Dry skin on the face during menopause

What happens to facial skin during menopause?

The visible effects of menopausal facial dryness result from three biological shifts.  

The first is in collagen. Clinical and Experimental Dermatology research suggests that skin collagen falls rapidly after menopause, with nearly a third lost during the first five post-menopausal years, followed by a more gradual decline. 

The second is in sebum, as sebum production can also change with age and around menopause. For some people, changes in surface oils may contribute to skin feeling drier than it did previously. 

The third is in the skin barrier itself. Menopause is associated with changes in the skin barrier, including changes in ceramides in the outer layer of the skin. These changes may affect how well the skin retains moisture and can contribute to dryness or sensitivity. 

The combination of these three can lead to a face that is drier and quicker to react to irritants than two or three years earlier. None of this is inevitable in its severity, but the underlying trajectory is consistent enough that they are often treated by dermatologists as a distinct clinical pattern.

Skin around the eyes

The skin around the eyes may become dry, flaky, itchy, or more sensitive. If the eyes themselves feel persistently gritty, sore, or dry, this may be dry eye rather than simply dry skin, and a pharmacist, optometrist, or GP can advise.

Products that have been fine on the rest of the face for years often start to sting or swell here. Fragranced creams, alcohol-based serums, and high-strength actives can become harder to tolerate. A simple, fragrance-free moisturiser, applied gently and not too close to the lash line, can help.

Persistent dry patches

Some people develop dry areas during the menopausal transition that do not behave like ordinary dryness. They can be sharply defined, sometimes flaky, sometimes itchy, and they can fail to clear with moisturiser alone. They may, however, respond well to appropriate treatment.

A persistent dry, flaky or irritated facial patch is not always caused by menopause. Conditions such as eczema, contact dermatitis, or seborrhoeic dermatitis can cause similar symptoms, and other causes are possible. Speak to a pharmacist or GP if a patch persists, worsens, becomes painful or inflamed, or does not improve with appropriate self-care. A new or changing, bleeding, crusting, or non-healing facial patch should be assessed by a GP, rather than managed indefinitely as dry skin.

Menopause facial skincare routines

The basics of an effective menopausal facial routine are well established. The American Academy of Dermatology recommends a mild cleanser instead of soap, a moisturiser after bathing and when skin feels dry, and broad-spectrum SPF 30 with at least 4-star UVA protection used in the morning. The principle is to remove what does not belong on the skin without removing what does.

Use a mild, fragrance-free cleanser rather than harsh soap, and apply a fragrance-free moisturiser soon after cleansing while the skin is still slightly damp. Different textures suit different people, so choose a moisturiser that feels comfortable and does not irritate your skin.

Moisturiser does most of the work, and the rule of damp skin still applies. Applied within a few minutes of cleansing, while the skin still holds some surface water, a fragrance-free face cream containing humectants and emollients can sometimes reduce the dryness some people describe. The format can matter less than the ingredients: a lighter lotion suits some, while a richer cream suits others.

Protecting your skin from UV exposure can help reduce further sun-related skin damage. When sunscreen is needed, choose at least SPF 30 with at least 4-star UVA protection, and use it alongside shade and protective clothing. SPF helps to prevent the cumulative collagen breakdown that ultraviolet light drives in skin already losing collagen for hormonal reasons. Sunscreen texture and finish matter, particularly on dry skin where a chalky or matte SPF may not have the desired effect.

Active ingredients, used carefully

There can be room in a menopausal routine for the active ingredients that suit younger skin, but with adjustments. Keeping a skincare routine simple and introducing new products one at a time may help reduce irritation.

Some active skincare ingredients can irritate skin that is already dry or sensitive. Introduce new cosmetic products gradually, one at a time, follow the product instructions, and stop using a product if it causes persistent irritation. Retinol and related vitamin A products can cause dryness and irritation and should not be used during pregnancy. If you use prescription skin treatments or have persistent redness or inflammation, speak to a pharmacist, GP, or dermatologist for advice.

When to ask for help

Speak to a pharmacist or GP if your skin becomes painful, very inflamed, swollen, cracked, weeping, or infected, or if a persistent or changing patch does not improve with gentle skincare.

Speak to a pharmacist, optometrist, or GP if your eyes themselves feel persistently dry or gritty. If you have a painful red eye, seek an urgent GP appointment or contact NHS 111. Go to A&E or call 999 if you develop changes in your sight, pain when looking at light, a very dark red eye, or other severe eye symptoms.