Skin. Estrogen loss through menopause has a significant impact on skin elasticity and thickness, with collagen and dermal thickness measurably declining in post menopausal years (Brincat et al, 2005). The first sign of change will likely be dry skin. Over time dry skin may contribute to additional lines and wrinkles. 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 (Roster et al, 2025). 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 (Williams et al., 2020). The extent varies by individual and may also be linked to genetic and lifestyle factors (Williams et al., 2020, Kamp et al., 2022). 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 (Kamp et al., 2022). 

 

Nails. Nails are made of keratin, the same structural protein found in hair and skin (NIH Informed Health, 2024). Estrogen receptors are expressed in keratinocytes throughout skin appendages, and estrogen helps regulate keratin production (Ohnemus et al., 2006). Declining estrogen during perimenopause is one of several factors associated with thinner, more brittle nails. Roughly 20% of the general population is estimated to have brittle nails and women over 50 are more even more likely to have them (Chessa et al, 2019) 

 

You're not alone. Changes in composition of skin are noted in more than 70% of women (Le-Pillouer-Prost, 2020), women in menopause are particularly likely to have brittle nails (Chessa et al, 2019). 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.