Menopause and your skin: what changes and what helps

What oestrogen actually does for your skin

Before menopause, oestrogen is doing quiet but essential work in your skin. It's a hormone, not a topical ingredient, but its effect on the deeper layers is significant. Oestrogen supports fibroblasts (the cells that make collagen and elastin) and increases the presence of hyaluronic acid in the dermis. That matters because hyaluronic acid is a humectant, meaning it draws and holds water. When oestrogen is abundant, your skin holds moisture more effectively and the barrier function stays resilient.

As oestrogen levels drop during perimenopause and menopause (typically between ages 45 and 55), fibroblast activity decreases substantially. The loss is not gentle. Clinical research shows that women lose nearly a third of skin collagen in the first five years after menopause, and then continue losing roughly 2% per year over the following 15 years. That's a dramatic shift from the stable collagen you had at 40.

The three main changes you'll see

Understanding these shifts helps you tell the difference between normal ageing and menopause-specific changes. Most clients I see in clinic report a combination of the three below.

Thinner, less elastic skin

Collagen loss means skin becomes noticeably thinner. This is not just a wrinkle issue. You may notice your skin feels less bouncy, bruises more easily, and takes longer to spring back if you gently press it. Fine lines deepen faster. Texture that used to feel smooth starts to show irregularity. Loose skin on the neck, jawline, and under the chin becomes more apparent because there's less structural support underneath.

Dryness and barrier fragility

Oestrogen loss means your skin's water-holding capacity drops. You may notice your usual moisturiser no longer cuts it. Even oily skin can become dehydrated during menopause, which is confusing but common. Some clients develop sensitivity they didn't have before: products sting, wind or air conditioning irritates more easily, and the skin feels tight or uncomfortable. This is because the barrier function, supported by oestrogen-dependent mechanisms, is less robust.

Slower healing and more inflammation

Wound healing relies on a healthy inflammatory response and adequate collagen remodelling. With less oestrogen, both slow down. In clinic, this means that if you have a minor injury, a spot, or an aesthetic treatment, it may take longer to settle and look refined. Some clients find that acne they thought had resolved resurfaces, or that small procedures leave marks that take weeks longer to fade. Redness after micro-needling or laser may linger. This is not a reason to avoid treatment, but it is a reason to plan longer review periods and be realistic about healing timescales.

Skincare and your GP first

Before you book any aesthetic treatment, this is the conversation that matters. I always advise clients in perimenopause or menopause to have a conversation with their GP about HRT, progesterone, or other systemic support. That's not something an aesthetics nurse can address, but it's foundational. If systemic support suits you, skin changes often improve. If you choose not to pursue that route, or if it's not appropriate for you, skincare becomes even more essential.

For menopausal skin, the skincare priorities shift. Heavy occlusives (oils, rich balms) matter more than before. A hyaluronic acid serum makes sense, but only if you follow it with a moisturiser that seals it in, because hyaluronic acid alone can leave skin feeling tighter if the air is dry. Ceramides and peptides support barrier function. Niacinamide can help with sensitivity. Sunscreen is still non-negotiable. And it may be worth revisiting products you've used for years if your skin no longer tolerates them.

A good skincare routine won't reverse collagen loss, but it will slow visible damage and make your skin feel more comfortable. In my clinic, I find that clients who sort out their skincare first, and then add in-clinic treatment, see better results than those who try to skip the skincare step.

Skin boosters for menopausal skin: Profhilo and polynucleotides

If you're looking for an aesthetic treatment, skin boosters are often the most realistic choice for menopausal skin. They address the core problem (hydration and collagen support) rather than trying to work against time itself. The two most common options are Profhilo and polynucleotides, and they work through different mechanisms.

Profhilo: immediate hydration

Profhilo is a distinctive skin remodelling treatment. Unlike traditional fillers, which sit in one place and fill wrinkles, Profhilo contains one of the highest concentrations of hyaluronic acid available in aesthetic medicine and works by spreading through the dermis to stimulate collagen and elastin production. It enhances skin tone, texture, and elasticity rather than just filling lines.

The treatment usually involves two sessions, four weeks apart. Visible hydration often appears within days, and results continue to improve over the following weeks. For menopausal skin, this addresses the water-holding deficit directly. Clients often report that their skin feels plumper, more resilient, and less tight. The effect typically lasts around six to nine months.

If you want to explore Profhilo in more detail, I've written a detailed guide that covers the treatment process, realistic expectations, and aftercare. You can read more at our Profhilo treatment guide.

Polynucleotides: regenerative depth

Polynucleotides (PDRN) are a different animal. They consist of DNA fragments, typically derived from salmon. Rather than providing hydration, they activate cells called fibroblast precursors, triggering a cascade of cellular repair and regeneration. The effect is anti-inflammatory and works at the level of collagen and elastin rebuilding.

A typical polynucleotide course involves three to four sessions, spaced three to four weeks apart. Results build more gradually than Profhilo, appearing over six to twelve weeks. The effect is often described as longer-lasting, with results reported to last eight to twelve months. For menopausal skin, this is valuable because it's addressing the collagen deficit at source.

Using them together

Because they work through different mechanisms, many practitioners now combine Profhilo and polynucleotides. A common approach is to start with Profhilo (two sessions, four weeks apart) to establish hydration and baseline improvement, then follow with polynucleotides (three sessions, two to four weeks apart) to add regenerative depth. This sequencing allows the skin to respond to each stimulus in turn and often yields better results than either alone.

What to expect, realistically

Skin boosters won't erase lines or lift sagging skin. They improve the quality and hydration of your skin and support collagen production. You'll look fresher and feel more comfortable in your skin. Fine lines often soften because skin is better hydrated and has more structural support. Texture improves. Dryness settles. But if you're hoping for a dramatic change in the jawline or a lift in the cheek, you'd need a different approach, and that's worth discussing in a consultation.

Also bear in mind that because menopausal skin heals more slowly, you may see results build a bit more gradually than you would have at 35. This is normal. I always advise a two-week review after the first treatment and then a full assessment after the course is complete, to give skin time to respond properly.

A short safety note

Any injectable treatment carries a small risk of bruising, swelling, or infection if aftercare isn't followed. With menopausal skin, which is more fragile, I'm particularly cautious about technique and aftercare. Make sure you book with a practitioner who has proper credentials and experience. If you're on blood thinners or have a history of keloid scarring, mention it beforehand. Avoid NSAIDs like ibuprofen for a few days after treatment if possible, as they can increase bruising. And don't exercise or apply heat to the treated area for 24 to 48 hours.

The bottom line

Menopause is a real inflection point for skin. The changes are not vanity; they're biology. Understanding what's happening (collagen loss, hydration shift, slower healing) helps you make decisions that suit your skin, not just chase what worked at 40. Start with the conversation with your GP and a proper skincare routine. Then, if in-clinic treatment appeals, skin boosters like Profhilo and polynucleotides offer a genuine way to support your skin during this transition. They won't turn back time, but they can help you feel comfortable and confident in your skin right now.

Common questions