Symptoms

Itchy skin in menopause

The NHS lists dry and itchy skin among perimenopause and menopause symptoms, which can start while periods are still coming, and says itch after the menopause is common and usually eases over time. Use an emollient on dry or irritated skin, and see a GP if the itch is severe or comes with warning signs.

By Ines Kovac. Published 21 October 2026. 7 minute read.

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A white towel with an open jar of white cream, a small closed white jar, and a white lid on a pale surface.

Why skin changes in perimenopause and menopause

Lower oestrogen is linked with drier skin and with changes in the skin barrier. The British Skin Foundation states that collagen, the main protein that gives skin its support and structure, falls by about 2.1% a year after menopause, and that 30% of dermal collagen is lost in the first five years. The foundation gives both figures. It does not name a study on that page.

Hormonal changes in the menopausal transition can make skin thinner and drier, according to the National Institute on Aging. Loss of elastin and collagen contributes to skin that is more fragile.

NICE Clinical Knowledge Summaries list dry skin, also called xerosis, among the contributors to widespread itch, and they include menopause among the conditions linked with that dryness.

The British Menopause Society booklet Understanding Menopause includes dry or itchy skin on its symptom checker.

The US Office on Women's Health says menopause can affect hair and skin.

Dry skin in menopause

For itch tied to dry or irritated skin, the NHS says to use an unperfumed moisturiser or emollient regularly, to wash in cool or lukewarm water, and to avoid perfumed soaps and deodorants.

A separate NHS page on emollients says to apply them ideally at least three or four times a day. The best time is after washing, once the skin has been patted dry. If stinging carries on, or if hair follicles become inflamed, talk to a GP, a nurse or a pharmacist.

NICE Clinical Knowledge Summaries, in emollient notes written for eczema, suggest an ointment when skin is dry and not inflamed. Where soap is a problem, an emollient can stand in for it. Aqueous cream should not be a leave-on moisturiser, and it should not be a soap substitute.

Many older adults develop dry patches that may itch, often on the lower legs, the elbows or the lower arms (National Institute on Aging: skin care and aging).

Itch on the vulva has its own causes. NICE Clinical Knowledge Summaries name hormonal changes, especially atrophic changes in peri- and postmenopausal women. They also suggest an emollient instead of soap. The guide to vaginal dryness and local oestrogen explains the local options.

Formication: crawling or prickling skin

Formication in menopause is the name an NHS Tayside menopause policy uses for a sensation like insects crawling all over the skin. The national NHS symptoms page lists dry and itchy skin. That list does not use the word formication.

On assessment of widespread itch, NICE Clinical Knowledge Summaries say a feeling like insects crawling over the skin may be psychogenic and may suggest delusions of parasitosis. That line names no link with menopause. Describe the sensation to a GP in ordinary words, so other causes can be considered.

Intense itching, especially at night, with a raised rash, is how the NHS describes scabies. A severe itch with that rash is one cause to rule out.

Facial hair in menopause

Finer facial hair is a common change with age. The NHS hirsutism page says most women grow more hair on the face or body as they age, and that this new hair is lighter and finer, particularly after the menopause.

Hirsutism is the thicker, darker hair that grows in androgen-dependent areas. That page treats this pattern as a reason for a GP review.

NICE Clinical Knowledge Summaries say that in menopausal women, reduced oestrogen and progesterone can cause hair and skin changes, and that lower progesterone may increase androgen effects on sebaceous glands and hair follicles. For postmenopausal women, the options they name are cosmetic removal and eflornithine cream for facial hirsutism, not a combined oral contraceptive.

Thinning on the scalp is a separate change. The menopause symptoms page lists hair thinning or hair loss, and the HRT side-effect list includes hair loss with oestrogen and unusual hair growth with tibolone. That evidence is covered in HRT and hair loss.

What HRT does for skin

NICE guideline NG23 says to offer hormone replacement therapy for vasomotor symptoms, the hot flushes and night sweats. The same recommendations address genitourinary symptoms such as vaginal dryness. They do not offer systemic HRT as a treatment for general dry or itchy skin on the body.

The NHS list of HRT side effects includes itching or a mild rash with oestrogen, and itchy skin with a progestogen. Side effects can look like menopause symptoms, so the cause can be unclear. Try a preparation for at least three months, then speak to a GP if a problem is severe or does not settle.

Hormone replacement therapy for menopause explains what HRT is and the forms it comes in. How long HRT takes to work covers timing after you start. How to start HRT with your GP is for a first appointment.

People writing on forums describe crawling or prickling skin in these years, often at night. Some say the feeling eased after they started HRT or raised the dose. Others say it was unchanged after weeks on oestrogen and progesterone tablets, or that it continued after years on oestrogen. Those are personal reports. NHS and NICE guidance cited here does not report a trial of HRT for formication.

When to see a GP

The NHS says to see a GP if the itch affects your daily life, if it does not improve with self-care, if there is a worrying new rash, lump or swelling, if it is all over the body, if it is severe, or if you are pregnant.

Yellowing of the skin or the whites of the eyes is jaundice. The NHS treats it as urgent, because it can signal a serious illness such as liver disease. It may come with itchy skin, darker pee and paler poo. Get an urgent GP appointment or call NHS 111.

The skin care page linked above adds a direct prompt: see a doctor if skin is very dry and itchy.

Itch that is worse at night is not, by itself, set out as a menopause warning on the NHS pages above. The reason to be seen is the pattern with it: a raised rash, yellow skin, a severe or widespread itch, or thick dark hair in androgen-dependent areas.

Mark skin and hair on the menopause symptom checklist for your GP and take the sheet in. If the stage is unclear, the stage checker uses your age and the date of your last period. Joint aches, a racing heart and poor sleep sit alongside these skin changes on the symptoms page.

My take

I would start with the emollient routine above. If the itch gets in the way of ordinary tasks, spreads widely, or comes with a new rash or yellow skin, I would book a GP appointment and describe any crawling sensation in plain words.

For hormones, I would judge a prescription by the symptoms named above: hot flushes, night sweats and vaginal dryness. Itch can also be a side effect of oestrogen or a progestogen.