Menopause and Skin, Hair, and Nail Changes

08/31/2023 | 8 min. read

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Estrogen is an incredible hormone that has a beneficial impact on many aspects of our health. As women move through the menopausal transition and estrogen production slows and eventually stops, changes in estrogen-sensitive tissues are inevitable—and among the most noticeable are changes in our skin, hair, and nails.

Hormones play a central role in skin hydration, elasticity, thickness, and overall skin health. Declines in estrogen and imbalances in other hormones impact the sebaceous (oil) glands, pigment-producing melanocytes, hair follicles, and growth factors required for repair and rejuvenation.

Menopause also affects the production of collagen, the major building block of skin and connective tissues; elastin, a protein that allows your skin to stretch; and keratin, a key structural component of the nails, hair, and outer layer of the skin.

Common concerns during the menopausal transition—which typically occurs in a woman’s early to mid 40s through her mid 50s—include an increase in dryness, dullness, age spots, and sagging, wrinkled skin, along with thinning hair and brittle nails.

That’s why this stage of life is a great time to start giving your skin, hair, and nails a little extra TLC. After all, as in most aspects of our health, an ounce of prevention can be worth a pound of cure.

Dry Skin

As we age, our skin loses hydration and the collagen and elastin framework that keep it plump and moist in our youth. The production of oil in the sebaceous glands decreases and, along with it, the skin’s ability to retain moisture. It’s important to combat this loss of essential oils and hydration because the resulting dryness contributes to several skin problems.

  • Cream or nourishing oil cleansers are preferable to soaps and sudsy cleansers, which can strip the essential fatty acid barrier and be quite dehydrating.
  • Hydrating serums such as hyaluronic acid, applied directly after patting your skin dry, help lock in the moisture from your freshly washed face. Additional serums can also be helpful, depending on what else is going on with your skin.
  • Following up with a moisturizing product such as squalane helps to replenish hydration.

Dull, Rough, Flaky Skin

Skin cell turnover becomes less efficient after menopause, and old cells don’t slough away as often, leaving layers of dry skin cells that can feel rough and flaky. Because these old cells don’t reflect light as effectively as smooth skin, they also give the complexion an unwanted dullness.

  • Gentle exfoliation helps remove these skin cells. I personally have sensitive skin, so my face can get red and irritated with an exfoliator that is too abrasive. Instead, I use a silicone scrubber with my moisturizing cleanser. This gently but efficiently removes all the old skin cells and the impurities from the day, leaving my skin smooth and soft.
  • Serums such as retinol can also help to gently slough off dull, rough skin cells.

Age Spots

Age spots, also called liver spots, are most common in people with light skin and those who have had excessive sun exposure. These small, darkened spots may be unattractive but they are harmless.

  • Prevention is the best medicine. Protect the areas where age spots are most common—the face, neck, chest, hands, and arms—by wearing a hat and using sunscreen. I choose a zinc oxide non-nanoparticle facial sunscreen that has a little natural tint to help combat the white that zinc oxide sunscreens often leave behind.
  • Vitamin C serums and creams applied to darkened spots may help lighten them.

Wrinkles and Sagging Skin

Crow’s feet, smile lines, and related wrinkles are caused by the plummeting production of collagen as we age. We lose 1% of our collagen annually beginning in our 30s—and 30% of our remaining collagen in the first five years after menopause!

  • Retinol, a form of vitamin A applied to the skin, stimulates collagen production and helps reduce fine lines and wrinkles.
  • Topical vitamin C serums and creams have been shown to improve wrinkles and other skin problems.
  • Oral antioxidant supplements may also help by protecting your skin against free radical damage from UV radiation, pollutants, etc. Proven antioxidants for skin health include vitamin E, zinc, selenium, beta-carotene, and vitamin C which also promotes collagen formation.


Unfortunately, we don’t always “outgrow” acne. As estrogen decreases during the menopausal transition, the ratio of estrogen to testosterone tips, and we can have acne breakouts reminiscent of puberty.

  • All the suggestions for improving cell turnover (gentle exfoliation, retinol and other serums) help to clear your pores and keep pimples at bay.
  • Red light therapy, which uses low-wavelength red light, is a promising treatment for acne as well as wrinkles, scars, and redness.

Full-Body Skin Care

We tend to concentrate on our faces, but don’t neglect the skin on the rest of your body.

