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The Best Products for Perimenopausal Skin, According to Dermatologists

Photo-Illustration: The Strategist; Photos: Retailers

Not long after I turned 47, my glow up and left me. I woke up one morning, and my skin was lackluster. My face looked drawn, defeated. “You see dullness and dryness when estrogen starts to decline,” says dermatologist Adeline Kikam. “That is the hallmark of perimenopause, and not enough people talk about how it affects your skin.” Considering that more than 1 billion women around the world — including me — will experience perimenopause by 2025, it’s about time we started chatting about this natural midlife hormonal shift.

First, a few facts: Perimenopause is the precursor to menopause, which officially begins once you haven’t had a period for 12 months. It typically kicks in in your 40s with symptoms like hot flashes, mood changes, and headaches. White women encounter it around the age of 45, while Black and Latina women tend to enter it a few years earlier, according to some studies. (Perimenopause lasts an average of four years.) But trust me, you will notice when it happens to you. The most common symptoms in the skin are a lack of hydration, acne, brown spots, bigger pores, and dullness. “I explain to my patients that you have to understand that your skin is changing,” says 56-year-old Manhattan Beach–based dermatologist Glynis Ablon. But, keep in mind, perimenopausal skin is sensitive: “You’re not going to exfoliate your way to smaller pores,” says New York City cosmetic surgeon Lara Devgan, who cautions that thinner, mature skin should be “babied,” not bullied. I talked to several skin-care experts — including a celebrity facialist and a cosmetic surgeon — about products to address the changes that come up most frequently during perimenopause.

For extreme dryness

Every dermatologist I consulted calls out this drugstore moisturizer as the holy grail of potent protective ingredients — ceramides to restore the skin barrier, hyaluronic acid to attract moisture, calming niacinamide — and price point. “Your loyalty should be to ingredients and not fancy packaging,” says Kikam, who stresses the need for women of color to seek out products with synthetic ceramides because their skin cells contain fewer of these fatty acids. Echoes Ablon: “As we go through menopause, the surface level of our skin degenerates and becomes thinner. CeraVe creates a new barrier on your skin that protects it.”

This lightweight, quick-to-penetrate formula contains both vitamin B5 and B3, which attract moisture and encourage cellular renewal, respectively. When I apply this serum, it plumps my parched skin instantly, likely because of its hyaluronic acid.

For hormonal breakouts


“I see women in their 40s and 50s suffering with cystic breakouts along the jawline and chin who may never have had acne as a teenager. They’re shocked,” says L.A.-based dermatologist Jessica Wu. This FDA-cleared LED mask features two treatments: a blue light that kills bacteria and reduces oil production (a 2021 review of studies on blue-light therapy and acne showed it to improve inflammatory acne), while the red light encourages collagen growth and reduces inflammation. For a systemic approach, Wu and Kikam recommend Spironolactone ($90 for three month supply with prescription) — a diuretic pill typically used to treat edema and heart conditions — for hormonal acne. For oversize stubborn nodules and cysts, Wu recommends visiting a dermatologist for cortisone shots.

Wu also steers perimenopausal patients with hormonal acne away from topicals geared to teenagers, which are too aggressive for sensitive skin. She prefers the milder azelaic acid — found in grains such as barley, wheat, and rye — contained in this oil-free cream-gel formula that can be added to your moisturizer or serum.

This line, specially designed for aging skin, features gentle yet powerful ingredients like willow-bark extract. This natural source of salicylic acid simultaneously exfoliates and soothes inflamed skin.

For hyperpigmentation

“As a darker-melanated person, I started to develop spots on darker areas during perimenopause and knew I needed to incorporate vitamin C into my routine,” says Nyakio Grieco, the co-founder of inclusive beauty retailer Thirteen Lune, who started experiencing symptoms at age 42. Vitamin C helps to prevent melanin production and lightens targeted pigmentation without affecting the surrounding skin. “After a few weeks of using this serum,” says Grieco, “I recognized myself in the mirror again.”

This topical cream recommended by Wu and Ablon contains cysteamine, a chemical compound clinically proven to fade sun spots, freckles, and melasma. I saw stubborn hyperpigmentation (thanks to my wafer-thin Irish skin and sun damage in my teens) on my face and décolletage lighten after two months of nightly usage. Apply to dry skin only and wash off after 15 minutes.

For enlarged pores

Wu loves that this affordable formula gently exfoliates pores clogged with dirt or dead skin cells. “It’s mild enough to use every day if your skin is resilient,” she says, noting that the added hyaluronic acid plumps skin to make pores appear smaller.

Bicoastal aesthetician Shani Darden, 47, whose fans include Kim Kardashian and model Rosie Huntington-Whiteley, name-checks this SPF 50 sunscreen to fight pore expansion. She points out that sunscreen is an essential in fighting against collagen loss. And this one from Goop is an elegant, lightweight moisturizer-and-sunscreen in one.

For excess facial hair

“It’s cruel that we get more hair on our face just as we’re starting to lose it on our head and brows and lashes,” says Wu, who adds that any beauty aisle in Asia has an entire section devoted to female razors. The peach fuzz on our jawline and cheeks comes from the surge in masculine androgen hormones when estrogen depletes. Dermaplaning with this handheld device, which I also use weekly to exfoliate off dead skin cells, is perfectly safe and effective — “hair does not grow back faster or thicker” — but Wu warns that stubble is a by-product. If your hair is darker, opt for waxing or sugaring to remove the hair shaft and root.

For fine lines

When you’re perimenopausal, every skin doctor strongly suggests a prescription retinoid like Retin-A or Renova. For an over-the-counter alternative, Ablon likes that this formula allows you to start at a lower retinol level — to avoid irritating your skin — and build tolerance from there.

Facialist Darden formulated her own retinol product with lactic acid and apple extract after seeing too many clients who overused potent retinols with inflamed complexions. It’s a gentle alternative to full-blown retinoids, for anyone who’s new to the category. Start out using the product a few times a week until your skin adjusts.

For getting back that glow

These these exfoliating pads come recommended by Darden, and I happen to agree with her. The soothing chamomile and retinol break up those dead skin cells, and over time my skin regained its dewiness. Important for fending off future damage, the green-tea extract, an antioxidant, protects your skin from free radicals, too.

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The Best Products for Perimenopausal Skin