7 Signs Your Skin Might be in Perimenopause ...

... and what to do about it

🦋 This Week’s Substack

• Thank you to Ann Marie McQueen of Hotflash inc for the kind words about Phosis in last week’s newsletter—your support means the world. Ann Marie is a fierce advocate for women’s health in midlife and menopause, and her Substack and podcast are essential listening. She recently interviewed Phosis advisory board member, pelvic floor physical therapist, and author Dr. Sara Reardon, and is currently working on a powerful series exploring the midlife experience beyond North America. Hotflash inc is one of my weekly must-reads—and I highly recommend subscribing if you haven’t already.

• 7 Signs Your Skin Might Be in Perimenopause. Have one of these symptoms? Whether it’s whispering or shouting, your skin is trying to tell you something.

• News from the Peri/menosophere. TLDR: Keep sipping that morning cup of coffee.

• Have you ever tried Twisted Flamingo? This week’s movement snack has a sense of humor.

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🦋 7 Signs Your Skin Might be in Perimenopause

It started with a blush I couldn’t explain. Not a romantic flush or a reaction to skincare—just a sudden, unpredictable rashy warmth across my cheeks and around my mouth that left me slightly blotchy and very bewildered. It would come and go, sometimes with small, raised bumps that looked like pimples, but were not.

Then came the dryness. Not just a bit of tightness after cleansing, but a deep, persistent dehydration that no amount of my usual moisturizers seemed to soothe.

And then the dullness. My skin looked tired, fatigued, and lackluster. It was hard for me to pinpoint exactly what was wrong, but it just didn’t look radiant. And forget about “glowy” — there was no glowing in sight.

I hadn’t changed my products. I wasn’t under unusual stress. But my skin was clearly changing—and not for the better.

It wasn’t until I finally connected the dots between my increasingly erratic periods, joint pain, insomnia, night sweats, and this new, unfamiliar skin that I realized: this is perimenopause.

So today, I want to walk you through some of the signs. Because when we understand what’s happening, we can care for ourselves with greater intention, compassion, and yes, nourishing skincare.

If you’ve been reading this Substack for awhile, you’ll remember my long journey to understanding I was in perimenoapuse — and how none of the many doctors I visited years ago in search of answers even suggested that hormones could be causing my issues. And while perimenopause is currently a buzzy word generating a lot of attention, that was not the case 8 years ago when I first started experiencing symptoms (skin and otherwise.)

1. Sudden Dryness or Dehydration

Estrogen helps your skin retain moisture and maintain a healthy lipid barrier. As estrogen begins its uneven descent in perimenopause, that barrier becomes compromised, leading to a loss of hydration, a duller complexion, and that tight, thirsty feeling no matter how much water you drink.

When choosing a moisturizer, it’s critical to read the ingredients list. You want something thick, but not greasy, that contains barrier-strengthening ingredients like ceramides, along with calming botanical extracts to bring lasting relief.

2. Increased Sensitivity

Products you’ve used for years may start to sting or induce rashes. Your skin anywhere on your body might flush more easily, or react to changes in temperature, fabric, or stress. This heightened sensitivity is common in perimenopause as your skin becomes thinner and more vulnerable to inflammation.

What’s important here is what DOES NOT appear among the ingredients in your skincare. Be sure to avoid added fragrance, essential oils, aggressive acids or scrubs — especially when skin is angry or flaring from a reaction. Less is more if your skin becomes sensitive.

3. Acne or Breakouts (Again? Really?)

Yes, breakouts can return—even if you left them behind in your teens. With estrogen declining and testosterone relatively unopposed, some women experience a resurgence of hormonal acne, particularly along the jawline and chin. Do not be tempted to pick at these (or any) skin blemishes; it can only lead to scarring. See a professional if breakouts continue.

4. Loss of Firmness and Elasticity

Collagen production begins to drop in your 30s, but the decline accelerates during perimenopause. Less estrogen means less collagen, and that shows up as sagging, more pronounced fine lines, and a general loss of plumpness as the structural integrity of your skin changes. You may notice nasal labial folds — the lines extending from the sides of your nose to the corners of your mouth.

