¹Leitch C, Doherty V, Gebbie A. "Women's perceptions of the effects of menopause and HRT on skin." Menopause International. 2011;17(1):11-13. PMID 21427418
Key takeaways
- Over 64% of perimenopausal and menopausal women experience dry skin
- Women lose roughly 30% of their skin’s collagen in the first five years after menopause begins
- Falling oestrogen reduces collagen, ceramides, hyaluronic acid, and natural oil production
- Practical skincare changes like daily SPF, gentle cleansing, and moisturising damp skin can help
- Studies show HRT can improve skin thickness, hydration, elasticity, and collagen quality
- Voy’s E3 Skin Plumping Moisturiser is formulated to support skin affected by hormonal collagen loss and dehydration
Why does perimenopause cause dry skin?
The short answer: declining oestrogen levels disrupt your skin's ability to stay hydrated.
Oestrogen plays a crucial role in maintaining your skin's structure and function. It supports the production of four key substances that keep your skin healthy and hydrated:
- Collagen — the structural protein that gives skin its firmness and elasticity
- Ceramides — lipids (fats) that form a protective barrier on the skin's surface, locking in moisture
- Hyaluronic acid — a molecule that holds up to 1,000 times its weight in water, keeping skin plump and hydrated
- Sebum — the natural oil your skin produces to protect and lubricate itself
When oestrogen levels start to decline during perimenopause, (which can begin years before your periods stop) your skin's ability to produce these substances decreases. The result: thinner skin, a weakened moisture barrier, and significantly reduced hydration.
It's not just oestrogen. Testosterone levels also decline during perimenopause, and testosterone contributes to sebaceous gland activity, these are the glands responsible for producing sebum. Less testosterone means less natural oil production, compounding the dryness.
There's also a pH shift. Around age 50, your skin's pH begins to change, making it more sensitive and reactive. This can mean products that worked for years suddenly cause irritation or fail to deliver the same results.
The link between oestrogen and skin hydration
To understand why perimenopause affects your skin so dramatically, it helps to understand what oestrogen has been doing behind the scenes for the past few decades.
Oestrogen stimulates fibroblasts, these are the cells responsible for producing collagen and elastin in the deeper layers of your skin (the dermis). It also enhances the production of glycosaminoglycans like hyaluronic acid, which bind water in the skin keeping it hydrated, and it supports the epidermal barrier (the outermost layer of your skin) by promoting ceramide production.
When oestrogen declines, all of these processes slow down. Your skin produces less collagen, so it becomes thinner and less elastic. It produces less hyaluronic acid, so it holds less water. The ceramide-rich barrier weakens, so moisture escapes more easily through a process called transepidermal water loss.
The impact is measurable. Studies show that oestrogen deficiency decreases the skin's ability to defend against oxidative stress, accelerates thinning, reduces elasticity, and increases dryness and wrinkling.
This isn't a cosmetic issue, though it can certainly affect how you feel about your appearance. It's a structural change in your skin's biology, driven by hormone changes you didn't choose.
How much collagen do you lose during perimenopause?
One of the reasons skin can suddenly feel different during perimenopause is collagen loss. In fact, women lose around 30% of their skin’s collagen in the first five years after menopause begins.
That’s a big shift in a short amount of time and it helps explain why skin can become drier, thinner, less firm, or more sensitive seemingly overnight. For many women, it can also mean more noticeable sagging around the jawline, deeper lines, or skin that doesn’t feel as plump and supported as it once did.
Collagen is what keeps skin feeling smooth, bouncy, and resilient. As oestrogen levels decline, collagen production slows down, and the collagen that remains becomes less effective at supporting the skin. The most noticeable changes tend to happen during perimenopause and the early years of menopause, before collagen loss continues more gradually over time. After that initial five-year period, collagen loss continues more gradually at around 1–2% per year.
Common symptoms of perimenopause dry skin
Perimenopause dry skin can look and feel different for everyone, but common symptoms include:
- Tightness after washing — especially after washing your face or showering
- Flaking or peeling — patches of dry skin that shed visibly
- Itchy skin - persistent itchiness is reported by around 78% of women attending menopause clinics
- Increased sensitivity or redness
- Rough or dull texture
- More visible fine lines
- Skin that heals more slowly
These changes often affect the face, neck, hands, arms, and legs (areas with thinner skin).
