Not everyone experiences perimenopause in the same way. While some may experience night sweats, others may struggle with the dreaded brain fog. However, there is one common factor that affects everyone: the decline of oestrogen levels.

Perimenopause is the transitional time that ends in menopause – the day the menstrual cycle has ceased for 12 consecutive months. During perimenopause, the ovaries gradually produce less oestrogen as they prepare to stop releasing eggs altogether. While progesterone levels can also fluctuate significantly, it appears that the decline in oestrogen is the most problematic hormonal change.

The decrease in oestrogen levels negatively impacts the skin’s ability to defend against oxidative stress, leading to a reduction in collagen and elastin production. Consequently, the skin may become thinner, sag, and develop wrinkles. Oestrogen also plays a crucial role in regulating melanin synthesis, so as its levels decline, there can be an increase in melanin production, resulting in the appearance of dark “age spots” in areas repeatedly exposed to UV radiation.

Thankfully there are a host of treatments that can help counteract the impact a lack of oestrogen can have on the skin. Read on to understand exactly how oestrogen affects the skin and some of my favourite ways to tackle the changes…

What actually is oestrogen?

Oestrogen is a group of hormones, including estrone, oestradiol, and estriol, produced primarily in the ovaries. It not only regulates the menstrual cycle and supports reproductive health but also plays a vital role in maintaining overall well-being. Oestrogen helps regulate bone density, supports cardiovascular health, affects mood, and contributes to the health and appearance of the skin.

Why is oestrogen so important?

Oestrogen wears many hats – it helps to regulate our menstrual cycles, triggers the development of secondary sex characteristics like breasts and pubic hair, helps to maintain things like our skin’s moisture, our mood and even our bone and heart health.

The changes in oestrogen levels during perimenopause and menopause can have noticeable effects on the skin…

Dryness and Wrinkles

Reduced Oestrogen levels leads to a decline in collagen and elastin production, resulting in dry, thinning skin and increased wrinkle formation. The skin may lose its youthful glow and appear dull.

The solution: There’s a lot that you can do at home to tackle this and the most important is to use skincare with ceramides in. Ceramides are fatty acids that form part of the skin’s barrier. They will help to nourish and restore the membranes in our skin that help keep moisture inside. Hyaluronic acid will also help you wage the war against dryness in the menopause. It’s your skin’s natural sponge and helps it hang on to more water. In clinic, injectable moisturisers and polynucleotides are both good options, as they work to significantly boost hydration levels from deep within the skin whilst simultaneously boosting collagen and elastin production.

Loss of Elasticity

Oestrogen deficiency affects the skin’s collagen and elastin levels, leading to decreased elasticity and sagging. The skin may appear lax and develop fine lines and deep wrinkles.

The solution:  To combat the loss of firmness I recommend firstly using a good retinoid in your regime to help stimulate new collagen and speed up skin cell turnover. Treatments like Profound RF and Sofwave work very well to tighten the skin, improving laxity and firmness, and redefining the facial contours.

I also highly recommend exploring hormone optimisation as balancing hormone levels will in turn, improve skin elasticity and firmness. But I do recognise that not everyone wants to take HRT and there are alternative options if this is the case.


Researchers have found links between lower oestrogen levels and inflammation, making inflammaging aka redness, enlarged pores, volume loss, thinner skin, darker under eye circles, and acne more of an issue during perimenopause and beyond.

The solution: Red and infrared LED light can help quell inflammation and calm the skin. The Byonik Laser is also a good option since it rejuvenates, repairs, and protects your skin from inside the cells and helps to address inflammation at its core.

Acne and Breakouts

Fluctuating oestrogen levels can disrupt the balance of hormones in the body, leading to increased sebum production and clogged pores. This can result in acne breakouts and blemishes, even in women who previously had clear skin.

The solution:  Speak to an expert practitioner about topical treatments including prescription skincare that contains zit-zapping ingredients such as salicylic acid or benzoyl peroxide. Procedures such as skin peels and the HydraFacial are an excellent option to clear dead skin cells, eliminate dirt and debris from the pores and restore a healthy complexion.