Whether we realize it or not, hormones influence our skin. “Hormones play an enormous role in how our skin looks and behaves, and often the skin is the first place we notice changes,” says New York dermatologist Marina Peredo, MD. She notes that skin can reflect what’s happening inside our bodies, so we shouldn’t ignore notable changes. “Beautiful skin starts with healthy skin. Sometimes the best treatment is understanding what your body is trying to tell you.”
While it’s worth scheduling an appointment with a dermatologist when you notice new or persistent changes, there’s no need to panic. “I always remind my patients that not every skin change means there’s a hormonal imbalance. Sometimes these changes are simply part of the natural aging process,” says Dr. Peredo.
We asked the experts which skin changes could signal a hormonal shift, whether related to a health condition, menopause, medication or something else.
Featured experts
- Marina Peredo, MD is a board-certified dermatologist in New York
- Joel Schlessinger, MD and Daniel Schlessinger, MD are board-certified dermatologists in Omaha, NE
- Janine Hopkins, MD is a board-certified dermatologist in Southlake, TX
Acne along the chin and jawline
“Acne along the chin and jawline is one of the most common signs of hormonal imbalance,” says Dr. Peredo. “Chin acne in adult women is almost always hormonal,” Miami dermatologist Dr. Deborah Longwill previously told us. “Fluctuations around your cycle, elevated androgens, stress and even dietary triggers like dairy and high-glycemic foods all show up in this specific zone.” However, acne in this area doesn’t necessarily mean your hormone levels are abnormal. Normal shifts can trigger it, too. I started breaking out along my jawline after coming off oral contraceptives. Depending on the severity, Dr. Peredo says she may recommend topical retinoids, azelaic acid, oral antibiotics or spironolactone.
Dryness, thinning skin and loss of elasticity
Omaha, NE dermatologist Daniel Schlessinger, MD says perimenopause and menopause can bring on dryness and changes in skin texture and firmness. Dr. Peredo explains that declining estrogen levels can contribute to these changes. In these patients, Dr. Peredo tends to “focus on restoring the skin barrier with ceramides and hyaluronic acid, along with retinoids and collagen-stimulating treatments to improve skin quality.”
Southlake, TX dermatologist Janine Hopkins, MD recently met with a 56-year-old woman concerned about dryness, crepiness and increased wrinkling that had worsened over the past year. “When I asked about menopause symptoms, she reported several and shared that she had stopped hormone replacement therapy (HRT) a year and a half earlier. Her skin changes were consistent with declining estrogen levels.” As a dermatologist with expertise in HRT, Dr. Hopkins included systemic HRT and a targeted skin-care regimen in the patient’s treatment plan before moving forward with laser skin rejuvenation. Systemic HRT isn’t recommended solely to treat skin aging; the decision to use it depends on menopause symptoms, medical history and individual benefits and risks.
Hair thinning or increased facial hair
Thinning hair or increased facial hair can also be clues to hormonal changes and may require more targeted treatments, says Dr. Peredo.
Melasma and pigmentation
Dr. Peredo says hormonal fluctuations can trigger changes in pigmentation. To address these changes, “Sun protection is essential, along with carefully selected brightening ingredients and targeted in-office treatments,” she says.
When to see a doctor
Dr. Hopkins says it’s important to look beyond the immediate skin complaint. “Sometimes what a patient notices in the mirror is the first clue to an underlying health condition.” According to Omaha, NE dermatologist Joel Schlessinger, MD, “If something is bothering you or isn’t improving, that is enough reason to see a dermatologist. What barely troubles one patient may significantly affect another, and we take that seriously.”
When skin changes are accompanied by other symptoms suggesting a hormonal disorder, such as irregular menstrual cycles, unexplained weight changes, excessive facial hair or persistent fatigue, Dr. Peredo recommends seeing an endocrinologist, who can evaluate for conditions involving the thyroid, insulin resistance or excess androgen production.
For example, “sudden adult acne, especially when accompanied by irregular periods, facial hair growth or scalp hair loss, deserves further evaluation. These can sometimes be signs of elevated androgens or polycystic ovary syndrome (PCOS),” says Dr. Peredo. Dr. Hopkins recently saw a patient with some of these complaints, which prompted her to recommend a hormonal workup, pelvic ultrasound and referral to a gynecologist, along with appropriate topical and systemic treatment for the skin concerns.
“Changes that develop quickly, particularly a deepening voice or rapidly increasing facial hair, should be evaluated promptly,” says Dr. Daniel Schlessinger. “Not everyone needs an endocrinologist or an extensive hormone panel, but they do need someone to look at the whole picture.”