How to manage dry skin during perimenopause: Practical steps
While you can't reverse hormonal changes with skincare alone, you can significantly improve how your skin feels and functions with some targeted adjustments. Here's what the evidence supports:
1. Moisturise while your skin is still damp
Apply moisturiser within a few minutes of washing to help lock in hydration. Look for ingredients like:
- Hyaluronic acid
- Ceramides
- Glycerin
- Niacinamide
2. Avoid hot baths and showers
Hot water strips your skin of its natural oils, worsening dryness. Switch to lukewarm water and keep showers short (under 10 minutes where possible).
3. Use gentle, fragrance-free cleansers
Harsh soaps and foaming cleansers can strip away natural oils and worsen dryness. Choose fragrance-free cream or oil-based cleansers designed for sensitive skin. Avoid products with sulfates (SLS, SLES) or high alcohol content, which are particularly drying.
4. Apply sunscreen daily
UV exposure accelerates collagen breakdown and skin thinning. Daily SPF 30+ helps protect skin health year-round.
5. Be cautious with retinol
Retinol is often recommended for anti-ageing, but it can cause significant dryness and irritation in menopausal skin. If you use it, start slowly and pair it with a rich moisturiser.
Can HRT help with perimenopause dry skin?
“For many women, yes. HRT addresses the hormonal changes driving perimenopausal skin symptoms, and research shows it can improve: declining oestrogen. Multiple studies show that HRT improves skin hydration, thickness, elasticity, and overall quality.”
Here's what the research shows:
- 30% increase in dermal thickness after 12 months of oral oestrogen therapy
- Improved epidermal hydration — skin retains more water
- Increased skin elasticity — skin becomes more supple and resilient
- Reduced wrinkling — particularly fine lines
- Enhanced collagen content and quality — HRT increases both the amount and the structural integrity of collagen
A 2025 narrative review in the Journal of Cosmetic Dermatology concluded that oestrogen replacement can diminish the effects of menopause on the skin by enhancing collagen content and quality, increasing vascularisation (blood flow to the skin), and improving epidermal hydration, elasticity, and thickness.
Women on HRT report that their skin feels softer, less dry, and more like it used to before perimenopause began. One study found that postmenopausal women on hormone therapy had skin that held onto water better than those not on treatment.
When to seek help for perimenopause skin changes
You don’t need to wait until symptoms become severe to seek support.
Consider speaking to a menopause specialist if:
- Your skin remains persistently dry despite good skincare
- Itching or sensitivity is affecting your sleep or confidence
- You’re also experiencing symptoms like hot flushes, irregular periods, low mood, or brain fog
- You suspect hormonal changes may be affecting your skin
Dry skin is often one part of a wider hormonal picture, and treatment may involve more than skincare alone.
Voy's menopause specialists offer 45-minute consultations to assess your full symptom picture, not just your skin, but everything you're experiencing. Dry skin is rarely the only symptom, and comprehensive care addresses the whole picture: HRT, testosterone therapy if appropriate, menopause face creams, nutrition support, and behavioural coaching to help you feel like yourself again.
93% of Voy members reported an improvement in their overall quality of life after starting treatment (Voy patient internal data, February 2026, sample size = 301). That's not a vague promise, it's published outcome data, presented at The Menopause Society 2025.
Not sure what’s normal anymore?
When you're experiencing new symptoms, it can be hard to know what’s part of menopause and what’s not. You deserve care that looks at the full picture.
The bottom line
Dry skin during perimenopause is common, but it’s not something you simply have to put up with. Hormonal changes reduce collagen, hydration, and natural oil production, which can leave skin feeling dry, thin, and sensitive. Women lose around 30% of their collagen in the first five years after menopause begins, making these changes especially noticeable.
The good news is that effective support exists. Gentle skincare, daily SPF, and moisturising consistently can help protect the skin barrier, while HRT may improve hydration, elasticity, and collagen quality by addressing the underlying hormonal changes.
