Taula de Continguts
- What happens to the skin when oestrogen falls
- Why an integrated approach rather than a single treatment
- Hormone treatment: where our work stops
- Daily care: sun protection and cosmeceuticals
- In-clinic treatments for skin firmness and quality
- How we work at Santé Madrid
- Realistic expectations and follow-up
- Frequently asked questions
After menopause, the drop in oestrogen tends to bring thinner, drier skin with less collagen, which is why many women notice it losing firmness within a few years. At Santé Madrid we approach that change in an integrated way: a medical consultation, a nutrition consultation, well-chosen daily care and, only if indicated, in-clinic treatments that work on skin quality and firmness. In this guide we explain what the scientific literature says about skin in menopause, which part of the plan belongs to each professional, what falls outside our work and how we organise the process at the clinic in Chamberí.
Key points
- Scientific reviews describe that, with oestrogen deficiency after menopause, skin becomes thinner, with less collagen, less elasticity and more dryness.
- An integrated approach combines a medical consultation, a nutrition consultation, daily care at home and, where appropriate, in-clinic treatments.
- Hormone treatment is a matter for your gynaecologist or your doctor: at Santé Madrid we do not prescribe it in this context.
- Sculptra, Radiesse, polynucleotides, skin boosters, Ultraformer MPT and INDIBA are options in the catalogue that the medical team assesses case by case.
- Results vary from skin to skin, and every treatment is carried out by the medical team after an assessment.
What happens to the skin when oestrogen falls
Oestrogens do more than regulate the menstrual cycle. A review published in Dermato-Endocrinology explains that they act on keratinocytes, fibroblasts, melanocytes, hair follicles and sebaceous glands, and that their deficiency after menopause is associated with thinner skin, with less collagen, less elasticity, more wrinkles, more dryness and reduced vascularity (Thornton, 2013).
Another review, focused on oestrogen-deficient skin, notes that one of the first symptoms women describe is increased dryness, followed by loss of firmness and elasticity. The same review cites studies according to which up to 30% of dermal collagen may be lost in the first five years after menopause (Rzepecki et al., 2019). These figures come from specific studies and every woman changes differently, but they help explain why the change can sometimes feel quite fast.
Sun-related ageing adds to this. Thornton's review points out that ultraviolet exposure sustains a low-grade inflammation that also damages the skin. So, in practice, the skin of a woman in menopause usually reflects the hormonal change, age and accumulated sun exposure all at once. If you would like a more general explanation of these mechanisms, you will find it in our article on menopause and skin ageing; here we focus on how the plan is organised.
Why an integrated approach rather than a single treatment
When the skin changes in menopause, it is tempting to look for a single treatment that solves everything. In practice, dryness, loss of firmness and a dull look have overlapping causes, and no procedure on its own acts on all of them. That is why we prefer to organise the plan in steps, with each professional working in their own field and with one plan that brings all the steps together.
This table summarises how the work is shared. Not every woman needs every step: the plan is adjusted to your skin, your medical history and what concerns you.
| Step | Who does it | What it is for |
|---|---|---|
| Aesthetic consultation | Beauty Coach | Listening to what concerns you, reviewing your routine and guiding the process |
| Medical consultation | Medical team | Reviewing your history, your medication and your skin, and deciding which treatments are indicated and which are not |
| Nutrition consultation | Nutrition professional | Reviewing your eating habits within a general health plan |
| Daily care | You, with guidance from the team | Sun protection, hydration and cosmeceuticals adapted to your skin |
| In-clinic treatments | Medical team | Working on skin firmness and quality, only if indicated |
The order matters. Starting with the assessment avoids choosing a treatment before knowing whether it suits you, and makes it possible to combine options sensibly instead of piling them up.
Hormone treatment: where our work stops
The reviews we cite analyse, among other things, the effect of hormone therapy on the skin. It is a relevant topic, but the decision to start, continue or change hormone treatment depends on your general health, your history and your symptoms, not only on your skin. That is why it is a matter for your gynaecologist or your doctor, who knows your full history.
At Santé Madrid we do not prescribe hormone treatment in this context, nor will we advise you to start or stop it. What we do is ask whether you are on it, because it is part of your medical history and may influence how we plan the rest. If you have questions about it, we will recommend that you discuss them with your gynaecologist.
In these cases, your doctor's assessment comes first. Once that is settled, we can pick up the skin plan with you.
Daily care: sun protection and cosmeceuticals
Care at home is the foundation of the plan and what works on your skin on most days of the week. The first step is daily sun protection. A review on sunscreens concludes that, beyond protecting against erythema, there is evidence that they help prevent photoageing, pigment changes and DNA damage (Guan et al., 2021). In skin that is already losing collagen because of the hormonal change, stopping the sun from adding more damage makes sense.
The second step is hydration. If dryness is one of the first changes you notice, a routine with gentle cleansing and consistent moisturising is usually more useful than piling up products. If you live in Madrid, you may notice it most in winter: in general, dry air and heating can leave the skin feeling tighter, and sun exposure can be intense for much of the year.
