Skin & Hair Changes - Come Sit With Me | A Perimenopause Resource

Nobody warned you about the itching.

Skin changes during perimenopause are real, common, and often dismissed as cosmetic concerns—when they’re nothing of the sort. Living in skin that crawls, itches, or doesn’t feel like yours is maddening. And there’s a reason it’s happening.

There are estrogen receptors throughout your skin. When estrogen fluctuates, your skin notices.

The Itching (Formication)

Many perimenopausal women experience unexplained itching—sometimes described as crawling sensations under the skin, like ants walking on you. This has a name: formication (from the Latin formica, ant).

Why it happens:

Decreased estrogen affecting skin nerve endings—the signals get scrambled
Skin dryness from reduced oil production—dry skin itches
Thinning skin becoming more sensitive to everything
Histamine changes during hormonal fluctuations—some women become more reactive

The itching can be:

Generalized (all over) or localized (specific spots)
Worse at night—like so many perimenopause symptoms, it intensifies when you’re trying to rest
Maddening when you can’t identify a cause or find relief

You’re not imagining it. This is a real phenomenon with a real cause.

Dry Skin

Estrogen helps maintain skin moisture and oil production. As levels fluctuate:

Skin becomes drier, sometimes dramatically so
It may feel tight, uncomfortable, almost papery
It’s more prone to irritation and cracking
It heals more slowly when injured

Products that worked for decades may suddenly not be enough.

Skin Thinning

Collagen production decreases with declining estrogen. Studies suggest women lose approximately 30% of skin collagen in the first 5 years after menopause.

What this means:

Skin becomes thinner and more fragile
You bruise more easily—sometimes from things that wouldn’t have left a mark before
Wound healing slows
Elasticity decreases—skin doesn’t bounce back the way it used to

This isn’t vanity. Skin is your largest organ, and its integrity matters for protection, healing, and comfort.

Hair Changes

Hormonal shifts affect hair too—and not in ways anyone prepared you for:

Thinning on the scalp: Hair may become finer, or you may notice more hair loss than usual
Increased facial hair: As estrogen drops relative to androgens, some women notice more facial hair growth
Changed texture: Hair may become drier, coarser, or even curlier than it was
Slower growth: The hair cycle changes; growth may slow

What Might Help

For itching:

Gentle, fragrance-free moisturizers—fragrance is often an irritant
Avoiding hot showers (they strip what natural oils remain)
Colloidal oatmeal products—genuinely soothing for irritated skin
Antihistamines (if the itching has a histamine component)
Hormone therapy can help if symptoms are severe

For dryness:

Heavier moisturizers, especially at night—look for ceramides and hyaluronic acid
Layering: lighter products first, heavier ones on top
Humidifier in the bedroom
Gentle cleansers without sulfates (they’re too stripping now)

For skin health generally:

Sun protection becomes even more important as skin thins
Retinoids can help with collagen production (but start slowly—skin is more sensitive now)
Vitamin C serums for antioxidant support
Adequate hydration—from the inside

For hair:

Gentle handling—hair is more fragile
Check iron, vitamin D, and thyroid levels (deficiencies can contribute)
Consider whether hair products have become too harsh
Dermatologist consultation if loss is significant

When It’s Not “Just” Perimenopause

Some skin symptoms warrant medical evaluation:

Rashes that don’t resolve
New or changing moles
Severe or localized itching (could indicate other conditions)
Signs of infection
Significant, sudden hair loss

Dermatologists increasingly recognize the connection between hormones and skin. If your provider dismisses your concerns, seek another opinion. This is a recognized phenomenon, not imagination.

The Invisibility Problem

Skin symptoms often get dismissed because they seem “superficial”—not as dramatic as hot flashes or mood changes. But living in skin that constantly itches, feels wrong, or doesn’t look or feel like “you” takes a real toll on quality of life and sense of self.

Your experience is valid. This is a real physiological change, connected to the same hormonal shifts driving all your other symptoms. It’s not vanity to want comfort in your own skin.

And like many perimenopause symptoms, it often improves as hormones stabilize—or with appropriate intervention. You don’t have to just endure this.