Aesthetic Medicine and Hormones — How They Interact

Last updated: 5 March 2026

Hormones are the body’s chemical messengers, and their influence on the skin is profound. From the acne of puberty to the skin changes of menopause, hormonal fluctuations affect virtually every aspect of skin health and appearance. Understanding this relationship is essential for both patients and practitioners, as hormonal status can influence treatment selection, timing, efficacy, and even safety. At Axiom Aesthetics, we consider hormonal factors as an integral part of every treatment plan.

Key Hormones That Affect the Skin

Oestrogen

Oestrogen is perhaps the most significant hormone for skin health. It stimulates collagen and hyaluronic acid production, maintains skin thickness and hydration, supports wound healing and skin barrier function, promotes even pigmentation, and regulates sebaceous gland activity.

When oestrogen levels decline — as occurs during perimenopause and menopause — skin undergoes significant changes: thinning, dryness, loss of elasticity, increased wrinkling, and slower healing. Research published in the American Journal of Clinical Dermatology estimates that skin loses approximately 30% of its collagen in the first five years after menopause, with a further 2% per year thereafter.

Progesterone

Progesterone increases sebum production and can contribute to skin congestion and breakouts. This is why many women experience premenstrual acne — progesterone peaks in the luteal phase (the two weeks before menstruation), stimulating oil production that can clog pores. Progesterone also promotes water retention, which can cause facial puffiness, and increases melanocyte sensitivity, contributing to pregnancy-related pigmentation (melasma).

Testosterone and Androgens

Androgens (including testosterone, DHEA, and DHT) have significant effects on the skin:

• Stimulate sebaceous gland activity and oil production
• Increase skin thickness
• Promote hair growth in androgen-sensitive areas (face, chest) while potentially causing hair thinning on the scalp
• Contribute to acne when present in excess or when the skin is hypersensitive to normal androgen levels

Cortisol

As discussed in our stress and skin article, cortisol — the primary stress hormone — breaks down collagen, impairs barrier function, increases inflammation, and disrupts wound healing. Chronically elevated cortisol accelerates skin ageing significantly.

Thyroid Hormones

Thyroid hormones regulate metabolism throughout the body, including the skin. Hypothyroidism (low thyroid) causes dry, rough, pale skin, hair loss, and slow wound healing. Hyperthyroidism (excess thyroid) can cause warm, moist, flushed skin with increased sweating and hair thinning.

Growth Hormone and IGF-1

Growth hormone stimulates collagen and elastin production, cell renewal, and tissue repair. Its decline with age (a process called somatopause) contributes to skin thinning, reduced elasticity, and slower wound healing.

Insulin

Insulin and insulin-like growth factor 1 (IGF-1) play a role in skin ageing through multiple pathways. Chronic insulin elevation (insulin resistance) promotes inflammation, increases androgen production, stimulates sebaceous gland activity, and accelerates glycation of collagen. This is why patients with type 2 diabetes or metabolic syndrome often exhibit premature skin ageing.

How Hormones Affect Aesthetic Treatment Outcomes

Menstrual Cycle Considerations

The menstrual cycle creates predictable hormonal fluctuations that can influence aesthetic treatment experiences:

• Days 1-5 (menstruation): Oestrogen and progesterone are at their lowest. Pain sensitivity is increased, and bruising tendency may be higher due to prostaglandin effects. Not the ideal time for painful procedures
• Days 6-14 (follicular phase): Rising oestrogen levels promote better healing, improved skin barrier function, and lower pain sensitivity. This is generally the optimal window for aesthetic treatments
• Days 14-28 (luteal phase): Progesterone rises, increasing oil production and potentially causing pre-treatment breakouts. Pain sensitivity increases towards the end of this phase. Skin may be more reactive and prone to post-treatment inflammation

While these variations are generally mild, patients who are particularly sensitive to hormonal fluctuations may benefit from scheduling treatments during the follicular phase (approximately days 7-14 of their cycle).

Pregnancy

Pregnancy involves dramatic hormonal changes that significantly affect the skin and limit treatment options:

• Increased melanin production: Melasma (pregnancy mask) affects up to 70% of pregnant women. This should NOT be treated with lasers, IPL, or strong peels during pregnancy, as it is likely to worsen or recur
• Collagen changes: Increased relaxin and other hormones alter collagen structure, potentially affecting how skin responds to collagen-stimulating treatments
• Restricted treatments: Most aesthetic treatments are contraindicated during pregnancy as a precaution, including botulinum toxin, retinoids, chemical peels (medium/deep), laser and IPL treatments, and most injectable treatments
• Safe options: Gentle facials, LED light therapy (except blue light), certain topical skincare (vitamin C, niacinamide, azelaic acid), and gentle hydrating treatments are generally considered safe

Perimenopause and Menopause

The perimenopausal transition (typically ages 45-55) creates the most dramatic hormonal shifts affecting aesthetics:

Skin Changes During Menopause

• Accelerated collagen loss (30% in the first 5 years post-menopause)
• Significant reduction in skin hydration
• Decreased skin thickness and elasticity
• Increased wrinkling and skin laxity
• Redistribution of facial fat (loss in the midface, gain in the lower face)
• Changes in skin sensitivity and healing capacity

