The Link Between Hormones and Skin Ageing

Last updated: 5 August 2026

The relationship between hormones and skin health is one of the most important yet frequently overlooked aspects of aesthetic medicine. Hormonal fluctuations throughout life, from puberty and pregnancy to perimenopause and beyond, have significant effects on skin structure, function, and appearance. Understanding this connection can help patients make more informed decisions about both their skincare and aesthetic treatments.

The clinical team takes a whole-body approach to skin health, recognising that effective treatment must consider the hormonal context in which skin ageing occurs. This article explores the key hormonal influences on skin and how modern aesthetic medicine can address hormone-related skin changes.

Key hormones that affect the skin

Oestrogen

Oestrogen is the most significant hormone for skin health. It influences virtually every aspect of skin biology:

• Collagen production: Oestrogen stimulates fibroblasts to produce collagen types I and III. It also inhibits matrix metalloproteinases (MMPs), the enzymes that break down collagen.
• Skin thickness: Oestrogen maintains dermal thickness. Skin thickness decreases by approximately 1.13% per year after menopause.
• Hydration: Oestrogen promotes the production of hyaluronic acid and other glycosaminoglycans, which bind water in the dermis.
• Sebum production: Oestrogen modulates sebaceous gland activity, helping to maintain the skin’s lipid barrier.
• Wound healing: Oestrogen accelerates wound healing, its absence is associated with slower recovery from aesthetic procedures.
• Pigmentation: Oestrogen influences melanocyte activity, which is why melasma is more common during pregnancy and in women taking oral contraceptives.

Progesterone

Progesterone increases sebum production, which is why many women experience oilier skin and breakouts during the luteal phase of their menstrual cycle (the two weeks before menstruation) and during pregnancy. It also has anti-inflammatory properties and affects skin hydration.

Testosterone and Androgens

Androgens, including testosterone and its more potent metabolite dihydrotestosterone (DHT), stimulate sebaceous gland growth and sebum production. In excess, they contribute to:

• Acne (particularly hormonal acne along the jawline and chin)
• Increased facial hair growth
• Androgenetic alopecia (pattern hair loss)
• Thicker, oilier skin

Thyroid Hormones

Thyroid hormones regulate metabolism throughout the body, including the skin. Hypothyroidism (underactive thyroid) can cause dry, rough, pale skin, hair loss, and brittle nails. Hyperthyroidism can cause warm, moist, flushed skin and hair thinning.

Cortisol

The stress hormone cortisol, when chronically elevated, has significant negative effects on skin health:

• Accelerates collagen breakdown
• Impairs the skin barrier function
• Increases inflammation and sensitivity
• Triggers or worsens acne, eczema, and psoriasis
• Impairs wound healing

Growth Hormone and IGF-1

Growth hormone and its mediator insulin-like growth factor 1 (IGF-1) stimulate cell proliferation, collagen synthesis, and skin thickness. Both decline with age, which adds to skin thinning and reduced regenerative capacity.

Menopause and skin ageing: The critical connection

The most dramatic hormone-related skin changes occur during perimenopause and menopause, when oestrogen levels decline rapidly. Research has quantified these effects:

• Collagen loss: Up to 30% of skin collagen is lost in the first five years after menopause, with a further decline of approximately 2% per year thereafter.
• Skin thickness: Decreases by approximately 1.13% per year post-menopause.
• Elasticity: Reduced by approximately 0.55% per year.
• Hydration: Decreased hyaluronic acid production leads to progressive dehydration.
• Wound healing: Becomes slower, which is clinically relevant for recovery from aesthetic procedures.

These changes mean that the decade surrounding menopause is a critical window for skin health intervention. Treatments that stimulate collagen production during this period can partially offset the hormonal decline.

Aesthetic treatments that address hormonal skin changes

Collagen-stimulating treatments

Treatments that boost collagen production are particularly valuable for perimenopausal and post-menopausal skin:

• Profhilostimulates four types of collagen plus elastin
• Microneedlingtriggers collagen through controlled micro-injury
• Radiofrequency treatments, thermal stimulation of collagen synthesis
• Bio-stimulatory fillers (Sculptra, Radiesse), long-term collagen induction

Hydration Treatments

As hormonal hydration mechanisms decline, treatments that restore moisture become increasingly important:

• Skin boosters, injectable hyaluronic acid for deep tissue hydration
• Mesotherapy, delivery of hydrating and nourishing ingredients directly into the skin
• Medical-grade hyaluronic acid serums

Skincare Adjustments

Hormonal changes necessitate adjustments to skincare routines:

• Richer moisturisers: As sebum production decreases, lighter formulations may no longer be sufficient
• Retinoids: Even more important post-menopause for maintaining collagen production
• Ceramide-rich products: To support the declining skin barrier
• Phytoestrogen-containing products: Topical plant-derived oestrogen mimics may provide some benefit

Hormone replacement therapy and skin

Hormone replacement therapy (HRT) has been shown to partially mitigate the skin effects of menopause. Studies demonstrate that women taking systemic HRT have:

• Higher skin collagen content
• Greater skin thickness
• Improved hydration and elasticity
• Better wound healing capacity

However, HRT is a medical decision with implications far beyond skin health and should be discussed with your GP or menopause specialist. Aesthetic treatments can complement HRT or serve as an alternative strategy for those who cannot or choose not to take hormone therapy.

“Understanding the hormonal context of a patient’s skin is essential for effective treatment planning. A 55-year-old woman’s skin is not simply an older version of her 35-year-old skin, it is fundamentally different in its biology, and our treatments must reflect that understanding.”

Hormonal acne in adults

Adult hormonal acne, particularly common in women in their thirties and forties, is driven by androgen fluctuations and typically presents along the jawline, chin, and lower cheeks. Treatment approaches include:

• Topical retinoids and azelaic acid
• Spironolactone (an anti-androgen medication, prescription only)
• Hormonal contraceptives (for premenopausal women)
• Professional skincare treatments (chemical peels, LED therapy)
• Dietary modifications (reducing high-glycaemic-index foods and dairy may help some patients)

Frequently asked questions

Conclusion

The relationship between hormones and skin health is complex, dynamic, and deeply influential. By understanding how hormonal changes affect the skin, we can develop more targeted, effective treatment strategies that work with the body’s biology rather than against it. Whether you are understanding the hormonal changes of perimenopause, managing adult acne, or seeking to optimise your skin health at any life stage, a hormone-aware approach to aesthetics delivers superior outcomes.

For a comprehensive skin assessment that considers your hormonal health and life stage, book a consultation with