Hormonal shifts impact collagen, hydration, and elasticity—here’s what’s really going on beneath the surface.
Perimenopause isn’t just about hot flashes—your skin feels it first. As estrogen retreats, cell turnover slows, barrier lipids thin, and natural hyaluronic-acid stores dry up. The result? Rough texture, sudden tightness, and a face that no longer bounces back the way it did at 25. I’m not trying to be harsh, I am hoping to give you a reason behind why your skin feels different and hoping to help give you strategies to prevent or lessen the change.
Estrogen is the master switch for collagen types I & III and for the elastin fibers that keep cheeks high and jawlines crisp. When the hormone drops, collagen production can fall by as much as 30 percent in the first five post-menopausal years. This can be a good reason to incorporate Sculptra® or Radiesse to increase your collagen bank as you transition through perimenopause and enter into menopause. These treatments can be incorporated as early as your late 30s or early 40s, depending on when you’re noticing signs of skin thinning, loss of elasticity, and crepiness in texture. Elastin frays, dermal thickness shrinks by roughly one percent each year, and micro-vessels become fragile—hello bruising and slower healing.
roughly one percent each year, and micro-vessels become fragile—hello bruising and slower healing.
The Five Biggest Skin Complaints After 45
| Concern | Why It Happens | Home Support | In-Clinic Boost |
| Dryness & Itch | Lipid loss, slower turnover | Ceramide-rich cream, humidifier | Microneedling with VAMP |
| Thinning & Easy Bruising | Collagen drop | Peptide serum, daily SPF | Sculptra® (or other biostimilator) |
| Sagging Cheeks & Jawline | Elastin breakdown | ??? | Deep-pad filler + RF microneedling |
| Breakouts & Redness | Androgen rebound | Salicylic / azelaic acid | Gentle chemical peel |
| Pigmentation Patches | Hormone shift + UV | Vitamin C, tranexamic acid | IPL or laser toning |
The Five Biggest Skin Complaints After 45 Caring for Your Skin in Menopause
Protein with every meal, a couple of quick resistance-workouts each week, proper sleep routine, gentle barrier-supporting skincare, and daily SPF 40+ are the simple habits I rely on—and they lay the groundwork for everything we do in clinic. To reinforce that foundation, I prescribe three core longevity supplements you can order through my Fullscript dispensary and have shipped right to your door: Whole Body Collagen peptides for dermal density, Hair Skin & Nails Ultra for zinc-powered skin support, and CellGuard-NR for NAD⁺-driven cellular repair. Stay tuned and follow along for a more in depth “inside-out” education coming from my recent research in preparing to treat women through the perimenopause and beyond transition.
When your skin is primed from the inside, my precision injectables do the visible lifting: smooth neuromodulators for expression lines, balanced hyaluronic-acid fillers for volume, and Sculptra® when we want to bank your own collagen to slow the more noticeable signs of aging. I know this all sounds so strategic and almost robotic but I do want to stress that I am also PRO-aging, and want to also support the beautiful transition that menopause can bring. I just want all women to know the different options to choose from.
Neuromodulators (BOTOX® Cosmetic, Dysport®, Nuceiva™) temporarily block presynaptic release of acetylcholine, allowing hyperactive facial muscles to rest. That pause does more than smooth expression lines—it also reduces the mechanical shear that frays newly formed collagen, so your fresh fibres last longer. Hyaluronic-acid fillers replace the native HA that drops as estrogen wanes; because each HA molecule binds up to 1,000 × its weight in water, the gel re-hydrates tissue while physically restoring contour. Even better, studies show cross-linked HA creates a “biostretch” effect that up-regulates dermal fibroblasts for mild, ongoing collagen production.
For a deeper rebuild, Sculptra® (poly-L-lactic acid) acts like a slow-release scaffold: microparticles trigger a controlled, low-grade inflammatory response that recruits fibroblasts and ramps up type I collagen over 8–12 weeks, with firmness that can hold for two years or more. Each modality tackles a different aspect of hormone-related aging, and when they’re sequenced properly the whole is greater than the parts—smoother muscle action, hydrated volume, and a self-renewing collagen matrix that keeps improving long after the appointment.
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Menopause & Skin FAQs
Do over-the-counter estrogen creams erase wrinkles?
No. Canadian OTC products can’t contain active estrogen. Prescription topical estradiol may thicken skin slightly but won’t restore lost volume.
Can supplements replace injectables?
They complement, not replace. Think of nutraceuticals as nourishing the canvas; injectables rebuild the three-dimensional frame. Here are the three longevity supplements I swear by.
Is downtime longer after 50?
A little—plan a couple of bruise-friendly days while thinner vessels settle.
Perimenopause and Menopause Skin Plan
Less estrogen means less collagen, and with it comes dryness, sagging and pigment. A strategic blend of longevity supplements and intentional injectables can help restore what is lost and help you look the age you feel. Choose your closest clinic and let’s help you age confidently: Nanaimo, Parksville, Courtenay, or Langley.
Hormone Replacement Therapy
Hormone replacement therapy (HRT) can ease the menopausal transition and may also support skin hydration and elasticity. HRT, also known as Menopausal Hormone Therapy (MRT), should be prescribed on an individual basis. If it’s on your radar, making an appointment with your primary care provider is the first step. I’m gearing up to better support you, but in the meantime, you can join my community on instagram for accessible education surrounding perimenopause, longevity living and beyond. From there, click here to learn how we can work together to create a holistic and collaborative plan for your skin during perimenopause and menopause.
Dr Heather Iverson, ND, combines her education as a Naturopathic Doctor with over 9 years of injecting experience to offer her patients across Vancouver Island and the Fraser Valley undetectable cosmetic injection results.
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