5. Uneven Tone and Hyperpigmentation

Those fluctuating hormones can trigger melanin overproduction just like it does during pregnancy, leading to dark spots, blotchiness, and uneven tone. Add excessive sun exposure to the mix, and it can become a recipe for hyperpigmentation.

Start by protecting skin with an SPF – anything mineral-based sunscreen you like enough to use regularly is perfect. I recently took Zealios Sport Performance Mineral SPF 30 Sunscreen on a biking trip in Spain since it doesn’t run into my eyes when I sweat.

6. Slower Healing and More Irritation

That scratch that lingers, the breakout that leaves a mark for weeks, the random rash that overstays its welcome—your skin’s recovery rate naturally slows in perimenopause.

What once resolved in days might now take weeks. And again, it’s all connected to declining hormones, impaired barrier function, and a more reactive immune response.

This is when simplicity matters most. This is the time to pare back your routine to simple, clean products that won’t irritate.

7. Changes in Skin Texture

You may notice your skin feels less smooth overall, almost like it’s lost some of its refinement. Pores might appear larger. Skin might feel rougher to the touch.

This is often due to a combination of dryness, reduced cell turnover, and the cumulative effects of hormonal change. Consistent use of barrier-repairing products helps improve texture and restore your skin’s natural softness.

What To Do About It

The most powerful thing you can do is listen to your skin, your body, and your intuition. This is not a time for aggressive exfoliation (for me, gentle dry brushing a few times a week in the evening works best) or 10-step routines with countless products. It’s a time for nourishment. For simplicity. For ritual.

I intentionally started my line with just two products. I believe your skin doesn’t necessarily need more—it needs better products with better ingredients.

On days my skin is looking red and blotchy, I pare back my routine to just water and moisturizer in the morning, followed by a face oil. While it may be tempting to cover the unevenness with makeup, try to skip it as makeup ingredients can also be irritating. If I’m in front of a camera that day, I’ll wear mascara and a tinted lip balm, but leave the rest behind until my skin calms down.

In the evening, I'll use a gentle oil cleanser followed by a moisturizer and a face oil to seal in hydration. (And it might be worth mentioning that even if I’m not using a lot of products, that doesn’t mean I rush through my routine. I still take time to slowly massage in my products and intentionally slow my breath to calm my nervous system.)

One last thought: There is emerging research on the gut-skin connection. So if your skin is suffering, it may be time to examine your diet.

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🦋 Perimenopause / Menopause News

• Phosis Advisory Board Member Dr. Sara Reardon launched her first book this week: Floored: A Women’s Guide to Pelvic Floor Health at Every Age and Stage. If you’ve ever been curious about how different life stages (hello, perimenopause) affect your pelvic floor, this is a must-read. Inside you’ll find:

  • A guide to the pelvic floor's anatomy and its critical role in your overall health.

  • Practical advice to help you assess the current state of your pelvic floor and recognize the signs of potential issues.

  • Exercises and routines designed to strengthen, rehabilitate, and maintain pelvic floor health across different life stages.

  • Tips and secrets for treating a variety of symptoms caused by pelvic floor dysfunction, such as involuntary urine leakage and pain during sex. Click on the link above to learn more and order!

• New research offers hopeful news: becoming more physically active in midlife may help protect the brain from Alzheimer’s. A four-year study found that adults who increased their activity levels had less beta-amyloid buildup and healthier brain structure.

• Findings from a new study of almost 50,000 women followed for 30 years suggest that a morning cup of coffee might do more than boost energy; it could also help women stay sharp, strong, and mentally well as they age. The study was recently presented at the American Society for Nutrition’s annual meeting.

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🦋 This Week’s Movement Snack

Inspired by the new research underscoring the benefits of regular movement on brain health, I’m sharing a short movement snack to inspire you to move your body today. Below you’ll find a quick and fun session featuring a variation on Twisted Flamingo. Be sure to keep a block handy and a sense of humor; I lost my balance repeatedly when I first learned this pose.

Cheers to looking and feeling your best,

Susan

Susan Campbell
Founder and CEO, Phosis