*Content reviewed by HotPause Health Medical Advisor & Board-Certified Dermatologist Corinne Erickson, MD, FAAD, MSCP
Welcome to the skin health guide you wish you had 10 years ago. At HotPause Health, we know menopause is a whole-body experience, and that includes your skin.
Here’s the truth we don’t say loudly enough: When you hit perimenopause, your hormones are different, your skin is different, and your skin care needs to be different too.
If perimenopause finds you facing wrinkles, acne, discoloration, redness, irritation, flaking, and sagging that has you on high alert, take a breath. Your skin isn’t broken and neither are you. Your skin is just sending some pretty visible signals that its needs have changed and it’s time for you to change with it and give it what it actually needs now. The goal remains protection and prevention, but the strategy shifts toward repair, regeneration, and barrier restoration.
Let’s start with the basics and biology.
Ever wonder why men seem to age so gradually while women fall off an aging cliff? That’s the impact of estrogen, that goddess of a hormone that imparts hydration, structure, blood flow, and balance to our skin before she sputters like an emptying gas tank (perimenopause) and then just disappears (menopause.) She loves us and then she leaves us. Meanwhile, men just coast along since their aging process is not so estrogen dependent. Hence the sagging, sinking, and crinkling that comes from loss of collagen, elastin, and hyaluronic acid. It’s the midlife birthday present that didn’t come with a gift receipt.
When we talk about aging, we usually divide it up into “Intrinsic Aging” which includes genetics/epigenetics, and hormones and “Extrinsic Aging,” which includes UV exposure, environmental pollution, crappy American Diet, alcohol, and smoking. Intrinsic aging has generally been viewed as beyond our control and written in our stars, or possibly in our pores in this scenario. Extrinsic aging, on the other hand, is something we can modify with prevention and correction strategies.
The return of menopause hormone therapy (MHT) to the scene after over a 20-year hiatus is shifting the way we think about intrinsic aging. No longer are our hormones “beyond our control.” We understand that we can and should not let estrogen entirely leave. Women need her for optimal body functioning, not just for reproduction. Bones, muscles, brain, heart, gut, liver, and SKIN are all rich with estrogen receptors that help them function better. While menopause hormone therapy (MHT) is beyond the scope of this article, it’s a key player in female longevity and skin health when safe and appropriate. As always, speak with your physician about what treatments might be right for you.
Skin health is a critical piece of the puzzle. Here is Dr. Erickson’s must have skincare routine across various day-parts, body areas, and skin products.
Morning Musts: Protection and Prevention
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New Rationale: SPF alone isn't enough in midlife. Your skin is under oxidative attack from pollutants and UV exposure. Antioxidants like Vitamin C neutralize free radicals that sunscreen can’t fully block, offering increased protection, brightness, and collagen support.
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The Strategy: This is now a non-negotiable. Apply a medical-grade Vitamin C/antioxidant serum first, followed by SPF, every single morning.
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What to Stop/Avoid: Relying on SPF alone.
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Key Ingredients: Medical-grade Vitamin C/Antioxidant Serum (L-ascorbic acid or tetrahexydecyl ascorbate (THD)). SPF 30+ (preferably tinted for added blue-light protection).
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Dr. Erickson’s favorite antioxidants and SPFs can be found in our Skin Care Collection.
Sleeping on the Job: Nighttime Repair
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New Rationale: As estrogen declines, skin cell turnover slows, inflammation rises, and the barrier becomes more fragile. At night, our skin shifts into repair mode, which we fuel with products that support cell turnover, DNA repair, and restoration.
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The Strategy: Gold Standard: Use milder forms of retinoids (not the aggressive formulas from your 20s). Application: Start slowly (three nonconsecutive nights a week) and gradually increase. For super sensitive skin, moisturize both before and after retinoid application.
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What to Stop/Avoid: Aggressive Retin-A or Tazorac formulas from your younger years.
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Key Ingredients: Milder retinoids (retinol, retinal, or retinyl esters) at least 3 nights per week. Moisturizer with hyaluronic acid, glycerin, and/or ceramides to minimize water loss.
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Dr. Erickson’s retinoids and PM moisturizers are available in the Skin Care Collection.
Toners & Exfoliation: Less Burn, More Balance
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New Rationale: Midlife skin doesn’t like being bullied. Shift your thinking around toners from stripping oil to restoring the skin’s healthy acidic pH. Gentle, consistent exfoliation is better than harsh stripping.
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The Strategy: Toners should be applied immediately after washing and drying.
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What to Stop/Avoid: Salicylic acid overload (No more SeaBreeze, please!). Anything you used in high school.
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Key Ingredients: Hypochlorous acid (calms bacteria and inflammation). Gentle AHAs (glycolic or mandelic acid) for a smoother texture.
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Dr. Erickson’s favorite toner, Hydrinity Hyacyn Active Mist, is available in the Skin Care Collection.
Eyes Need Strategy (Not Slathering)
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New Rationale: The eyelid area is quick to show puffiness, dark circles, redness, and crepiness. Eye products matter, but thicker is not better—slower cell turnover + heavy creams = milia (tiny hard white bumps) city.
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The Strategy: Use targeted, lightweight eye products. Apply sparingly. Let absorption happen before layering makeup.
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What to Stop/Avoid: Heavy, thick creams that can lead to milia.
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Key Ingredients: Targeted products that reduce edema, fade discoloration, and keep the barrier smoother (e.g., Hydrinity Eye Renew Complex).
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Dr. Erickson’s favorite eye products are available in the Skin Care Collection.
Neck & Décolleté: Don’t Skip South of the Chin
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New Rationale: The neck, due to its reliance on elastin fibers, can show hormonal aging and crash quickly. You must treat it like your face; it’s an extension of your facial routine.
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The Strategy: Daily: Treat everything from the chest up (to your bra line) just like your face, including SPF. Night: Give your neck the same care as your face
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What to Stop/Avoid: Only applying SPF or skincare to your face.
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Key Ingredients: Gentle Retinoids. Products that boost collagen and elastin. Rich moisturizers to support thinning skin.
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Dr. Erickson’s favorite neck and décolleté products are available in the Skin Care Collection.
Skin Is a Full-Body Organ (Yes, Really)
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New Rationale: Perimenopause shows up everywhere. If your black pants look like a snow flurry, read on. Your body care needs an upgrade.
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The Strategy: Swap harsh body washes for gentle, hydrating cleansers. Take a “Pits and Privates” approach to soaping up and spare the legs, arms, and torso most days. Moisturize right after showering.
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What to Stop/Avoid: Harsh, stripping body washes.
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Key Ingredients: Gentle, hydrating cleansers. Colloidal oatmeal to soothe and repair.
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Dr. Erickson’s favorite body care products are available in the Skin Care Collection.
