If you’ve noticed that your skin feels drier, looks less firm or seems to have developed fine lines more quickly during perimenopause or menopause, you’re not alone.

Hormonal changes during this stage of life can influence skin structure, hydration and elasticity. This has led to growing interest in whether hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT), can help maintain skin quality.

But what does the research actually tell us? And what can you do to support your skin during this transition?

Let’s look at the evidence.

How does menopause affect your skin?

Oestrogen plays an important role in maintaining healthy skin. It influences collagen production, skin thickness, elasticity and the skin’s ability to retain moisture.

As oestrogen levels fluctuate during perimenopause and decline after menopause, changes in skin quality may become more noticeable. These can include:

• Reduced firmness and elasticity: Changes in collagen and other structural components can contribute to skin laxity.

• Fine lines and wrinkles: Changes in skin structure, combined with cumulative sun exposure and natural ageing, can make lines more apparent.

• Dryness and dehydration: Some women experience increased dryness or a feeling of tightness.

• Changes in skin texture: Skin may feel thinner, less supple or more delicate.

These changes do not occur at the same rate or to the same degree in everyone. Genetics, UV exposure, smoking, skincare habits and general health also influence how skin changes over time.

Does HRT improve skin quality?

Research suggests that menopausal hormone therapy may improve certain aspects of skin quality, particularly collagen content, skin thickness and, to a lesser extent, elasticity.

A 2023 systematic review and meta-analysis examined 15 studies involving 1,589 women. The researchers found evidence of improvements in collagen content, skin thickness and elasticity among women using menopausal hormone therapy.

However, the studies varied in their design, treatments and methods of measuring skin changes. The authors also highlighted the need for better-quality research.

Importantly, the findings relate mainly to measurable changes in skin structure. They do not establish that every woman will notice a significant improvement in facial appearance.

The takeaway:

There is evidence that oestrogen-related treatments may benefit some aspects of skin quality, but the extent of visible improvement varies and further research is needed.

Can HRT reduce wrinkles or reverse skin ageing?

This is an important distinction.

Improvements in collagen content, skin thickness or elasticity may be beneficial, but they do not necessarily translate into noticeable facial rejuvenation.

Skin ageing is influenced by multiple factors, including hormonal changes, genetics, cumulative UV exposure, smoking and natural changes in facial volume and structure. Hormonal changes are one part of a much bigger picture.

Although some studies suggest potential benefits for wrinkles and other signs of skin ageing, the evidence is not strong enough to predict how much visible improvement an individual woman might experience.

It is therefore more accurate to say that hormone therapy may support certain aspects of skin quality, rather than promising that it will reduce wrinkles or reverse skin ageing.

Should HRT be used solely for skin rejuvenation?

Current evidence and clinical reviews do not support starting systemic menopausal hormone therapy solely to improve skin appearance.

HRT is a medical treatment that requires an individual assessment of its potential benefits, risks, suitability and the person’s medical history. Decisions should be based on recognised medical indications and individual circumstances, rather than cosmetic skin concerns alone.

For women considering hormone therapy for menopausal symptoms or another medical reason, questions about potential effects on the skin can be discussed with their treating doctor.

It is also important to understand that different forms of hormone therapy are not interchangeable. Evidence relating to systemic hormone therapy cannot automatically be applied to vaginal oestrogen or topical products, and applying hormone products to the face without appropriate medical guidance is not recommended.

How can you support your skin during perimenopause and menopause?

Although hormonal changes cannot be addressed through skincare alone, a consistent routine can help maintain skin hydration, support the skin barrier and improve some visible signs of ageing.

1. Use broad-spectrum sunscreen every day

UV exposure contributes significantly to collagen breakdown, pigmentation and premature skin ageing. Apply a broad-spectrum SPF 50+ sunscreen daily and reapply as directed, particularly when spending time outdoors.

Sun protection is one of the most important steps in maintaining skin quality over time.

2. Focus on hydration and barrier support

A gentle cleanser and a moisturiser containing ingredients such as ceramides, glycerin or hyaluronic acid can help maintain hydration and support the skin barrier.

If your skin has become more sensitive or dry, consider simplifying your routine and avoiding excessive exfoliation.

3. Consider evidence-based skincare ingredients

Depending on your skin concerns and tolerance, ingredients such as topical retinoids and vitamin C may help improve certain signs of photoageing.

Introduce active ingredients gradually, particularly if your skin is sensitive. Some ingredients are not suitable for everyone, so professional guidance may be helpful when choosing a routine.

4. Support your overall health

A balanced diet, adequate protein intake, regular physical activity, good-quality sleep and avoiding smoking all contribute to general health and can support healthy skin.

These habits cannot stop the natural ageing process, but they form an important foundation for long-term skin health.

5. Seek individual advice about persistent skin changes

If you are concerned about persistent dryness, new pigmentation, changes in skin texture or other skin symptoms, a qualified health professional can help assess possible causes and discuss appropriate options.

Skin changes should not automatically be attributed to menopause, particularly if they are sudden, unusual or persistent.

The bottom line: What does the evidence tell us?

Oestrogen plays a role in maintaining skin structure, and research suggests that menopausal hormone therapy may improve certain measurable aspects of skin quality, including collagen content, thickness and elasticity.

However, visible results may vary, and the evidence does not establish HRT as a reliable treatment for facial rejuvenation.

HRT is not recommended solely for skin rejuvenation. It is a medical treatment, and decisions about its use should be made with an appropriately qualified healthcare professional.

For most women concerned about skin changes during menopause, a thoughtful skincare routine, daily sun protection and individualised advice are practical places to start.

At Clinical Cosmetics, we believe in an evidence-based, personalised approach to skin health. If you have questions about caring for your skin during perimenopause or menopause, we’re here to help you understand your options.

This article is for general educational purposes only and is not a substitute for individual medical advice or diagnosis.

References and further reading

1. Pivazyan G, et al. Skin Rejuvenation in Women using Menopausal Hormone Therapy: A Systematic Review and Meta-Analysis. Journal of Menopausal Medicine. 2023;29(3):97–111. Read the research.

2. Wentworth A. Menopause and skin. Menopause. 2026;33(9):1031–1033. Read the review.

3. Australian Government Department of Health, Disability and Ageing. Menopause and perimenopause: Treatment options.