Perimenopausal and menopausal skin: How to tackle the most common problems

Irish Times

5 days ago

The dawn of my 40s has brought plenty of welcome changes, but along with the good, there have been a few unpleasant surprises, many of them showing up on my skin. My once occasional hormonal breakouts are, annoyingly, more frequent. Stubborn spots, often deep, painful ones, congregate around my chin and jawline, immune to my usual quick fixes, and my skin feels more prone to dullness than ever before.
What is going on? I asked Eavanna Breen,
aesthetician
and clinical director of Eavanna Breen Skin and Laser Clinic to break down exactly what's happening to our skin during perimenopause and menopause – from dryness and dullness to breakouts and pigmentation changes – and what we can do about it.
Why does it feel like our skin changes overnight during perimenopause and menopause?
Because in many ways, it does. Hormonal shifts, particularly the drop in oestrogen, impact multiple systems at once, and skin is often the first place women see those changes. It's not your imagination – what used to work suddenly doesn't, and skin can go from stable to reactive, dull, dry or breakout-prone seemingly overnight.
What is happening in the skin?
Oestrogen plays a huge role in skin health. It regulates collagen production, moisture retention, wound healing and skin thickness. As oestrogen declines, so does the skin's ability to stay firm, hydrated and resilient. Cell turnover slows down, skin barrier function weakens and inflammation becomes more likely. Everything becomes just a bit more delicate.
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What about collagen loss – does it speed up?
Yes. The numbers are stark. Women lose about 30 per cent of their collagen in the first five years after menopause. After that, collagen continues to decline at roughly 2 per cent per year. This loss is one of the main reasons for accelerated signs of ageing, such as sagging, fine lines and thinner, less elastic skin.
Eavanna Breen, aesthetician and clinical director of Eavanna Breen Skin and Laser Clinic
What does that look like in the mirror?
In clinic, the two most common concerns I hear are: 'My face looks like it's dropping' – a result of volume loss and skin laxity, and 'My skin looks dull and dry, no matter what I use' – due to impaired barrier function and reduced oil production.
You mention 'impaired barrier function' – does that mean our skin becomes more sensitive?
Absolutely. As oestrogen drops, so does the production of lipids and ceramides, otherwise known as the 'glue' that holds your barrier together. This makes skin more reactive, more prone to redness and less able to bounce back from irritation or environmental stress.
What about pigmentary changes – is it common to see patchy, uneven skin?
Yes. Melanin production becomes irregular, often leading to age spots, melasma and uneven tone. UV damage from childhood years starts to become more visible as the skin's repair mechanisms slow down.
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Let's talk about hormonal acne. Why does it happen during perimenopause and menopause – and why does it feel so intense?
The drop in oestrogen throws off the balance with androgens like testosterone, which can lead to increased oil production and deeper, cystic breakouts, especially around the jawline and chin. At this stage, the breakouts feel more aggressive because the skin is drier, slower to heal and more reactive.
What products are best for managing hormonal acne?
Use gentle, non-stripping cleansers such as
Skinmade Clean and Care Cleanser
(€30 from
eavannabreen.ie
). I've personally trialled nearly every recommended cleanser out there and this is by far the best one. Spot treat with ingredients like salicylic acid, sulphur or benzoyl peroxide (in moderation), and avoid over-exfoliating or layering too many actives.
Skinmade Clean & Care Oil (€30 from eavannabreen.ie)
It's also important to pre-treat to reduce occurrence. Focus on supporting the skin barrier year-round. Try to keep hormones as stable as possible with lifestyle factors (managing your sleep, stress and blood sugar), and look at (under guidance from your GP) introducing supplements like zinc, DIM, omega-3s, or evening primrose oil. They can help support hormonal balance and inflammation levels.
Are branded 'peri/meno' skincare lines helpful or just fear-based marketing?
In many cases, it's more marketing than science. Skin doesn't need an entirely different product range because of your age – it needs supportive ingredients tailored to what your skin is going through. Look for products that respect barrier health, support collagen and calm inflammation, not just ones labelled for 'mature skin'.
What do women actually need in their routine during this phase?
A very simple and strategic approach. In the morning, a gentle cleanser, an antioxidant serum (like Vitamin C), a hydrating serum (like hyaluronic acid or peptides), a moisturiser and broad-spectrum, high-factor sunscreen.
In the evening, a creamy, milky or oil-based cleanser, a retinoid (if tolerated – or bakuchiol as a gentler alternative), a ceramide-rich moisturiser and a nourishing oil or barrier repair balm as needed.
What habits can work against us?
During this phase, several habits can unintentionally work against us. One common mistake is over-exfoliating. In an attempt to combat dullness, many turn to acids too frequently, which only increases sensitivity and disrupts the skin barrier.
Product hopping is another issue, where the search for quick results leads to constantly switching products instead of giving the skin time to adjust and respond. Neglecting sunscreen is especially problematic, particularly when pigmentation concerns are becoming more noticeable, as unprotected UV exposure can worsen uneven tone.
Lastly, and often most damaging, is self-criticism. Being harsh about how your skin is changing instead of responding with understanding and support can undermine both your skin health and your confidence.
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Do supplements help, and which ones do you recommend?
Yes, but think of them as support, not magic. My go-to supplements for skin support during perimenopause and menopause include collagen peptides (high-quality, hydrolysed), Omega-3 fatty acids (anti-inflammatory, barrier-supporting), Vitamin D3, zinc (especially for inflammation/acne) and adaptogens (like ashwagandha or rhodiola for stress management). Consult your GP for advice.
What in-clinic treatments do you use most for perimenopausal and menopausal skin?
Microneedling with skin boosters to stimulate collagen and deeply hydrate, Inmode Lumecca IPL to tackle redness, pigmentation and overall skin clarity. Radiofrequency to lift and firm without downtime, and LED therapy to support healing, inflammation and mood regulation.