Menopause brings a laundry list of symptoms and changes to women’s lives, from hot flashes and sleep disruptions, to increased anxiety and heart palpitations. But it’s less commonly known that midlife changes prompt a multitude of skin changes, too.
A new review presented last month at the 2025 American Academy of Dermatology annual meeting in Orlando, FL, looked at more than 30 studies that had previously explored the connection between menopause and skin conditions like rosacea, acne, and eczema. And while the review’s lead author Shoshana Marmon, MD, PhD, FAAD, assistant professor of dermatology at New York Medical College in Valhalla, NY, concluded that, to date, the findings have been mixed — for example, although three papers suggested that psoriasis worsens in menopause, a fourth paper found no impact — she issued a call both for more research and more well-rounded training of dermatologists. “Dermatologists are often the first point of medical contact for many menopausal women due to the visibility of their cutaneous symptoms (skin and hair changes),” Dr. Marmon wrote, “yet the subject of menopause is rarely addressed in training and practice.”
Ahead, we spoke with dermatologists about why, despite the limited research, there are compelling indications that menopausal skin experiences drastic changes — including increased sensitivity, more frequent rosacea flare-ups, and unexpected allergic reactions —— what might be driving these changes, and what you can do about it.
The Estrogen and Skin Connection
Dr. Beth Goldman, a board-certified dermatologist and the co-founder of ModernRitual.com, says that while estrogen is most commonly known for aiding in healthy reproduction and ovulation, it also plays a vital role in skin reproduction and elasticity.
During our teens and twenties, estrogen levels are increasing, with a natural peak occurring around age 30. “From there, we experience a small declination in estrogen production every year for the rest of our lives with a particularly fast-declining period occurring when ovaries slow down estrogen production — which typically occurs between 40 and 55 in women,” Dr. Goldman explains.
But declining estrogen levels don’t just change egg production; they also cause a slowdown in skin cell production. Dr. Goldman says that this is part of the reason why “our skin becomes drier, rougher, less elastic, less rich,” in midlife.
Other Factors Disrupting Midlife Skin Health
This change in skin quality is also impacted by a decline in ceramide lipid cells, which are, essentially, fats in the skin cells that make up about half of the skin barrier. In other words, ceramides help to keep your skin tone plump and even. Unfortunately, “in midlife, not only are we producing fewer and fewer lipids to begin with,” Dr. Goldman explains, “but the actual lipid structures are not as ideally round as they were at age 30.” These changes can leave midlife skin more vulnerable to, among other changes, skin redness, including rosacea, a condition marked by chronic flushing.
Then there are lifestyle factors that negatively impact skin health, including alcohol, cumulative exposure to damaging UV rays, and stress. “Stress is particularly susceptible to make you break out by releasing more cortisol into your system, which makes blood vessels widen and create redness,” says board-certified dermatologist Dr. David Johnson, co-founder of the red light therapy company RedliteX.
How You Can Calm and Strengthen Your Skin
Calming skin down starts with addressing the lifestyle factors noted above, before taking a closer look at the skin care products you’re using. “Apply gentle, fragrance-free products that moisturize your skin’s barrier without irritating it,” Dr. Johnson recommends, like the Grownup Moisturizer from Caire Beauty. In addition, prioritize products that have ingredients formulated to calm and protect, like the following:
- Hyaluronic acid: Hydrates deeply to give your skin hydration and plumpness, reducing dryness and fine lines.
- Ceramides: Repair and restore the skin barrier by holding in moisture and protecting against environmental stress. “They keep your skin firm and less prone to irritation,” Dr. Johnson explains.
- Niacinamide: According to Dr. Johnson, this ingredient reduces redness, inflammation, and blotchiness and helps tighten pores and smooth out overall skin texture. It also reinforces the natural skin barrier and makes it less reactive with repeated use.
- Antioxidants: Dr. Goldman says to seek products that include antioxidants like vitamins C, E, ferulic acid, and green tea.
- Pro-collagen peptides: “These are great as they are compensating for the loss in collagen production directly caused by estrogen decline,” Dr. Goldman shares.
Treatments that Help Manage Chronic Redness & Rosacea
There are many methods to help manage chronic redness and rosacea, and that are effective in menopausal women, including laser treatments and prescribed creams. So if you’re struggling with these or any other skin conditions, your best course of action is to talk to your dermatologist.
“We usually prescribe a prescription medication or two firstly, and they can be effective, but results are variable from person to person and, in some people’s cases, are more temporary in nature than we’d like,” Dr. Goldman explains. “It’s only then that we consider a light or laser therapy. If you have visible blood vessels or thickening skin that isn’t resolved from a combination of better skincare, prescription medication support and lifestyle changes, you might be a candidate.”
The bottom line is that menopause impacts your skin, but you do not have to just deal with it. “By understanding what is happening and doing what you can do, you can keep your skin calm and healthy,” Dr. Johnson notes.