Skin changes

Perimenopause skin, explained

Spots and dryness at the same time? Here’s why, and what helps.

Also in Skin changes: Perimenopause skin · Menopause skin · GLP-1 skin

In a nutshell: in perimenopause, hormones rise and fall rather than simply dropping, so skin can change from week to week. Keep a gentle, flexible routine: a calm base you use every day, plus one breakout treatment and a richer cream you add when you need them. Daily SPF stays non-negotiable.

What is perimenopause?

Perimenopause is the time of changing hormones before your periods stop. It starts with the first signs, such as irregular periods or hot flushes, and ends 12 months after your last period. In the UK the average age of menopause is 51, so perimenopause often begins in your 40s, and it can last several years.

What changes in your skin

  • Breakouts: as oestrogen and progesterone swing up and down, adult acne can return, often around the jaw and chin.
  • Dryness and itching: dry, itchy skin is one of the skin changes the NHS lists for perimenopause and menopause.
  • Both at once: many women find their skin is oilier and spottier one week and tight and dry the next.
  • Flushing and sensitivity: hot flushes can leave the face red, and products you’ve used for years may suddenly sting.
  • Dullness and dark spots: skin can look less bright, and pigment patches may show more.

What helps, by concern

Breakouts

What helps: Azelaic acid, niacinamide Good

Try: COSRX The Niacinamide 15 Serum

Dryness

What helps: Ceramides, hyaluronic acid Good

Try: Haruharu Black Rice 5 Ceramide Cream

Redness and sensitivity

What helps: Centella, azelaic acid Promising to good

Try: Purito Wonder Releaf Centella Serum (unscented)

Fine lines

What helps: Retinal or retinol Strong

Try: Beauty of Joseon Revive Eye Serum Ginseng + Retinal

Protecting it all

What helps: Daily SPF50 Strongest

Try: Beauty of Joseon Relief Sun SPF50+

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A flexible routine

Every day

Morning: gentle cleanser, light moisturiser, SPF50. Evening: cleanser, then moisturiser.

Spotty week

Add azelaic acid or niacinamide in the evening, and keep your moisturiser light.

Dry, tight week

Pause the breakout treatment for a few nights and switch to a richer ceramide cream.

Change one thing at a time, so you can tell what’s helping. Not sure where to start? Take the routine quiz.

What to go easy on

Harsh drying spot treatments, scrubs and stacking several actives at once. They can tip changeable skin into irritation. Our pairing guide shows what works well together.

When to see your GP

Talk to your GP if you’re under 45 and think you have perimenopause symptoms, or if your symptoms are affecting your daily life. See them too for sudden severe acne, very flushed skin that could be rosacea, or a rash that won’t settle. There are effective treatments, including HRT for perimenopause symptoms.

Good to know

Can you get spots and dry skin at the same time?

Yes, it’s very common in perimenopause. Treat the spots with something gentle like azelaic acid, and use a moisturiser that suits how your skin feels that week.

Is it too early to think about menopause skin?

No. Building a gentle routine with daily SPF now protects your skin through the years ahead. See our menopause skin guide for what comes next.

Can I use retinol in perimenopause?

Yes. Start slowly, two or three nights a week, and pause it on weeks your skin feels irritated.

Sources

  1. NHS North East London. Menopause clinical pathway, September 2024.
  2. NHS Salisbury. Menopause factsheet.
  3. Calleja-Agius J, Muscat-Baron Y, Brincat MP. Skin ageing. Menopause International. 2007;13(2):60-64.

This page is general information, not medical advice. Last updated 5 November 2026.