Many women notice changes in their skin during perimenopause—dryness, irritation, and even sudden itchiness that wasn’t an issue before. So what could be at play? The short answer: a lot. Thyroid health, dermatitis, weather, fabrics, and skincare products all play a role, but fluctuating estrogen levels are also a significant factor, especially for women in perimenopause.
I want to keep this focused, but it’s important to remember that nothing in the body works in isolation. I truly don’t want you to read this as us zeroing in on one thing while ignoring the bigger picture.
A key point before diving in: whenever I mention “high estrogen” or “low estrogen,” understand that context matters. High estrogen for someone who was at rock bottom could mean it’s finally detectable, while a pregnant woman’s estrogen levels are entirely different. Likewise, a decline in estrogen doesn’t have to mean a total crash—fluctuations alone can trigger symptoms, just ask a migraine sufferer. And when I say irritation, I mean exactly that—it doesn’t have to be a severe, blistering rash. Minor irritation is still irritation.
How Estrogen Affects Skin
Higher Estrogen Levels and Skin Sensitivity
Increased Sebum Production: High estrogen can boost oil production, which, aside from contributing to acne, may clog pores or trigger an immune response leading to irritation.
Histamine Release: Estrogen increases histamine levels, contributing to allergic reactions, hives, or general skin irritation. If this occurs in the context of hormone therapy, an initial response doesn’t mean you should abandon treatment.
Environmental Sensitivity: Higher estrogen may make skin more reactive to temperature, fabrics, and topical products. (More on this below.)
Lower Estrogen Levels and Dry, Itchy Skin
Reduced Moisture Retention: As estrogen declines, the skin’s ability to retain water decreases, leading to dryness and irritation.
Collagen Loss: Lower estrogen impacts collagen production, making the skin thinner and more prone to irritation.
The Role of Hormone Therapy
For some women in perimenopause, hormone therapy (HRT) can influence skin symptoms. The type of hormone, its delivery method (oral, transdermal, or injectable), and individual response all play a role. While some may find relief with consistent hormone levels, others may experience increased sensitivity due to fluctuations or histamine-related reactions. Also, if you still have your ovaries, you are producing hormones even while on HRT.
Additional Factors Influencing Skin Sensitivity
Add these to what your learned above!
Temperature Sensitivity
Estrogen affects blood flow, which can make skin more reactive to heat and cold.
Hot weather can trigger excessive sensitivity or itching due to increased vasodilation.
Cold environments can worsen dryness and irritation in estrogen-deprived skin.
Bonus: add temperature shifts on top of hormone fluctuations, and it’s a great time (sarcasm fully intended).
Fabric and Clothing Sensitivity
Dry, thin skin is more prone to irritation from rough or synthetic fabrics.
Low estrogen weakens the skin’s barrier, making it more reactive to clothing friction.
Skin Care Product Sensitivity
Changes in estrogen levels can alter skin pH and moisture balance, leading to increased reactions to previously well-tolerated products.
Estrogen-driven histamine release can amplify allergic responses to ingredients in lotions, fragrances, and cleansers.
Managing Itchy Skin During Perimenopause
Hydration & Moisturization: Use hydrating skincare and barrier-supporting ingredients. A personal favorite for those with sensitive skin:
La Roche-Posay Lipikar Baume AP+M (I live in the Arctic and have dry skin—this product is dermatologist-recommended, but your needs may differ.)
Antihistamines: If histamine sensitivity is a factor, antihistamines may help reduce itching.
Natural antihistamine herbs include:
Quercetin (found in apples, onions, and capers–I am not a caper girl, but if you are here is your full send moment).
Stinging Nettle
Bromelain.
Vitamin C (helps stabilize mast cells to reduce histamine release).
That said, I see zero wrong with using an antihistamine in the very short term if needed.
Clothing Adjustments: Opt for breathable, natural fabrics to minimize irritation.
Hormone Support: If using HRT, track your symptoms and discuss any changes with your provider. No need to panic.
Gut Health: You didn’t think I’d leave out digestive health, did you?
Stay on Top of Blood Work: Know where your health stands. Way more than estrogen can be in the mix
Estrogen fluctuations during perimenopause can impact skin moisture, sensitivity, and reactivity. Understanding how estrogen and histamine interact can help mitigate itchy skin through targeted skincare, lifestyle adjustments, and hormone management.
If you’re a coach looking to deepen your understanding of hormone health or a woman navigating Perimenopause and looking for real, actionable guidance, reach out. Mentorship, education, and professional consultation can make all the difference in reclaiming control of your health.
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