadaki M, et al.
8. Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women. Clinical Endocrinology. 2025. Elhassan YS, Hawley JM, Cussen L, et al.
9. A Study Comparing the Clinical and Hormonal Profile of Late Onset and Persistent Acne in Adult Females. International Journal of Dermatology. 2020. Sardana K, Bansal P, Sharma LK, Garga UC, Vats G.Observational.
10. Efficacy and Safety of Hydrolyzed Collagen Supplementation on Skin Health Outcomes: A Systematic Literature Review of Randomized Controlled Trials. European Journal of Clinical Nutrition. 2026. Bassila C, Bassila JC, Slim M.
11. Effects of Collagen Supplements on Skin Aging: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. The American Journal of Medicine. 2025. Myung SK, Park Y.

• Jean Hailes for Women's Health: Skin and menopause
• Australasian Menopause Society: Skin changes at menopause
• Healthdirect Australia: Skin care after 50
• Australasian College of Dermatologists: Hormonal skin changes
• Cancer Council Australia: Sun protection and skin cancer prevention