Perimenopause tends to get talked about in terms of hot flushes, sleep and mood, but skin is one of the areas it affects most. Once you understand why skin is changing, there is a lot we can do to support it.

We see this across our clinics in Beckenham, Orpington and Sevenoaks. Someone who has had reliable, predictable skin for decades suddenly finds it drier, more reactive, or breaking out again in their forties, and it can be genuinely unsettling when nothing about their routine has changed. What has changed is the hormone environment underneath it.

Why does perimenopause affect the skin?

Oestrogen does far more for skin than most people realise. It supports collagen production, helps skin hold onto water, keeps the oil glands functioning properly and plays a part in wound healing. As oestrogen starts to fluctuate and gradually decline through perimenopause, all of those jobs become harder for skin to do consistently.

It is estimated that skin can lose around a third of its collagen in the first five years following menopause, with a slower ongoing decline after that. Perimenopause is when this process begins, which is why changes often show up well before periods actually stop.

The main changes clients notice

Dryness and dehydration. Skin that has never needed much moisturiser suddenly feels tight, flaky or rough. Lower oestrogen reduces the skin's ability to hold water and can affect oil production too, so the usual routine stops being enough.

Loss of firmness and increased fine lines. As collagen and elastin decline, skin loses some of its bounce and support, particularly along the jawline and around the eyes. This tends to be more noticeable and faster moving than the gradual ageing most people expect.

Increased sensitivity. Products that were fine for years can start to sting or cause redness. The skin barrier is thinner and less resilient, so it reacts more easily to actives, weather and even certain fabrics.

Hormonal breakouts. Confusingly, some clients see more spots rather than fewer, particularly along the jaw and chin, as the balance between oestrogen and other hormones shifts.

Duller tone and slower cell turnover. Skin renews itself more slowly, so it can look tired or uneven even with a decent routine, and product results generally take longer to show.

More visible thread veins and skin tags. Changes in circulation and skin structure during perimenopause can bring on both of these, and they are both very treatable in clinic rather than something to live with.

What can help

Adjust your skincare, not just add to it

The instinct is often to add more products, when the better move is usually to simplify and switch to gentler, more targeted ones. A ceramide-rich moisturiser helps rebuild the barrier. Hyaluronic acid supports hydration at a deeper level than a standard cream. Retinol, introduced gradually and at a lower strength if skin has become more reactive, remains one of the most effective ingredients for supporting collagen and cell turnover, even though it needs a gentler approach during this stage than it might have a decade earlier.

In-clinic treatments that support collagen

Profhilo and skin boosters work well for the dehydration and loss of density that comes with declining oestrogen, hydrating skin from within and stimulating collagen and elastin production over a course of sessions.

Morpheus8 combines microneedling with radiofrequency to rebuild collagen and improve firmness, which suits the structural changes happening at this stage more directly than surface treatments alone.

LED therapy is a gentle option for clients whose skin has become more reactive, supporting cell repair without the irritation risk of stronger actives.

Skinpen microneedling and courses of peels can help with tone, texture and slower cell turnover, though we usually go gentler on peel strength if sensitivity has increased.

Thread veins and skin tags

Both are extremely common during perimenopause and both are quick to treat. Thread veins respond well to laser treatment, and skin tags can be removed in clinic with minimal risk of scarring. Neither needs to be something you simply put up with.

Sun protection matters more, not less

With collagen already under pressure from hormonal change, UV damage does more visible harm during this decade than it did in your twenties or thirties. A broad spectrum SPF every day, all year, is one of the simplest ways to protect what collagen you have left.

Do not overlook the basics

Diet, sleep and stress all influence skin resilience, and perimenopause tends to disrupt all three at once. Protein intake matters more here, since it supplies the building blocks for the collagen your skin is working harder to replace.

You do not have to guess your way through this

Every client's perimenopause looks slightly different, and skin that is dry and sensitised needs a different plan to skin that is breaking out or losing firmness. Rather than trying every product on the shelf, a proper consultation lets us look at what your skin actually needs and build a plan around it, whether that is a skincare switch, a course of in-clinic treatment, or both.

We see clients going through perimenopause and menopause regularly at our clinics in Beckenham, Orpington and Sevenoaks. If your skin has changed and you are not sure why, that is exactly what a consultation is for.

Book a consultation here, or take our skincare quiz to find your starting point.

By Emma Coleman