At the clinic we work with cosmeceuticals from SkinCeuticals, ZO, ASM and Biotricología. There is no single routine for everyone: the team suggests products according to your skin type, its sensitivity and the treatments you are going to have, and adjusts the routine over time. If any product irritates you, it is best to stop it and mention it before carrying on.
In-clinic treatments for skin firmness and quality
When daily care is not enough for what concerns you, the medical team may assess treatments from the Santé Madrid catalogue. We describe them cautiously and with the source for each mechanism; results vary from skin to skin.
Sculptra. It is an injectable made of poly-L-lactic acid. A review gathers studies according to which this material triggers a tissue response that stimulates fibroblasts, and describes type I collagen increasing gradually over the following months (Ao et al., 2024). That is why its effects are not judged on the same day. You will find more information on the Sculptra page.
Radiesse. It is made of calcium hydroxylapatite microspheres in a gel. A narrative review describes that, besides providing immediate volume, it may increase collagen, elastin and other components of the skin's matrix; it is a narrative review, not a clinical trial (Aguilera et al., 2023).
Polynucleotides. A systematic review found promising results for wrinkles, texture and elasticity, with side effects that were generally mild and transient, but based on few studies of low or moderate quality (Lampridou et al., 2025).
Skin boosters. A review defines them as injectables, often made of hyaluronic acid, designed to improve the condition of the dermis rather than to add volume, with benefits described for hydration and elasticity (Yi et al., 2024).
Ultraformer MPT and INDIBA. Ultraformer MPT is a HIFU device, using focused ultrasound. A systematic review on microfocused ultrasound, a technology of the same family, with studies only in women, concluded that it can tighten mildly to moderately lax facial skin (Contini et al., 2023). INDIBA is a radiofrequency that, according to the manufacturer, works deep in the tissue and activates fibroblasts, collagen and elastin (INDIBA, anti-ageing). Like any medical procedure, all of them can have side effects and there are situations in which they are not indicated; the medical team explains this before deciding.
How we work at Santé Madrid
Santé Clinics Madrid is at C. de Amador de los Ríos, 1, Chamberí, 28010 Madrid, close to Almagro and Colón. We are open Monday to Friday from 9:00 to 21:00 and on Saturdays from 10:00 to 15:00; the clinic is closed on Sundays.
The process usually starts with a free aesthetic consultation with a Beauty Coach, where we talk about what concerns you and about your routine. Then the medical consultation, which costs €50, is used to review your history, your medication, whether you are on hormone treatment prescribed by your doctor and the condition of your skin. With that information, the Santé Madrid medical team proposes a plan and explains which treatments make sense in your case, which do not and why.
If you would like to review your eating habits, the nutrition consultation costs €50 and fits into the same plan. We do not propose diets for the skin: if you are interested in a supplement, mention it and it will be assessed with you.
We make no promises about results. Results vary from skin to skin, which is why we prefer to explain calmly what you can expect before starting.
Realistic expectations and follow-up
Skin in menopause does not go back to how it was at thirty, and that is not the goal either. The reasonable aim is skin that feels more comfortable, is better hydrated and looks more cared for, at a pace that respects how your body responds. Treatments that stimulate collagen, like those described above, work progressively, and their effect is judged over months, not as you leave the clinic.
That is why follow-up is part of the plan. At the follow-up visits you agree with the team, we check how your skin is responding, whether you tolerate the home routine well and whether anything should change. Sometimes the answer is to add a treatment; at other times it is to keep what works and do nothing more for a while.
We also take the rest of your life into account. If your doctor changes your medication, if you start a new treatment or if you notice a different symptom, mention it at the next visit. The plan adapts to you, not the other way round.
Frequently asked questions
Why has my skin changed so much with menopause?
Scientific reviews describe that oestrogen deficiency is associated with thinner skin, with less collagen, less elasticity and more dryness. Age and accumulated sun exposure add to this. Every woman experiences it differently.
Do you prescribe hormone treatment at Santé Madrid?
No. Hormone treatment is a matter for your doctor or your gynaecologist. At Santé Madrid we do not prescribe it in this context, although we do ask whether you are on it because it is part of your medical history.
What does the integrated approach include?
A free aesthetic consultation with a Beauty Coach, a €50 medical consultation, a €50 nutrition consultation if you need it, a daily care routine and, only if indicated, in-clinic treatments.
Which treatments can help skin firmness?
Depending on your case, the medical team may consider Sculptra, Radiesse, polynucleotides, skin boosters, Ultraformer MPT or INDIBA. The choice is made after the assessment and results vary from skin to skin.
Which cosmeceuticals do you use?
We work with SkinCeuticals, ZO, ASM and Biotricología. The team chooses products according to your skin type, its sensitivity and the treatments you are going to have.
Does the nutrition consultation include collagen supplements?
The consultation reviews your eating habits within a general health plan. If you are interested in a supplement, mention it during the consultation and it will be assessed with you.
When do the effects of collagen-stimulating treatments show?
They usually work progressively, and their effect is judged over months. The team explains what to expect in your case and reviews your progress with you.
If you feel your skin has changed with menopause and you want an organised plan, a consultation at Santé Madrid is a good starting point. We will explain calmly which part of the change we can work on, which part belongs to your doctor and how to care for your skin at home.
