Editor’s Note: In this fortnightly column, top doctors share how they deal with their own health challenges, offering readers expert insight grounded in experience. Read more such stories here .

I’ve been a dermatologist for more than two decades, guiding countless women through perimenopause and menopause. Most didn’t come to me asking about hot flashes or cycle changes — they came in confused about skin and hair changes they couldn’t explain.

Dry, dull skin and hair

Hair brittleness and shedding

Onset of female pattern hair loss

New or darkening hyperpigmentation on the face and body

Flares of eczema, itching, and dryness

And surprisingly, adult acne

They would ask, “Why am I looking older overnight?” and that became the opening for deeper conversations about perimenopause.

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