What should a perimenopausal skincare routine look like?

From hormonal acne to sudden dryness and sensitivity, perimenopause can change the way your skin behaves.

If the moisturiser you have sworn by for years suddenly doesn’t feel rich enough, or spots are appearing at the same time as dry, sensitive patches, perimenopause could be playing a part.

There’s plenty of advice about “menopausal skin”, usually centred around dryness, thinning and loss of collagen. But perimenopause – the transitional years leading up to menopause – can be slightly more complicated.

Rather than oestrogen remaining consistently low, hormone levels fluctuate during perimenopause. This can make skin feel somewhat unpredictable: oily or spot-prone one month, dry and sensitive the next, with changes to texture, pigmentation and firmness potentially appearing too.

According to dermatological doctor Dr Nora Jaafar her clients often think “skin suddenly becomes ‘older’ overnight. In reality, it’s responding to changing hormones”.

So while skincare after menopause focuses heavily on replenishing moisture and supporting thinner, drier skin with retinoids, a perimenopausal routine needs to address hormonal breakouts, varying hydration levels and early collagen loss without stripping an increasingly sensitive skin barrier.

And that doesn’t necessarily require an entirely new bathroom cabinet. So, what should a perimenopausal skincare routine actually look like? Dermatologists break it down.

Why does skin change during perimenopause?

“The earliest signs are usually dryness, dullness and increased sensitivity,” says Jaafar.

“Many women also notice that their skin feels thinner, heals more slowly and becomes less bouncy, while others are surprised to develop hormonal breakouts, despite never having had acne before.”

Much of this is because of a drop in oestrogen.

Consultant dermatologist Dr Aiza Jamil at Sk:n Clinics explains that oestrogen plays an important role in maintaining collagen, skin thickness and the skin’s ability to retain moisture.

“As those levels fall and fluctuate, the skin’s support structure and barrier function are affected,” she says. “This is why changes that once felt gradual can seem to accelerate during perimenopause.”

But that doesn’t mean adding more products. Instead, prioritising hydration, protecting the skin barrier and being selective with active ingredients in most crucial.

What should a morning routine look like?

“You don’t need more products during perimenopause – you need the right ones,” says Jaafar.

Jaafar recommends switching to a gentle cleanser if what you’re currently using is quite stripping, followed by an antioxidant serum such as vitamin C and a moisturiser containing barrier-supporting ingredients.

Niacinamide and ceramides are the two ingredients to get when looking for barrier support, says Jamil, and recommends hyaluronic acid and glycerin for hydration.

Sunscreen is then a must, and SPF 50 on the face, daily, is your best bet to prevent UV-related collagen breakdown. Jaafar notes it is particularly important if you are using ingredients such as retinoids.

What should you use at night?

The evening can be similarly simple, depending on the issues you’re dealing with.

If you’re struggling with breakouts or the appearance of fine lines – a retinoid treatment could be perfect.

“Retinoids have the strongest evidence for improving collagen production, fine lines and pigmentation,” says Jaafar.

As it helps increase cell turnover, this can also help with blemish-prone skin. But more isn’t necessarily better, particularly when hormonal changes have left skin increasingly reactive.

Jamil recommends introducing active ingredients individually and gradually, while avoiding the temptation to combine strong acids or exfoliants and retinoids.

“If skin is feeling sensitised, it’s usually better to scale back and rebuild slowly,” she says.

Jaafar says if your skin feels irritated, skip the retinoid and instead use a gentle liquid exfoliant that night and follow up with a rich moisturiser.

What if you have dry skin and hormonal acne?

One particularly frustrating feature of perimenopause is that dryness and acne can occur at the same time.

“One of the biggest mistakes I see is women trying to ‘dry out’ hormonal acne,” says Jaafar.

Over-cleansing and harsh acne treatments can compromise an already vulnerable skin barrier, potentially making irritation and inflammation worse.

Instead, Jaafar recommends a cleanser containing azelaic acid or salicylic acid and lightweight, non-comedogenic moisturiser.

If you want something even more lightweight, Jamil says to opt for a niacinamide serum, which is both hydrating and supports barrier-repair.

If acne becomes persistent, painful or severe, however, it may be worth speaking to a GP or dermatologist rather than continually adding stronger skincare products.

How can you prevent collagen loss?

Collagen naturally declines as we age, but falling oestrogen can accelerate this process around menopause.

“Studies suggest women can lose up to around 30% of their skin collagen within the first five years after menopause,” explains Jaafar.

There is no moisturiser capable of simply replacing that lost collagen, but some ingredients can support collagen production and help protect what is already there.

Jamil points to retinoids and peptides alongside consistent SPF, while Jaafar says topical retinoids have some of the strongest evidence for stimulating new collagen production.

For those concerned about more significant changes in skin texture or firmness, professional treatments including micro-needling may also be an option, but this also has significant downtime which needs to be considered.