Skin. Estrogen loss during perimenopause and into menopause has a significant impact on skin elasticity and thickness (Brincat et al, 2003). The first sign of change will likely be dry skin. Over time dry skin may contribute to additional lines and wrinkles. (Health in Menopause UK). The decrease in estradiol causes changes in skin hydration, elasticity and oil production (Zouboulis et al, 2022). Hot flashes can cause worsening of rosacea due to repetitive vasodilation of the capillaries on the face. There may be worsening of melasma symptoms in menopause transition, which is darkening of skin which is known to be hormone sensitive. Menopausal women may have more melasma at non-facial sites (Roster et al, 2025). 

 

Hair. Hormone shifts in perimenopause and into menopause can ultimately lead to thinning and changes in hair texture. The extent varies by individual and is also linked to genetic and lifestyle factors (Rinaldi et al, 2023). Typically changes are seen in texture, thickness of hair caliber and density of scalp hair follicles. Conditions such as frontal fibrosing alopecia and female pattern baldness typically will be diagnosed during and after menopause transition. Temporary hair thinning called telogen effluvium can also be seen in menopause transition (Roster et al, 2025). 

 

Nails. Estrogen drives the production of keratin which is what nails are made of (NIH Informed Health, 2024). It is estimated nearly 20% of women in menopause experience brittle nails (Chessa et al, 2019) 

 

You're not alone. Changes in composition of hair, nails, and or skin are noted in more than 70% of women (Zouboulis et al, 2022). Most research we found focuses on the impact of declining estrogen and collagen. Given the permanent decline of estrogen as women move into post menopause, the changes here often last decades. 

 

The health of our hair, nails, and skin is often linked with our overall physical appearance and sense of self esteem. Taking time to understand and address changes here can be incredibly valuable for physical health, mental health, and the health of our social lives.