Perimenopause Skin Survival Guide: Why Everything Changes At Once And How To Cope With Dr Natalie Geary

Dryness, redness, breakouts and sensitivity can all spike during perimenopause. Here’s what’s going on and what actually helps.

While a wealth of information concerning menopausal skincare is available online, fewer sources discuss the stage that comes before. Estrogen levels don’t just drop overnight. During perimenopause, hormones can fluctuate for years before menopause, and your skin can feel the impact. Some people barely notice it, while for others it can last for years.

Because perimenopause looks different for everyone, skin changes can be unpredictable. You might notice sudden dryness, redness, sensitivity, pigmentation, or breakouts that feel like teenage acne all over again. Healing can also take longer than it used to.

Common perimenopause skin changes

Perimenopause can make your skin feel unpredictable because hormone levels can fluctuate rather than steadily decline. One week, your skin might feel dry and tight, the next it might be oily with breakouts, and the usual products can suddenly feel too strong. If any of this sounds familiar, you are not alone.

• Dryness and tightness
  Skin can feel dehydrated even after moisturiser, and fine lines may look more pronounced. Makeup can start clinging to dry patches.
• Redness and sensitivity
  You might notice stinging with products you have used for years, or flushing that shows up more easily. Over-exfoliation can make this worse fast.
• Jawline or chin breakouts
  Spots can appear in the lower face, sometimes deeper and more inflamed than typical blemishes. These can linger and feel harder to shift.
• Dullness and texture changes
  Skin can look less even and feel rougher, with a loss of “bounce” and smoothness. This is often a mix of slower cell turnover and barrier disruption.
• Pigmentation that lingers
  Marks from old spots, sun damage, or patches of uneven tone can become more noticeable, and may take longer to fade than they used to. Daily SPF becomes more important here than ever.

When to get professional help

If your skin changes are sudden, painful, affecting your confidence, or you’re seeing persistent acne, rosacea-like redness, or pigmentation, it’s worth speaking to a medical professional. A clinician can help you work out what’s hormonal, what’s barrier-related, and what needs targeted treatment.

“In clinic, I see perimenopause skin swing between dryness and breakouts,” Dr Natalie Geary of Light Touch Clinic says. “The mistake is doing too much too fast. A calm routine that protects the skin barrier usually makes the biggest difference.”

“One of the biggest challenges is filtering out what is actually effective from what is just fashionable. I’ve overcome this by staying anchored in clinical evidence, ongoing medical education, and investing only in technology that delivers meaningful results.”

Build a routine that fits your skin now

Your skin’s needs in perimenopause can change month to month. If you’re stuck in a cycle of trying new products and getting nowhere, a clinician can help you simplify, treat what needs treating, and avoid triggering irritation.

“The goal isn’t to chase perfection,” Dr Geary says. “It’s healthy, comfortable skin that looks like you.”

What to do at home

While it is best to get direction from a medical professional, there are a few general recommendations for caring for your skin during perimenopause. Hydrate and protect the barrier: Look for ceramides, glycerin, hyaluronic acid, and peptides.

Keep cleansing gentle: Avoid harsh foaming cleansers if you feel tightness after washing.

Introduce actives slowly: If you use retinoids or acids, start low and build gradually to avoid irritation.

Daily SPF: Choose a sunscreen you will actually wear. If you’re getting dryness, try a more moisturising formula.

In-clinic options that are commonly used

If your skin feels like it has changed overnight, it can be tempting to book the first treatment you see online. In perimenopause, it usually works better to stabilise the skin barrier first, then choose targeted treatments based on what your skin is doing now. A good clinician should explain suitability, risks, downtime, and what results are realistic.

• LED light therapy: Often used as a gentle option for reactive skin, inflammation, and breakouts, especially when you cannot tolerate strong actives.
• Light peels: Can help with dullness and uneven texture, but strength and frequency matter if you are dry or sensitive.
• Prescription topicals: A GP or dermatologist may suggest more effective options for persistent acne, pigmentation, or redness. Start slowly and keep the rest of your routine simple.
• Microneedling: Commonly chosen for texture and early laxity, but timing matters if you have active acne or are prone to pigmentation.
• Laser and light treatments: Can be effective for redness and pigment, but suitability varies by skin tone, sensitivity, and healing response.
• Injectables: If you are considering them, conservative, natural-looking plans tend to work best, guided by a qualified prescriber.

What a good consultation should include: a proper assessment, a staged plan, clear aftercare, and advice on what to stop using at home so your skin can recover.

Navigating Perimenopause With Confidence

Perimenopause can make your skin feel unpredictable, but it doesn’t mean you’re doing anything wrong. Focus on a steady routine, support the barrier, and protect your skin from the sun. If symptoms are persistent or worsening, getting tailored advice can save you time, money and frustration.

This article is for informational purposes only and does not substitute for professional medical advice. If you are seeking medical advice, diagnosis or treatment, please consult a medical professional or healthcare provider.