Treatment Implications

Menopausal patients often need more intensive and comprehensive treatment approaches:

• Collagen stimulation is critical: Biostimulators, microneedling, and polynucleotide treatments become especially valuable as the body’s natural collagen production plummets
• Hydration-focused treatments: Skin boosters, hyaluronic acid treatments, and hydrating facials address the significant moisture loss
• Volume replacement: Dermal fillers may be needed to address accelerated facial volume loss, particularly in the cheeks, temples, and perioral area
• Treatment timing: Healing may take slightly longer; we may recommend longer intervals between intensive treatments
• Skincare adaptation: Transitioning from lighter products to richer, more occlusive formulations that support the compromised barrier

Hormone Replacement Therapy (HRT) and Aesthetics

HRT can positively influence aesthetic treatment outcomes by partially restoring the oestrogen-driven skin benefits that decline during menopause. Research shows that women on HRT have:

• Better collagen density compared to non-HRT menopausal women
• Improved skin hydration and thickness
• Potentially better healing responses after aesthetic treatments
• Reduced rate of skin ageing progression

However, HRT is a medical decision that should be made with your GP or endocrinologist based on overall health considerations, not solely for aesthetic benefit. We can work collaboratively with your medical team to optimise your aesthetic treatment plan alongside any hormonal therapy.

Hormonal Conditions and Aesthetic Treatment

Polycystic Ovary Syndrome (PCOS)

PCOS affects up to 10% of women and is characterised by elevated androgens. Aesthetic implications include persistent adult acne (often jawline and chin), excess facial hair, acanthosis nigricans (dark, velvety skin patches), hair thinning on the scalp, and skin tags.

Treatment approaches for PCOS patients may include laser hair removal (addressing excess facial hair), targeted acne treatments (chemical peels, LED, skincare), and skin quality treatments that account for the oily, acne-prone nature of PCOS skin. Addressing the underlying hormonal imbalance with medical treatment often improves skin concerns significantly.

Thyroid Disorders

Thyroid dysfunction affects skin quality and treatment response. Hypothyroid patients may experience slower healing, reduced treatment efficacy, and increased sensitivity. Hyperthyroid patients may have heightened skin sensitivity and vascular reactivity. Optimising thyroid hormone levels before intensive aesthetic treatments is recommended.

Practical Recommendations

At Axiom Aesthetics, we integrate hormonal awareness into our practice:

• Our consultation forms include questions about hormonal status, menstrual cycle, pregnancy, and hormonal medications
• We adjust treatment timing recommendations when hormonal factors are relevant
• We modify treatment approaches for menopausal patients to account for changed skin biology
• We refer patients to endocrinologists or gynaecologists when hormonal conditions are significantly affecting skin health
• We stay current with research on hormone-skin interactions to provide evidence-based care

Frequently Asked Questions

Should I time my treatments around my menstrual cycle?

For most patients, the differences between cycle phases are subtle enough that treatment timing is not critical. However, if you find that you are particularly sensitive to pain, prone to bruising, or experience significant premenstrual skin changes, scheduling treatments during the follicular phase (approximately days 7-14) may optimise your experience and results. If you have a regular cycle and are scheduling an important treatment, choosing this window when possible is a simple way to potentially enhance your experience.

How does the contraceptive pill affect aesthetic treatments?

The combined oral contraceptive pill maintains relatively stable hormone levels, which can actually benefit treatment consistency and predictability. However, oestrogen-containing contraceptives slightly increase the risk of melasma (hormonal pigmentation), which is relevant for patients considering light-based treatments. Some progestogen-only pills and hormonal IUDs may increase skin oiliness and acne tendency. Inform your practitioner about your contraceptive method so it can be factored into your treatment plan.

Can hormone changes after pregnancy affect previous aesthetic treatments?

Yes. The significant hormonal shifts during and after pregnancy can affect the metabolism of certain products. Hyaluronic acid fillers may dissolve faster during pregnancy due to increased hyaluronidase activity. Post-pregnancy hormonal changes can alter skin quality, potentially affecting how previous treatments look. We recommend a reassessment 3-6 months after delivery (or after breastfeeding ends) to evaluate skin status and plan any appropriate treatments.

Are there aesthetic treatments that can help balance hormones?

Aesthetic treatments do not directly balance hormones. However, certain approaches can help manage the skin manifestations of hormonal imbalance. LED light therapy can reduce inflammation associated with hormonal acne. Professional-grade skincare with ingredients like niacinamide, azelaic acid, and zinc can help regulate the skin’s response to hormonal fluctuations. For genuine hormonal balancing, medical treatment (via your GP or specialist) is the appropriate route.

I am on testosterone therapy — how does this affect my aesthetic treatments?

Testosterone therapy (whether for gender-affirming treatment, post-menopausal therapy, or other medical reasons) can increase sebum production, skin thickness, and potential for acne. These changes should be communicated to your aesthetic practitioner so that treatment plans can be adapted accordingly. For example, skincare recommendations may need adjustment towards oil-controlling products, and acne management may need to be incorporated into the treatment plan. The skin changes associated with testosterone therapy are manageable with appropriate care.