Menopause Skin Changes

Hormonal changes during perimenopause and menopause can affect skin thickness, hydration, elasticity, pigmentation, and facial volume. Research suggests women may lose approximately 30 percent of their skin collagen during the first five years of menopause.

At Cosmetic Laser Dermatology in San Diego, our board-certified dermatologists use injectables and laser, light, and energy devices to address these changes while maintaining natural results.

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What Treatment Can Achieve

Improve firmness and skin quality

Laser, light, and energy devices can enhance fibroblastic function and support hyaluronic acid, collagen, and elastic fiber production.

Restore facial volume

Fillers and biostimulators can address volume changes affecting the cheeks, temples, and facial contours.

Smooth texture

Improve crepey skin, fine lines, enlarged pores, and uneven texture.

Improve tone

Address brown spots, redness, melasma, and other menopause skin pigmentation changes.

Support hydration

Strengthen the skin barrier and improve dryness associated with hormonal changes.

Refine the jawline

Nonsurgical treatments can improve mild to moderate laxity affecting the lower face and neck.

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Treatments for Menopause Skin Changes

Skin changes during menopause often involve several layers of the face, so treatment may combine different approaches based on skin quality, laxity, pigmentation, and volume loss.

Sculptra® Aesthetic and Radiesse®

Sculptra and Radiesse are biostimulator injectables that support gradual tissue remodeling and can improve skin quality and structural support. Sabrina G. Fabi, MD, has participated in published research investigating poly-L-lactic acid and its effects on dermal and adipose tissue.

Ultherapy PRIME, XERF, Sofwave, and Thermage FLX

These nonsurgical technologies address skin laxity at different tissue depths using microfocused ultrasound or radiofrequency energy. By enhancing fibroblastic function, they can support hyaluronic acid, collagen, and elastic fiber production, which improves firmness and overall skin quality over time. Treatment selection depends on the patient’s anatomy, degree of laxity, treatment depth, and goals.

Fractional CO2 Laser Resurfacing

Fractional CO2 resurfacing can improve fine lines, texture, sun damage, and thin periorbital skin. Cosmetic Laser Dermatology offers advanced resurfacing technologies including Lumenis UltraPulse Alpha combined with Sciton Contour TRL , allowing treatment depth and intensity to be selected according to the skin and desired degree of correction.

IPL Photofacial with Lumenis M22 Stellar

Intense Pulsed Light (IPL) can address brown spots, redness, and uneven tone. Depending on the concern, our board-certified dermatologists may also consider technologies such as Clear + Brilliant Touch, 3DMIRACL, or other laser, light, and energy devices.

Skinvive and Hyaluronic Acid Fillers

Skinvive can improve skin smoothness and hydration, while the Juvéderm and Restylane® filler families may restore volume and structural support where facial contours have changed.

What Causes Skin Changes During Menopause?

Skin changes during menopause as a result of various hormones. Estrogen and oxytocin loss drives transepidermal water loss, and xerosis is among the most common complaints in postmenopausal women. Epidermal thinning and declining dermal collagen are well-documented consequences of estrogen loss, and the resulting loss of extracellular matrix accelerates the visible signs of aging.

Skin collagen content declines approximately 1–2% per year after menopause, with nearly a 30% reduction in the first 5 years. This is not just a cosmetic concern, as menopause alters the onset, course, and severity of multiple chronic skin diseases, most likely as a result of increasing cortisol levels, as well as a decrease in cutaneous inhibition of cortisol-releasing hormone receptor by oxytocin during this time. Progesterone drives sebum production and a decrease compounds skin dryness. Testosterone supports muscle tone and basic metabolic rate, and a decline can contribute to a lack of muscle tone and weight gain.

Estrogen supports the extracellular matrix, hyaluronic acid, collagen, and elastic fiber production, and dermal blood supply, so its decline reduces skin thickness and elasticity. Progesterone supports extracellular matrix formation and dermal water retention. Testosterone influences cutaneous blood supply and sebum production. When all three decline, skin can become drier, thinner, more prone to bruising, and slower to heal after treatment.