  • Sunscreen isn’t only for your face. Use it on your arms, chest, and other exposed areas before spending time in the sun.
  • Your skin doesn't always need to be washed with soap. Unless you are really sweaty, plain water with soap on just your “bits and pits” is often enough.
  • Hydrating body washes are less drying than soap, which strips our skin of important fatty acids and beneficial bacteria. I like to use a body wash and exfoliating body mitts in the shower. I recommend choosing a cleanser with a neutral pH to minimize skin barrier damage.
  • Dry skin brushing supports lymphatic flow and exfoliates dead skin cells.
  • Oil massage (Abhyanga) is part of the recommended daily self-care practices of Ayurveda. Because I don’t like the feel of oil on my body during the day or the smell if it gets into my clothes and turns rancid, I prefer to do an oil massage in the shower, then rinse off and pat dry. My skin feels lusciously moisturized with no residual oiliness.
  • I have recently been using a “Fasciablaster” with oil or Dr. Bronner’s soap in the shower. This and similar handheld tools, which are used to massage various areas of the body, are helpful for stimulating blood and lymphatic flow to your skin, breaking up scar tissue and adhesions, and reducing cellulite, stretch marks, and sagging skin. It is also good for relieving muscle pain.

Thinning, Dry, Frizzy Hair

A common and distressing problem for women after menopause is changes in hair, especially thinning. A 2022 study published in Menopause found that 52% of postmenopausal women experienced female pattern hair loss. Characterized by overall thinning, this type of hair loss is caused by a combination of aging, hormones, and genetics.

  • Balancing hormone levels can help. Estrogen deficiency can affect hair growth cycles, shortening the growth phase and delaying the regrowth stage. It also creates imbalances with other hormones, particularly androgens like testosterone, which is a major cause of female pattern hair loss. These imbalances may also stimulate hair growth where you don’t want it, such as your chin and upper lip. Talk to your doctor about natural hormone balancing options and consider a conversation to learn if bioidentical hormone replacement therapy may be indicated for your situation.
  • Hair follicles miniaturize (become smaller) with age and particularly after menopause. This results in declines in natural oil secretion and scalp hydration and can cause finer hair strands and less dense overall growth. Red light therapy has been shown to reverse follicle miniaturization and stimulate hair growth.
  • Supplements known to enhance hair health include vitamins A and C, B vitamins (especially biotin), zinc, and silica. Collagen supplements may also be helpful because they provide amino acids your body uses to maintain healthy hair and skin.
  • Always be mindful of harsh shampoos and hair styling products and tools.

Brittle Nails

Nails are made of a hardened protein called keratin. Although menopause isn’t the only cause of brittle nails, decreased estrogen can weaken the keratin layer, causing nails to break more easily.

  • Nails need to be moisturized, so as you apply moisturizer to your face and body, remember to rub it into your hands and the skin around your cuticles.
  • Avoiding harsh and dehydrating hand soap is also recommended. I actually changed all our hand soaps to the same moisturizing wash with hydrating shea butter that I use in the shower.
  • Everyone should be mindful of the trauma that common nail treatments can have on your nails. Gel, acrylic, and other false nails require frequent nail polish remover, which often contains acetone. When you need to remove polish, choose an acetone-free remover.
  • If your nails are looking unhealthy, rule out iron-deficient anemia and other nutrient deficiencies, thyroid disease, and potential underlying infection.
  • Wear gloves while doing household chores such as dishwashing.

In Summary

As our kids have gotten older and, more importantly, as I have gotten wiser, I recognize that self-care is an essential priority, a way of nurturing myself and showing my body the love and attention it deserves. This includes making skincare part of my regular routine.

I hope you will find these suggestions helpful. We can’t stop aging, but we can slow, minimize, and even reverse some of its side effects. Failing that, remember William Shakespeare’s sage words: “With mirth and laughter let old wrinkles come.”

Dr. Briana Sinatra

Meet Dr. Briana Sinatra

Dr. Briana Sinatra is a board-certified naturopathic doctor with a vibrant practice in the Pacific Northwest. There she focuses on women’s and family health, taking a holistic approach to healthcare by empowering women with the knowledge and tools they need to live their best life now and protect their future wellness by looking at how all the systems in the body work together and how diet, lifestyle, and environment all influence health.

More About Dr. Briana Sinatra