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Written by Rosalie Orrostieta, MSN, APRN, FNP-C
Medically Reviewed for Accuracy and Safety by Rosalie Orrostieta, MSN, APRN, FNP-C
Last Updated: November 13, 2025
Let’s have a real talk about a shift that inevitably happens, the menopausal stage, but somehow still feels like a surprise when it arrives.
I witness this moment in my clinic almost every day. A patient sits in my chair, someone who has always had great skin and tells me, “Rosalie, my favorite moisturizer just isn’t cutting it anymore.” They describe a thirst in their skin they haven’t felt before, or a sudden change in texture that happened overnight.
I can see the frustration in their eyes. They’ve spent years caring for their skin, and suddenly, the rules have changed.
If you are reading this, maybe you are feeling that same frustration. Maybe you’ve noticed a sudden dryness that won’t quit, or jawline laxity that wasn’t there last year.
I often explain this to my patients as “Second Puberty.” Just like when we were teenagers, your hormones are fluctuating wildly. But instead of the oily chaos of our teens, menopause often brings the opposite: a “Collagen Cliff” that changes the structure of the face.
But here is the optimistic news: We have incredible, science-backed ways to handle this. At Rose Medical Aesthetics, I don’t believe menopause signals the “end” of your glow. I believe it’s just time for a new, smarter game plan and I am here to guide you through it.
The Science of Collagen Loss During Menopause
Before we jump into the treatments (my favorite part!), it is helpful to understand why this is happening. It helps take the emotion out of it. You aren’t doing anything wrong it’s just biology.
Estrogen is like a fertilizer for our skin. It stimulates the production of collagen (which keeps skin firm), elastin (which keeps it bouncy), and hyaluronic acid (which keeps it plump and hydrated).
When perimenopause hits and estrogen levels start to drop, that “fertilizer” goes away.
Here is a statistic that often shocks my patients: Studies show that women lose about 30% of their skin’s collagen in the first five years of menopause. After that, it settles into a slower decline of about 2% per year.
That initial 30% drop is why the changes feel so sudden. It’s what we call “accelerated aging.” But knowing this empowers us. It means we know exactly what we need to replace and repair.
5 Major Menopause Skin Changes to Expect
When patients sit in my chair here in Sarasota, they usually describe one of five specific things regarding Estrogen Deficient Skin. Let’s break them down so you know what to look for.
1. Extreme Dryness (Xerosis)
This is usually the first sign. You might feel like your skin is tight two sizes too small. Because estrogen regulates our natural oils and our ability to hold onto water, losing it impairs our skin barrier. A recent survey in 2024 actually found that nearly a quarter of menopausal women experienced eczema-like dryness for the first time during this transition. If you are itching or flaking, you are not alone.
2. Hormonal Acne Breakouts
I know, it seems unfair. Wrinkles and pimples? When estrogen drops, your testosterone levels usually stay about the same. This creates an imbalance. That relative “excess” of testosterone can trigger deep, cystic breakouts, usually along the jawline and chin. It’s different from teen acne, so the treatments we used in high school often don’t work here.
3. Sagging Skin & Jowls
This is the one that sends most people to my clinic. As collagen degrades, the skin loses its structural support. Simultaneously, we experience some natural bone resorption (bone loss) in the jaw and cheeks. The result? The skin starts to slide downward, creating jowls or a “crepey” texture on the neck.
4. Increased Sensitivity & Redness
Hot flashes aren’t just about feeling warm; they are vascular events. The constant expanding and contracting of blood vessels can lead to permanent redness or Rosacea. You might find your skin is suddenly sensitive to products you’ve used for years.
5. Facial Hair Growth
Again, blame the androgen (testosterone) imbalance. You might find “peach fuzz” getting thicker or coarse hairs popping up on the chin. It’s a nuisance, but very treatable.
Clinical Treatments for Menopausal Skin at Rose Medical Aesthetics
At Rose Medical Aesthetics, I don’t believe in just “covering up” these changes. My background as an FNP-C drives me to look for clinical solutions that actually change the biology of your skin.
We use a “Combination Therapy” approach. We have to treat the surface, but we also have to rebuild the foundation. Here is how we do it.
Morpheus8: The Heavy Lifter for Skin Tightening
If you have researched menopause skin treatments, you have probably heard of Morpheus8. There is a reason it’s so popular, and it is a staple in my practice.