The structural picture extends below the skin. Subcutaneous fat redistributes, producing midface volume loss and early jowl formation, and the maxilla and mandible resorb by 10 to 15 percent, deepening tear troughs and softening the jawline.

What to Expect from Treatment for Menopause Skin Changes

Receive a Comprehensive Skin Assessment

Our board-certified dermatologist evaluates skin quality, pigmentation, laxity, volume changes, anatomy, and your treatment goals.

Start a Combination Treatment Plan

Treatment may combine injectables, skincare, and laser, light, and energy devices rather than relying on one procedure.

Coordinate Care with Your Physician

Systemic hormone replacement therapy should be discussed with and managed by your gynecologist or menopause specialist. Cosmetic Laser Dermatology focuses on aesthetic treatment of the resulting skin and facial changes.

Experience Comfort Focused Care

Cooling, topical anesthetic, or local anesthetic may be used when appropriate depending on the selected treatment.

See Progressive, Natural Results

Many regenerative and energy based treatments develop gradually as the skin responds over time. The goal is to make a meaningful improvement that continues to look natural.

Plan for Maintenance

Hormonal and age-related changes continue, so treatment may evolve over time. Follow up allows our dermatologists to reassess the skin and recommend appropriate next steps.

Why You’ll Love Us

Cosmetic Laser Dermatology combines physician expertise, clinical research, advanced technology, and comprehensive treatment planning rather than relying on a single device or injectable.

Leaders in Menopause Research

Dr. Fabi co-authored 2026 publications examining aesthetic treatment considerations and facial aging during perimenopause and menopause.

Leaders in Laser, Light, and Energy Research

Our physicians have researched numerous technologies used for resurfacing, pigmentation, skin tightening, and comprehensive rejuvenation.

Expertise in Biostimulation

Cosmetic Laser Dermatology has participated in clinical research involving biostimulators, injectables, and regenerative approaches that can inform treatment planning.

300+ Clinical Research Studies

The practice has participated in more than 300 clinical research studies, including FDA clinical trials evaluating aesthetic technologies and treatments.

Board-Certified Dermatologists

Our experienced physician team evaluates the entire face, including skin quality, volume, laxity, and underlying structure, to recommend treatments that support natural results.

Signature Combination Treatments

Take5, Take10, and Take10Eyes demonstrate Cosmetic Laser Dermatology’s expertise combining multiple laser, light, and energy devices.

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Our Renowned Dermatologists

We are proud to share that Dr. Goldman, Dr. Butterwick, Dr. Groff, Dr. Fabi, & Dr. Boen have once again been recognized as Castle Connolly Top Doctors in 2026!

Cosmetic Laser Dermatology has been voted Best Cosmetic Dermatology Practice in San Diego Magazine’s 2026 “Best of San Diego” readers’ poll!

Dr. William Groff was voted Best Cosmetic Dermatologist, Best Cosmetic Surgeon, and Best Dermatologist for 4 consecutive years by the San Diego Reader Best Poll.

Dr. Mitchel Goldman was voted #1 Cosmetic Dermatologist in America by Newsweek

Dr. William Groff was voted Best Cosmetic Dermatologist and Best Cosmetic Surgeon for 9 consecutive years by the San Diego U-T Best Readers Poll.

Drs. Goldman, Butterwick, and Fabi made the top 8 in Newsweek’s Best Cosmetic Dermatologists in America for the last two years in a row

Voted in the top 10% of Realself Doctors by achieving high patient satisfaction and getting favorable feedback on Q&A

Dr. William Groff was voted Best Dermatologist for 10 consecutive years and Best Cosmetic Surgeon for 9 consecutive years by the La Jolla Light Best Readers Poll.

Drs. Goldman, Butterwick, Groff, Fabi, and Boen were named Castle Connolly Top Doctors in 2025, making us one of the Top 3 Practices in California with the most Castle Connolly Top Doctors in Dermatology.

Dr. Boen has been recognized as a Top Doctor in 2023 and 2024 by San Diego County Medical Society.

Dr. Butterwick, is a distinguished facial cosmetic surgeon certified by the American Board of Facial
Cosmetic Surgery (ABFCS).

