Skin Changes Around Perimenopause, and What Helps
Medically reviewed by
4 independent reviewers
Andrew Conrad Barile, PT, DPT
Doctor of Physical Therapy (DPT) | Licensed Physical Therapist (PT) | CEO and Founder, Xtreem Pulse LLC
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Dr. Andrew Conrad Barile is a Doctor of Physical Therapy and the CEO and Founder of Xtreem Pulse LLC, the engineering company behind PureLift. He earned his Doctorate in Physical Therapy from Daemen College and is a licensed physical therapist.
He brings over two decades of clinical and entrepreneurial experience across physical therapy, craniosacral therapy and medical device innovation, built on a working knowledge of human anatomy and muscle physiology.
For PureLift LAB he reviews how current is delivered across all ten levels, from sub-sensory nanocurrent and skin-level microcurrent to motor-level EMS, and how the Infuse pass fits into the same ten-minute routine.
Bertica M. Rubio, M.D.
Board-Certified Physician, Dartmouth Medical School | Medical Director, Antiaging Regenerative Medicine Clinic
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Dr. Bertica M. Rubio is a board-certified physician and Medical Director of the Antiaging Regenerative Medicine Clinic in Redlands, California. She earned her Doctor of Medicine from Dartmouth Medical School and completed her pediatrics residency at UC Irvine Medical Center.
With decades of clinical experience, she specialises in age management medicine, regenerative medicine, wound healing and growth factor therapies, and her practice integrates evidence-based medical science with advanced aesthetic treatment.
For PureLift LAB she reviews articles for medical accuracy across the whole dial, from the gentle nanocurrent and microcurrent settings through to muscle-level EMS and the Infuse pass.
Daniel Grinberg, MD, FACS
Board-Certified Otolaryngologist | Head and Neck Surgeon | Fellow, American College of Surgeons | Mount Sinai
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Daniel Grinberg, MD, FACS is a board-certified otolaryngologist and head and neck surgeon at ENT and Allergy Associates in West Nyack, New York. He earned his medical degree from Columbia University College of Physicians and Surgeons.
He completed his otolaryngology residency at New York University Medical Center, serves as Assistant Clinical Professor at Mount Sinai School of Medicine, and is a Fellow of both the American College of Surgeons and the American Academy of Otolaryngology.
For PureLift LAB he brings a wider clinical lens, connecting at-home facial stimulation from microcurrent to EMS to the anatomy underneath, with the same rigour we apply to every device specification.
Prof. Dr. med. Ivo Buschmann
Chair of Angiology, Medizinische Hochschule Brandenburg | Clinic Director, University Clinic for Angiology
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Prof. Dr. med. Ivo Buschmann is Chair of Angiology at the Medizinische Hochschule Brandenburg Theodor Fontane and Clinic Director of the University Clinic for Angiology at the Brandenburg University Hospital.
He trained at the University of Hamburg, was a Max Planck Society Fellow at the Max Planck Institute for Heart and Lung Research, and held senior consultant posts at the Charite Universitatsmedizin Berlin before his appointment as Chair in 2016.
One of Europe's leading authorities on arteriogenesis, with over 150 peer-reviewed publications and US and EU patents, he reviews for PureLift LAB how the evidence on electrical stimulation is read and where its limits lie.
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Skin collagen falls faster in the years around menopause than at any other point in adult life, which is why changes that felt gradual for a decade suddenly seem to accelerate.
This article walks through the routine step by step, such as:
- What changes in the skin
- What to change in the routine
- Where a device fits
- Using one on thinner skin
- What belongs with your doctor
and many more!
The hormonal side of the question belongs with a doctor; what follows is about the skin and the routine.
Key Points:
Skin often becomes drier and thinner, so products that suited oilier skin can stop suiting it.
The barrier is more easily disrupted, which means gentler exfoliation rather than stronger.
Muscle tone is the one part of the picture a home device addresses.
Retinoids still work and may need reintroducing more slowly than before.
Anything about hormone therapy is a conversation with your doctor, not with a device brand.
What changes in the skin
Collagen and elastin production fall, and the decline in the years around menopause is steeper than the roughly one percent a year of the decades before. Skin becomes thinner and loses some of its ability to spring back.
Oil production typically falls too, so skin that was comfortable with a light routine can become dry, and the barrier that oil helped maintain becomes easier to disrupt.
Hydration is harder to hold for the same reason, and the fine surface texture that follows dehydration scatters light, which reads as dullness.
Facial fat redistributes over the same period, and facial muscle loses tone as muscle does everywhere. All of that was happening before; the pace is what changes.
What to change in the routine
Move to a richer moisturiser than you needed before, and include a humectant with something occlusive over it. The face that needed a light gel at forty often needs a cream at fifty, and continuing with the gel out of habit is a common reason skin feels tight.
Exfoliate less, not more. A thinner barrier disrupts more easily, and the instinct to attack dullness with stronger acids usually makes the dullness worse.
Keep the retinoid. It still has the best evidence of anything over a counter for dermal collagen, and if it now stings, reintroduce it slowly, two nights a week, buffered with moisturiser, rather than abandoning it.
Extend everything below the jawline, since neck and chest skin is thinner still and ages faster.
Sun protection, which prevents more than any of the above reverses.
Where a device fits
Muscle tone, which is the one part of this picture within reach of electrical stimulation. Kavanagh and colleagues followed 108 women through 12 weeks of motor-level facial stimulation and measured an 18.6 percent increase in cheek muscle thickness (10.1111/jocd.12007).
Worth noting that the participants in that trial were women in the age range this article is about, which is unusual in a field where a great deal of research is done on younger people. Chang and colleagues ran a double-blind sham-controlled trial (10.3390/ijerph17113783).
Both are category studies rather than trials of a consumer device, and neither examined hormonal status as a variable.
What a device does not do is restore dermal collagen, replace redistributed volume, or affect anything hormonal.
Using one on thinner skin
Start lower than you might have previously. On PureLift, levels 1 and 2 are nanocurrent and microcurrent and do not contract anything, and there is no hurry to leave them.
Use more serum than feels necessary and reapply during the session, since drier skin dries out faster mid-session and a session that drags is a dry patch rather than a weak device.
Keep exfoliating acids and retinoids off the face during a session; a device distributes them far more thoroughly than they were formulated for, and a thinner barrier tolerates that badly.
Three minutes per side is the maximum on any PureLift model, and the ten minute session ends on its own.
What belongs with your doctor
Anything about hormone therapy, whether it is right for you, and what it might or might not do for your skin. That is a medical decision with a real evidence base and real considerations, and it is not ours to discuss.
Also anything that does not fit the pattern: sudden changes, itching that will not settle, new pigmentation, or hair loss.
A device is a reasonable addition to a routine during this period and it is not an answer to the underlying change.
For what each layer responds to, see the six layers of the face, and for laxity specifically, what skin laxity is.
This is general skincare information and not medical advice.