Abstract:
Perimenopause is a multiyear hormonal transition during which fluctuating estrogen and progesterone levels begin altering skin, hair, and mucosal physiology well before menopause. Dermatologic changes often precede systemic symptoms, making dermatologists uniquely positioned to identify early hormonal shifts. However, perimenopause remains under-recognized in routine skin assessments despite being the period when patients first present with new or worsening concerns.

This session will review the cutaneous effects of reduced estrogenic signaling—including impaired barrier function, increased sensitivity, pigment dysregulation, rosacea flares, jawline-predominant acne, early volume loss, and androgen-related hair thinning. Practical guidance will be provided for incorporating perimenopausal screening into dermatologic history-taking and initiating evidence-based management strategies such as barrier-repair skincare, retinoid adjustment, pigment stabilization, biostimulatory procedures, and structured approaches to female-pattern hair loss. Considerations for when to discuss hormonal therapy and coordinate interdisciplinary care will also be outlined.

By adopting a proactive, hormone-informed framework, dermatologists can improve outcomes, enhance patient satisfaction, and support women navigating a defining stage of midlife.

Dr. Mary Alice Mina is a Harvard-trained, double board-certified dermatologist and dermatologic surgeon with more than 15 years of experience. She is the founder and voice behind The Skin Real, where she focuses on practical, evidence-based skincare and cutting through myths in the beauty industry. Based in Atlanta, Georgia, Dr. Mina specializes in medical, cosmetic, and surgical dermatology and is widely known for her clear, science-driven approach to skin health education.