In 2026, Mitchel P. Goldman, MD, FAAD, received the Richard E. Fitzpatrick, MD Award from Masters of Aesthetics in recognition of his contributions to cosmetic dermatology and laser medicine. The honor reflects his longstanding leadership in research, physician education, and advancing aesthetic treatment.

Sabrina Fabi, MD has been named a finalist for Pioneer of the Year – Healthcare with San Diego Magazine’s Celebrating Women 2026

Mitchel P. Goldman, MD Board-Certified Dermatologist

Kimberly J. Butterwick, MD Board-Certified Dermatologist

Dr. William Groff Board-Certified Dermatologist

Sabrina G. Fabi, MD Board-Certified Dermatologist

Douglas C. Wu, MD, PhD Board-Certified Dermatologist

Monica Boen, MD Board-Certified Dermatologist

Raheel Zubair, MD Board-Certified Dermatologist

Kavita Darji Patel, MD Board-Certified Dermatologist

Leysin Fletcher, PA-C Physician Associate

Farzaneh Momeni-Salami, MA Medical Aesthetician

Meet the Team

Hear From Our Happy Patients

5/5 STARS

I trust Farzaneh Momeni completely with my skin. She is by far the best clinical aesthetician I’ve ever known. My skin has improved dramatically since I began monthly facials with her. Her treatments are 100% results-driven so if this is what you seek, look no further. Also, the entire Team at West Dermatology are top-notch. They’re always friendly, professional, & helpful, & greet everyone with a smile. 10 Stars all around!

My new regular cosmetic dermatology office. Dr Zubair is amazing and really patient with me. He has helped me over the last year with keloid scar removal, jaw Botox, and full facial acne scar treatment (ultra clear). The office is clean and the nursing/medical assistant staff is accommodating on all levels. I will always recommend this office and Dr Zubair to friends and family.

Most professional and most impressive! The service from the physicians to office staff is superb!

I live in Orange County and drove all the way out to see Dr. Wu because a friend of mine referred him (she had amazing results from her face and neck procedure). Dr. Wu is truly an artist! He made me feel extremely comfortable during my procedure. I was anxious when I got there, but he (and his staff) have such great energy and are so very kind and gentle that you can't help but feel at ease! The office was immaculate and they adhered to covid rules (sanitizing, temp checks, masks). This is my go-to place from now on and Dr. Wu is my go-to guy! Can't wait to see my final results! Thank you Phyllis (pre-op) for being so wonderful and informative! You were so very helpful and kind! I'll definitely be back!

Leysin and the entire team at Cosmetic Laser Dermatology are fantastic. They are professional, caring and communicative. The laser treatment was comfortable, efficient and effective! I highly recommend this practice. I definitely will come back and recommend her and Cosmetic Laser Dermatology to my family and friends.

Dr. Goldman is amazing! I came here for my permanent eyeliner removal (which is not offered anywhere near me), and they are completely removed in just one session. They use a special contact lens to protect your eyes from the laser, and there are no damages to my eyelashes. The healing was also nice and smooth. They have everything you need. I live almost 3 hours away, but it was totally worth the trip. For anyone who is looking to remove their permanent makeup, this is the right place to go :)-

Dr. Butterwick is fantastic, all of her team as well. They make sure your experience is pleasant and painless as possible. My tattoo removal and my injectables look amazing. I highly recommend her for any skin treatment.

Cosmetic Laser Dermatology was recommended to me by my dermatologist. He recommended Dr. Monica Boen. I'm so glad I took his recommendation. Everyone here at Cosmetic Laser Dermatology was super nice and friendly. Very welcoming. I came here for hair removal treatment. I did 4 sessions with Dr. Boen. Dr. Boen made me feel so comfortable and at ease when I talked to her. She explained everything before she did my treatment. I loved that. She was really easy to talk to. I definitely will come back and recommend her and Cosmetic Laser Dermatology to my family and friends.

This office is awesome. My visit today was with Dr. Groff. His bed side manner is so fun and welcoming. He understood my concerns and recommended a treatment plan that I feel was reasonable. I love his staff! They take there time to make sure you understand the treatment and after care. Everyone in the office, from the front desk to the nurses in the back, are so friendly and beautiful. They are very prompt and I trust my care with CLD. I can't wait for my next visit. See you guys in a few weeks!

