Skin and Hair Changes During Menopause: Advice From a Cosmetic Dermatologist

Menopause follows perimenopause and marks a new stage of hormonal change that can bring noticeable shifts in the skin and hair. These changes are a natural part of aging, and for many, adjusting to them can feel challenging as the body adapts to a new phase. Understanding what to expect during menopause provides helpful context for supporting skin and hair health through this transition.

In this blog, board‑certified dermatologist Dr. Kamrani shares insights on the common changes to skin and hair during menopause and how to support their health through this stage.

Menopause vs. Perimenopause: How Do Skin and Hair Needs Shift?

While perimenopause is characterized by fluctuating hormones, menopause begins when estrogen and progesterone levels have dropped to their lowest point and remain consistently low. This shift often brings more noticeable, stable changes than the unpredictable waves patients experience during perimenopause. Changes in the hair and skin include:

• Collagen loss accelerates: Up to 30% of skin collagen is lost in the first 5 years after menopause, leading to faster changes in firmness and elasticity.
• Skin dryness becomes more persistent: With steady low estrogen, hyaluronic acid and ceramide production remain low.
• Hair thinning often becomes more visible: The growth phase of the hair shortens, and follicles become more sensitive to hormonal influence.
• Cell turnover slows: Skin looks duller and heals more slowly.
• Pigmentation concerns may intensify: Sun damage becomes more noticeable as the skin thins.

Common Concerns in Menopausal Skin and Hair

Women may notice both hair and skin changes when they reach menopause and are not aware that this is related to hormones! The skin can have increased dryness, skin fragility, visible wrinkles, deeper folds, and skin sagging around the neck, cheeks, and jawline. Texture can become more noticeable with dullness and enlarged pores. Hyperpigmentation and sun spots may become more noticeable.

On the scalp, hair may become thinner and grow more slowly. Some women may even notice changes in their hair texture, such as more frizzy and more brittle! Hair may shed, and the scalp can become dry and irritated.

Navigating Hair Care in Menopause

At Home Tips:

1. Support Hair growth: Because of the decrease in estrogen, the hair growth cycle becomes shorter. Topical over-the-counter minoxidil has been shown to increase the hair growth cycle. Avoid tight hairstyles, heavy extensions, and aggressive heating styles.
2. Nutrition: what you eat is important during menopause. Ensure that you are having adequate protein intake, omega 3s, and vitamin D and iron if you are deficient.
3. Low level red light therapy: this can help boost cellular activity in the hair follicle and have been shown to increase hair density and growth.

In Office Treatments:

1. Prescription medications may be necessary to help grow the hair faster and thicker! There are many options for this, and it depends on your goals and medical history.
2. Platelet-rich plasma injections have been shown to promote hair growth and reduce shedding.
3. ScalpStim is an Aesthetic Solutions exclusive procedure that helps both hair density and hair quality.

Navigating Skin Changes in Menopause

At Home Tips:

• Strengthening and hydrating the skin barrier: Look for gentle, medical-grade skin care that has ceramides, hyaluronic acid, and is calming. Be mindful that your skin may get more sensitive, so products that you may have used previously may be too irritating.
• Introducing Retinoids: retinoids have been shown to increase collagen, improve skin texture, and minimize fine lines. Introducing this to your skin care slowly is important because overuse can cause skin irritation! I recommend that patients to start every 3 days for one week, then every day for two weeks, then if their skin tolerates it well, they can increase it to every night.
• Sun protection every day! The most important tip is protecting your skin from the sun! Thinner and more fragile skin will be more vulnerable to UV damage. Sun protection will reduce fine lines, hyperpigmentation, as well as reduce the risk of developing skin cancer.

In Office Treatments:

Collagen-Stimulating Injectables

These treatments help rebuild the skin’s foundation from within. Sculptra or Radiesse stimulates your body’s own collagen production, improving skin firmness, fine lines and skin texture, cheek support, and provides natural results.

Collagen-Stimulating Lasers

Energy-based treatments help counteract the accelerated collagen loss that occurs during perimenopause. We have all options for various skin types and downtime: Fraxel (1550/1927 nm), RF Microneedling, Sofwave, Microneedling, Halo Pro, and my personal favorite: the CO2 laser for resurfacing.

Wrinkle Relaxers

Neuromodulators (such as Botox, Dysport, Daxxify, and Jeuveau) soften expression lines and prevent deeper creases from forming as skin changes during hormonal transitions. These treatments can lift the eyebrows, open and refresh the eye area, soften forehead lines, and provide a subtle lift effect of the lower face and neck.

Hyaluronic Acid Fillers

Perimenopause accelerates volume changes in the cheeks, temples, jawline, and around the mouth. Hyaluronic acid (HA) fillers can help restore facial structure and support.

Menopause can feel like a turning point for skin and hair, but understanding the changes at play allows for informed decisions and thoughtful support. With the right approach, skin and hair can remain strong and healthy throughout this transition. If you are in the Raleigh, Chapel Hill, Durham area and looking for guidance, reach out to our team for a consultation.