Menopause skincare: dryness, collagen and what helps

Perimenopause and menopause are the transition years when the ovaries slow down, and levels of oestrogen, progesterone and testosterone fall. Like puberty or pregnancy, it’s a natural process. Yet it’s surrounded by misinformation, pseudoscience and supplements promising results without the evidence to back them.

Oestrogen production peaks around age 30. Many women first notice the signs of perimenopause, such as changes in cycle length and flow, in their 40s, around 10 years before menopause itself (12 months without a period). With longer life expectancy, women can now spend up to a third of their lives after menopause, living with the effects of lower oestrogen, including on their skin.

Why menopause changes skin

Oestrogens (a group of hormones that includes oestradiol, oestrone and oestriol) act as signals throughout the body, binding to receptors in many organs. Skin is one of them. Facial skin has more oestrogen receptors than most other areas, which is why changes there are often the most noticeable.

In skin, oestrogen:

• increases blood flow, delivering nutrients to skin cells
• supports skin cell renewal
• boosts hyaluronic acid, collagen and elastin, keeping skin thicker and better hydrated
• slows the enzymes that break collagen down
• helps wounds heal and strengthens the skin barrier
• acts as an antioxidant, helping protect against sun damage

Oestrogen also supports hair growth, so female pattern hair loss can begin in perimenopause too.

These aren’t just cosmetic concerns. Changes in visible skin can be hard to come to terms with, and can affect self-esteem and quality of life.

How skin changes

Dry, dull skin

Less hyaluronic acid and oil means skin holds less moisture. The barrier weakens, sensitivity increases, and slower circulation adds to dullness.

Fragile skin

Nearly every cell involved in skin repair responds to oestrogen. As levels fall, healing slows, so recovery after procedures such as microneedling or laser can take longer.

Laxity, sagging and wrinkles

Around 30% of the skin’s collagen is lost in the first five years after menopause, followed by an average decline of about 2% a year for the next 15 years. Skin becomes thinner and weaker, elastic fibres change, and wrinkles form more easily.

Sun exposure speeds all of this up. UV and visible light break down collagen and elastin, deepening wrinkles and adding pigmentation and sun-related skin lesions on top of hormonal changes.

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What helps

1. Talk to your doctor about menopausal hormone therapy

There’s good evidence that menopausal hormone therapy (MHT, sometimes called HRT) can improve menopause symptoms. Like any medicine, it has benefits and risks that depend on your own health history. There’s also a lot of misinformation about it, so it’s worth a proper conversation with your doctor to decide whether it’s right for you.

2. Be wary of supplements

There’s no shortage of people ready to sell supplements to women in menopause. Buyer beware: black cohosh and turmeric, two common ingredients, have been linked to liver injury, and black cohosh has no good evidence for easing menopause symptoms anyway. For personalised advice, a women’s health doctor and a dietitian are the best people to see.

Collagen peptide supplements do have some evidence for improving skin hydration and elasticity, but only when taken consistently and alongside good skincare and sun protection. On their own, they won’t work miracles.

3. Keep your routine simple

Oestrogen-deprived skin does best with plain, fragrance-free products: a gentle cleanser, a moisturiser that supports the skin barrier, and sunscreen applied properly every day. This isn’t the time to experiment with a complicated routine, which only raises the chance of a reaction.

And ignore the myth that drinking extra water fixes dry skin. Beyond what your thirst tells you, it does nothing for your skin.

4. Consider evidence-based actives

Prescription-strength retinoids, used with a high-SPF, broad-spectrum sunscreen, have the strongest evidence of any topical treatment for skin ageing. They can increase collagen and elastin, support repair of sun damage and reduce wrinkle formation. They can also cause dryness and irritation, particularly at first and particularly in drier skin, and they aren’t suitable for everyone. Whether they’re right for you is a decision to make with a doctor.

Once your skin is used to a routine, glycolic acid and vitamin C (L-ascorbic acid) can play a supporting role.

What about topical oestrogen face creams?

Here, the enthusiasm outruns the evidence. A 2026 review found topical oestrogen may stimulate collagen and increase skin thickness, but consistent, visible improvements haven’t been shown. In one study, two weeks of use increased collagen in sun-protected skin on the hip, but not in sun-damaged facial skin. Another found no significant improvement in facial wrinkles or elasticity after 24 weeks. No trials have compared these creams with retinoids, and many of the studies quoted on social media are unpublished.

The review also found oestrogen from these creams can be absorbed into the bloodstream and have hormonal effects, similar to hormone therapy. That matters for women who aren’t also using progesterone to protect the lining of the uterus. Long-term safety hasn’t been established, so anyone choosing these creams is accepting those uncertainties.

The bigger picture

The beauty industry ignored women over 40 for a long time. That’s changing, with around a billion women worldwide now estimated to be in or past menopause. Menopausal skin isn’t only about appearance. It’s about skin health and function, and you deserve clear, evidence-based information to make your own choices.

References

1. Merzel Šabović EK, Kocjan T, Zalaudek I. Treatment of menopausal skin – a narrative review of existing treatments, controversies, and future perspectives. Post Reprod Health. 2024;30(2):85-94.
2. El Mohtadi M, Whitehead K, Dempsey-Hibbert N, et al. Estrogen deficiency – a central paradigm in age-related impaired healing? EXCLI J. 2021;20:99-116.
3. Zomer HD, Cooke PS. Targeting estrogen signaling and biosynthesis for aged skin repair. Front Physiol. 2023;14:1281071.
4. Rzepecki AK, Murase JE, Juran R, et al. Estrogen-deficient skin: the role of topical therapy. Int J Womens Dermatol. 2019;5(2):85-90.
5. Silva LA, Ferraz Carbonel AA, de Moraes ARB, et al. Collagen concentration on the facial skin of postmenopausal women after topical treatment with estradiol and genistein. Gynecol Endocrinol. 2017;33(11):845-848.
6. Moraes AB, Haidar MA, Soares Júnior JM, et al. The effects of topical isoflavones on postmenopausal skin. Eur J Obstet Gynecol Reprod Biol. 2009;146(2):188-92.
7. Patriarca MT, Barbosa de Moraes AR, Nader HB, et al. Hyaluronic acid concentration in postmenopausal facial skin after topical estradiol and genistein treatment. Menopause. 2013;20(3):336-41.
8. Rosenthal MS. The Wiley Protocol: an analysis of ethical issues. Menopause. 2008;15(5):1014-22.

This article is general information only. It isn’t a substitute for personal medical advice, so speak with a health professional about your own skin.