"Dr. Sabrina Fabi is genius! Her technique is unlike anyone, her eye is precise, and her kindness and caring manner comes from the depth of her soul. She's simply brilliant! It's no wonder people travel the country just to be treated by her."

I wish I could give them 10 stars! I had such an awesome experience for my first visit and I am referring everyone I know to this office. From the super friendly staff to the state of the art procedures, they are the cream of the crop.

“I came to participate in a research study. All of the Doctors and staff at C.L. Dermatology are very professional, warm and friendly. All our my needs were anticipated and the hospitality of this office is like a five star hotel.”

Menopause Skin Changes FAQ

How does perimenopause affect my skin?

Perimenopause can accelerate visible changes in the skin as estrogen, progesterone, and testosterone fluctuate and decline. Research coauthored by Dr. Fabi shows that this transition can affect hydration, skin thickness, elasticity, facial volume, and recovery. At Cosmetic Laser Dermatology, our board-certified dermatologists evaluate these changes together rather than treating each concern in isolation.

Can skin changes start before my periods become irregular?

Yes. Skin changes can begin during perimenopause before menstrual changes become obvious because hormone levels may fluctuate for years before menopause. Research involving Dr. Fabi identifies this stage as an important period when changes in skin, facial fat, and underlying structure may already be developing. Earlier evaluation can help determine whether skincare, injectables, or other treatments may be appropriate.

Why is my skin suddenly so dry, itchy, or sensitive?

Declining hormone levels can reduce sebum production, water retention, and normal skin barrier function. As a result, skin may feel drier, tighter, itchier, or more reactive than it did previously. Our board-certified dermatologists can evaluate the skin barrier and recommend products that support hydration without unnecessarily increasing irritation.

Why am I getting acne again in my 40s or 50s?

Hormonal fluctuations during perimenopause can contribute to adult breakouts even as the skin becomes drier or more sensitive. This combination can make treatments that worked earlier in life feel too aggressive. Cosmetic Laser Dermatology can address acne while also considering changes in sensitivity, hydration, pigmentation, and overall skin quality.

Can menopause cause redness or make rosacea worse?

Hormonal changes may increase skin sensitivity and make existing redness more noticeable in some women. Menopausal skin may also become more vulnerable to environmental stress as barrier function changes. Our board-certified dermatologists can determine whether redness is related to rosacea, sun damage, sensitivity, or another concern before recommending appropriate treatment.

Why does my skin look thinner, crepey, or less firm?

Declining estrogen is associated with changes in skin thickness, elasticity, and structural support. Research reviewed by Dr. Fabi notes that women may lose approximately 30 percent of dermal collagen during the first five years of menopause, while elastic fibers and other components of the skin also change. When appropriate, laser, light, and energy devices can enhance fibroblastic function to support hyaluronic acid, collagen, and elastic fiber production and improve overall skin quality.

Why do my usual skincare products suddenly sting or stop working?

Changes in the skin barrier can make products that were once comfortable feel irritating during perimenopause and menopause. Retinoids, exfoliating acids, and other active ingredients may need to be used less frequently or at a different strength. Our board-certified dermatologist can help adjust your routine based on your current sensitivity, dryness, and treatment goals.

What should I change about my skincare routine during menopause?

A menopause skincare routine should prioritize hydration, barrier support, sun protection, and active ingredients that your skin can tolerate. Dr. Fabi’s research supports the use of moisturizers, antioxidants, retinoids when appropriate, and daily broad spectrum sunscreen for estrogen deficient skin. Because tolerance can change, products may need to be introduced more gradually or adjusted over time.

Where can I get personalized care for menopause related skin concerns in San Diego or La Jolla?

Cosmetic Laser Dermatology in San Diego provides comprehensive care for skin changes related to perimenopause and menopause. Sabrina G. Fabi, MD, FAAD has coauthored research on estrogen deficient skin, perimenopausal facial aging, and aesthetic treatment considerations during menopause. Our board-certified dermatologists combine this research experience with more than 60 laser, light, and energy devices, injectables, and advanced combination treatments to help patients achieve natural-looking results.