How It Works: Morpheus8 combines two powerful technologies: microneedling and radiofrequency (RF) energy. The tiny needles create micro-channels to trigger a healing response, while the RF energy heats the deep layers of the dermis.
Why I Love It for Menopause: Menopausal skin is thinning skin. Morpheus8 is unique because it can tighten skin and remodel the tissue underneath. It essentially “shrink-wraps” the skin back onto the muscle.
I had a patient recently who was feeling very self-conscious about her neck texture. She felt she had to wear scarves even in the Florida heat! After her second session of Morpheus8, the texture had smoothed out so significantly she came in wearing a V-neck. That confidence is what I live for.
Restoring Volume: Dermal Fillers & Hyperdilute Radiesse
Remember that bone loss I mentioned? We can’t regrow the bone, but we can mimic the support it used to provide.
The “Liquid Lift” We use structural dermal fillers to replace the deep support we’ve lost. By placing filler strategically on the cheekbones or the angle of the jaw, we can lift the lower face. It’s not about making you look “puffy” or filled; it’s about re-draping the skin back to where it used to sit.
Bio-Stimulation with Hyperdilute Radiesse For my patients who want a long-term investment in their skin quality, I recommend Hyperdilute Radiesse.
While traditional fillers are used to fill specific deep lines or folds, Hyperdilute Radiesse works differently. We thin the product out so it acts as a bio-stimulator rather than a volumizer. When injected, it spreads like a “blanket” under the skin, prompting your body to grow its own new collagen and elastin over the next 3 to 6 months.
It is like putting money back into your collagen bank. We aren’t just camouflaging the aging process; we are physically restoring the structural proteins that menopause has depleted.
SkinPen Microneedling: Improving Skin Texture
For women who are just starting to see texture changes or dullness, SkinPen is fantastic. It creates thousands of controlled micro-injuries. This forces your skin into “repair mode,” ramping up cell turnover that has slowed down due to hormone changes. It’s excellent for that menopausal dullness and large pores.
The Ideal Menopause Skincare Routine
Treatments in the clinic are like going to the gym for your face essential for big changes. But your home care is your diet. You have to feed your skin the right things every day.
Here is the advice I give my patients when they ask about skincare products for menopause:
Stop Stripping Your Skin If you are still using foaming, drying cleansers, please stop. Switch to a creamy or milky cleanser that protects your barrier.
Hydration is Key (But the Right Kind) You need lipids. Look for moisturizers with ceramides, fatty acids, and cholesterol. These mimic the natural oils your skin has stopped producing.
Retinoids: Proceed with Caution Retinol is the gold standard for anti-aging, but menopausal skin is sensitive. We often recommend AlphaRet by SkinBetter Science. It gives you the power of a retinoid but includes lactic acid to hydrate, so you don’t get the peeling and irritation of generic tretinoin.
Sunscreen is Non-Negotiable This is Florida! Menopausal skin is thinner and more susceptible to sun damage. A high-quality SPF is your best insurance policy against age spots.
FAQ: Managing Menopause Skin Changes
Q: Can I do these treatments if I am on Hormone Replacement Therapy (HRT)? A: Absolutely! In fact, they often work better together. Systemic HRT can help improve skin hydration from the inside, making your skin more responsive to our treatments. Just let me know during your consultation.
Q: Will treatments hurt more now? A: It is true that pain sensitivity can increase during menopause. I take this very seriously. At Rose Medical Aesthetics, we use medical-grade numbing creams to ensure you are comfortable. We want this to be a self-care experience, not a painful one.
Q: Is it too late to start if I’m already post-menopausal? A: It is never too late. While we can’t turn back the clock completely, we can absolutely improve the health, thickness, and appearance of your skin at any age. I have patients in their 70s seeing beautiful results.
Final Thoughts from Rose Medical Aesthetics
Navigating menopause can feel like a lonely journey, but it doesn’t have to be.
I founded Rose Medical Aesthetics because I wanted to create a space where medical expertise meets genuine empathy. I’ve been where you are-staring at the mirror, wondering what changed.
My goal isn’t to make you look like you’re 20 again. My goal is to help you look like the most vibrant, healthy version of you right now. Whether that means tightening a lax jawline with Morpheus8 or simply finding a skincare routine that doesn’t sting, we are here to guide you through it.
If you are in the Sarasota area and want to chat about your skin, come see us. Let’s make a plan that makes you feel confident in your skin again.
Ready to restore your glow? Book a consultation with Rosalie Orrostieta at Rose Medical Aesthetics today.
