Cosmetic Dermatology in Menopause

Yakir S. Levin, MD, PhD


Menopause. 2022;29(3):344-350. 

In This Article

Abstract and Introduction


Skin changes that accompany aging lead many to seek treatments that restore a more youthful appearance. Common issues of concern include skin tone, wrinkles, skin thinning, sagging, laxity and decreased elasticity, and hollowing of the face. This work discusses these concerns and their anatomic bases and highlights evidence for a causal role played by menopause-associated hormonal changes where such evidence exists. In addition, treatment options are discussed, with an emphasis on minimally invasive approaches. A variety of modalities are discussed, including botulinum toxins, fillers, multiple types of lasers, radiofrequency devices, focused ultrasound, chemical peels, and thread lifts. These interventions, often in combination, can achieve goals of patients seeking aesthetic rejuvenation.


Skin changes that accompany aging lead many to seek treatments that restore a more youthful appearance. The aging process is often divided into intrinsic aging and extrinsic aging, where intrinsic aging progresses with chronological age and is independent of external factors. Extrinsic aging is associated with environmental causes, including smoking and other toxins, but primarily long-term exposure to ultraviolet light.

There is evidence that menopause, characterized by a decrease in ovarian synthesis of estradiol and progesterone, plays a role in intrinsic skin aging.[1,2] The evidence derives from studies of skin function, content, and thickness that have been performed on postmenopausal women using systemic or topical hormone therapy (HT), as well as in mouse models of menopause.

This works endeavors to summarize many of the cosmetic concerns faced by women during and after menopause, as well as available treatment options. The focus is on facial cosmetic issues, and emphasis is placed on minimally invasive treatment options. However, many of the concerns and treatment options are relevant off-the-face as well. Changes that occur in the skin and subcutaneous tissues, whether due to extrinsic or intrinsic causes, are discussed. Evidence for a causal role of menopause-associated hormonal changes is presented where such evidence is available. Common conditions for which postmenopausal women may seek cosmetic treatment are then addressed; treatment approaches are summarized, with a focus on noninvasive and minimally invasive options.