The Cutaneous Connection: Skin Changes, Hormones, and the Menopause Conversation in Aesthetics

Welcome back to the Cutaneous Connection!

In this episode, Doris Day, MD, FAAD, a board-certified dermatologist in New York City with more than 25 years of clinical experience, discussed the evolving role of dermatologists in addressing skin health during perimenopause and menopause and emphasized the importance of integrating hormonal health into aesthetic care. Day, whose practice focuses on longevity aesthetics, highlighted that many women seeking cosmetic dermatology treatments in their late 30s and 40s are often experiencing early manifestations of perimenopause, even if they initially attribute their concerns solely to aging.

According to Day, common dermatologic complaints during this transitional life stage include sudden skin dryness, pruritus, acne flares, and hair thinning. Patients frequently report that their “skin suddenly fell apart,” prompting aesthetic consultations. However, when clinicians explore additional symptoms—such as irregular menstrual cycles, sleep disruption, irritability, hot flashes, and joint discomfort—a broader clinical picture often emerges that is consistent with perimenopause. Day noted that dermatologists are sometimes the first clinicians to identify these patterns, positioning them to guide patients toward appropriate multidisciplinary care while simultaneously addressing cutaneous concerns.

Day also reviewed findings from a recent menopause survey supported by Galderma and presented at the IMCAS World Congress. Nearly half of surveyed women (47%) reported interest in anti-wrinkle treatments to manage menopause-related changes, followed by hyaluronic acid fillers (40%) and skin quality treatments (39%), while 30% expressed interest in biostimulatory injectables. Notably, only 26% of respondents reported using aesthetic treatments preventively, and more than 60% indicated they would have approached skin aging differently had they understood menopause-related changes earlier.

Day believes that dermatologists should feel comfortable incorporating discussions about hormonal health into consultations. While collaboration with specialists such as OB-GYNs and primary care physicians remains essential, she emphasized that basic menopause hormone therapy is not overly complex and could reasonably be managed by physicians familiar with systemic treatments. Addressing menopause from both systemic and dermatologic perspectives, she said, can significantly improve patient outcomes.

From an aesthetic standpoint, Day advocates a balanced, multimodal approach combining bio-stimulatory injectables, hyaluronic acid fillers, neuromodulators, devices, and topical skin care. Such strategies aim to preserve collagen, maintain facial contours, and support skin quality without overcorrection. She also underscored the importance of patient psychology, encouraging clinicians to begin consultations by highlighting patients’ strengths and natural features rather than focusing exclusively on perceived flaws.

Looking ahead, Day noted that the growing use of GLP-1 medications for weight management may further shape aesthetic care for midlife patients. Early interventions, including collagen-stimulating treatments, may help preserve facial balance as patients lose weight. Ultimately, she emphasized that menopause represents not only a physiologic transition but also an opportunity for dermatologists to support patients’ long-term health, confidence, and quality of life.

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