The Impact of Menopause on Skin and Facial Ageing

As a facial plastic surgeon, I often meet women who, during menopause, describe feeling that they have “suddenly aged” and that their reflection no longer mirrors the youthful energy they feel within.

Understanding the biological changes that occur during this transition, and the reasons behind them, is essential to addressing these effects thoughtfully and restoring harmony between inner vitality and outward appearance.

The Science Behind the Shift

The average woman loses up to 30% of her collagen within the first five years after menopause. This sharp decline is driven primarily by falling oestrogen levels, which play a vital role in maintaining skin structure, hydration and elasticity. Reduced oestrogen slows collagen production, weakens the skin barrier and diminishes the synthesis of hyaluronic acid, the molecule responsible for keeping skin plump and hydrated.

This results in the skin becoming thinner, drier and less resilient. Fine lines deepen, the cheeks may appear more hollow, and the jawline begins to lose definition as soft tissue descends and elasticity diminishes. These are not simply aesthetic concerns; they reflect a structural change in the skin’s architecture and support systems.

Visible Changes in the Face

The menopausal face undergoes a complex interplay of volume loss, sagging and texture change. Fat pads in the mid-face shift downward, leading to hollowing under the eyes and accentuated nasolabial folds. Meanwhile, bone resorption in the cheeks and jawline subtly alters facial proportions, often creating a tired or sunken appearance.

Many women also notice increased dryness and sensitivity, with the skin feeling rough or prone to irritation. The decline in sebum production further compromises the lipid barrier, making the skin less able to retain moisture. Pigmentation changes, such as age spots or uneven tone, can also become more pronounced due to cumulative sun exposure and hormonal fluctuations.

Beyond Aesthetics: The Psychological Dimension

These visible signs of change can deeply affect confidence and self-perception. For many women, menopause coincides with a time of great personal and professional activity, and feeling that one “looks tired” or “different” can carry emotional weight. My role is not only to rejuvenate the face, but to help patients feel empowered and more in control of their ageing process.

Modern Solutions: Restoring Balance and Vitality

We now have a remarkable range of regenerative and aesthetic options to counteract the effects of menopause on the skin- treatments that go far beyond surface-level correction.

• Regenerative injectables such as polynucleotides and exosomes work at a cellular level to stimulate fibroblast activity, repair damaged tissue and restore the skin’s natural luminosity.
• Collagen-stimulating treatments like microneedling, PRP and bio fillers rebuild structural support and improve texture without over-volumising.
• Advanced laser and energy-based devices can resurface, tighten and rejuvenate the skin, while also stimulating new collagen formation.
• For patients experiencing more significant soft-tissue descent or bone resorption, surgical interventions such as microlifting, fat transfer (lipolifting) or a facelift with stem cells can restore youthful contours in a subtle, natural way.

Every face tells a different story, and treatment should always be tailored, respecting individual anatomy, hormonal stage and aesthetic goals.

A Holistic Approach

Addressing menopausal skin changes is not only about reversing visible ageing but supporting the body’s natural regenerative capacity. Nutrition, sleep, exercise and hormone balance all play crucial roles in skin health. In my practice, I advocate a multimodal approach, combining regenerative medicine, biotech skincare such as Morphiya and, where appropriate, surgical intervention to restore both structure and radiance.

Menopause marks a new chapter, not a decline. With the right understanding and expertise, it’s entirely possible to preserve vitality, confidence and natural beauty through this transition. Modern aesthetic medicine offers solutions that respect both biology and individuality, helping women look as youthful and dynamic as they feel.