Hormonal changes in women above the age of 40 are a major factor influencing skin pigmentation, particularly during perimenopause and menopause, a skin health expert has said.

According to Eke Boss, fluctuations in key hormones significantly affect melanin production, skin structure, and how the skin responds to environmental factors such as ultraviolet (UV) radiation, often leading to visible pigmentation changes.

He explained that skin pigmentation is primarily determined by melanin, a pigment produced by melanocytes in the epidermis, and is influenced by genetic factors, hormonal activity, sun exposure, and inflammation.

“Hormonal imbalances can disrupt normal melanin production, leading to either hyperpigmentation or hypopigmentation,” he noted.

Boss identified estrogen as one of the most important hormones in maintaining skin health, explaining that it plays a protective and regulatory role.

“Estrogen helps maintain even skin tone, hydration, and barrier function. However, its decline after 40 leads to increased dryness, uneven pigmentation, and greater susceptibility to UV-induced skin damage,” he said.

He added that progesterone can also influence pigmentation, particularly when imbalanced, noting that it may contribute to conditions such as melasma.

On androgens, including testosterone, Boss said although present in lower levels in women, they can increase oil production, leading to acne and subsequent post-inflammatory hyperpigmentation (PIH).

He further explained that melanocyte-stimulating hormone (MSH) directly regulates melanin production, while cortisol, the body’s stress hormone, can worsen pigmentation by triggering inflammation and disrupting skin repair processes.

The expert identified common pigmentation disorders among women above 40 to include melasma, post-inflammatory hyperpigmentation, solar lentigines (commonly known as age spots), and perimenopausal hyperpigmentation.

“Melasma often presents as symmetrical brown or grey patches on the face and is commonly triggered by hormonal fluctuations, sun exposure, and hormone therapies,” he said.

He added that solar lentigines result from cumulative sun exposure, becoming more visible as hormonal protection declines with age.

Boss also highlighted menopause as a critical stage, noting that the sharp decline in estrogen levels leads to reduced collagen production, thinner skin, and slower repair processes.

“This makes uneven pigmentation more noticeable and existing skin conditions more pronounced,” he said.

He stressed that external factors such as sun exposure, certain skincare products, and medications like hormonal contraceptives and hormone replacement therapy (HRT) can further worsen pigmentation in hormonally sensitive skin.

On management, Boss emphasised that sun protection remains the most critical step.

“Daily use of broad-spectrum sunscreen with SPF 30 to 50, along with regular reapplication, is essential in preventing and managing pigmentation,” he advised.

He also recommended topical treatments such as hydroquinone, azelaic acid, retinoids, vitamin C, and kojic acid, alongside procedures like chemical peels and laser therapies, although he cautioned about the risk of irritation and rebound pigmentation, especially in darker skin tones.

Boss further advised that hormonal evaluation and lifestyle modifications, including stress management, a balanced diet, adequate hydration, and quality sleep, are essential components of long-term skin health.

He noted that managing pigmentation in women above 40 can be challenging due to high recurrence rates, increased skin sensitivity, and the need for consistent, long-term care.

“Effective management requires a holistic approach that combines sun protection, targeted treatments, hormonal evaluation, and lifestyle adjustments,” he said.

He concluded that with proper care and adherence to treatment, pigmentation can be controlled and overall skin health significantly improved.