A note before we dive in: Yes, I had a facelift in 2025. I want to be upfront about that because I always am. But a facelift stretches skin, it does not change your collagen, your texture, your dryness, or your skin's ability to hold moisture. Everything I'm sharing here I started seven months before the surgery and I'm still doing it after. So… we good? Cool. Let's talk about your skin.
If you've been layering serums, rotating through every product a dermatologist or influencer ever recommended, and your skin still feels dry, thin, and like it belongs to someone older than you… you are not doing it wrong.
You're just following a skincare routine that was designed for a version of your body that no longer exists.
After 40 (and especially once you hit perimenopause or menopause) your skin is a completely different organ. The menopause skincare routine that actually works isn't about more products. It's about understanding what changed biologically and addressing that directly. Once I figured this out, I threw out half my bathroom cabinet and my skin started actually improving for the first time in years.
Three steps. That's it. Let me show you exactly what they are and why they work.
The Real Reason Your Skincare Stopped Working
I'll be honest with you. There was a point where I was doing a 12-step routine. Layering products from every expert I'd ever interviewed. And at one particularly low moment… I spent $700 on a face cream. Seven. Hundred. Dollars. Because someone convinced me it would save me from ever needing Botox.
I was like a crocodile in a robe, slathering on miracle creams that were doing absolutely nothing. And I couldn't figure out why.
Here's what nobody told me: the products weren't the problem. The problem was that I was treating the paint while the foundation of the house was crumbling.
Once estrogen starts to decline (and it can drop as much as 90% during perimenopause) your fibroblasts, the living cells inside your skin that manufacture collagen, stop getting the signal they need to do their job. No estrogen signal means no collagen production. No collagen means thinner skin, more dryness, less elasticity, and a compromised barrier that reacts to everything.
So no matter how beautiful or expensive the products you're putting on top… if you haven't addressed the foundation, you're painting a crumbling house.
Most women lose up to 30% of collagen production in the first five years of hormone decline. That's not a gradual drift. That's your skin becoming a completely different organ in a very short window of time. And it's why the routine that worked at 35 doesn't work now.
Once I understood that, I stopped chasing products and started asking a different question: what actually rebuilds the foundation?
The answer turned out to be three things.
The 3 Things Your Menopause Skincare Routine Actually Needs to Fix
Before I tell you what the three steps are, I want to give you the filter I now use for every product decision. Because once you have this, you'll be able to look at anything on your counter and ask: does this actually address one of these three things on a foundational level? If not… it's probably unnecessary.
The three things your skin needs to address right now:
- Skin thickness (rebuilding the dermis)
- Collagen production and cellular turnover
- Skin barrier repair and protection
That's it. Not hydration as a surface fix, or brightening, or tightening. Foundation first. Everything else is paint.
Now let's go through each step.
Step 1: A Gentle Cleanser That Protects Your Barrier (Not Strips It)
This one took me a while to accept because I used to think that tight, squeaky-clean feeling after washing meant my cleanser was doing its job.
It wasn't. That tightness is damage.
When your skin's barrier is already compromised from hormone decline (and it is, for most of us in midlife) a harsh cleanser is like pressure washing a house that's already got cracks in the foundation. You're making the problem worse every morning and night without realizing it.
What you need in a midlife cleanser:
- Zero fragrance
- pH as close to your skin's natural balance as possible
- No harsh stripping ingredients
- Ideally formulated to actively protect and support the barrier
When you're done washing your face, your skin should feel soft and normal. Not tight or squeaky. Just… calm.
This sounds simple but it rules out most popular cleansers immediately. If yours leaves your face feeling tight, swap it out before anything else. You're undermining every other step in your routine.
Step 2: The Two Actives That Actually Rebuild Your Skin (Alternated, Not Stacked)
This is where everything changes. And this is also where I need to be real with you: both of these actives require a prescription. I know that sounds like a lot. It's genuinely not. I'll tell you exactly how I get mine and how affordable they actually are.
Here's the approach: you alternate these two actives. Night A, one of them. Night B, the other. You do not use both on the same night. Stacking actives on midlife skin is like doing every muscle group in one workout. Your skin needs time to recover and rebuild between sessions. Overload it and it stays inflamed, which means zero progress.
Night A: Tretinoin
Tretinoin, you've probably heard it called Retin-A, has 40 years of clinical research behind it. It's the gold standard active for a reason.
What it actually does:
- Signals your skin to increase collagen production
- Speeds up cellular turnover so you're generating new, healthier skin cells
- Thickens the dermis over time
- Helps your skin hold moisture
It's strong. Start with less than a pea-size amount, and I mean that — start with half a pea. Your skin may get red or peel a little at first, especially if you've never used it. That's cellular turnover happening. It's not a bad sign. But you can blow up your skin if you go too hard too fast, so resist the urge to overdo it.
Mine costs less than $25 a month. I use it every other night so a small tube lasts a long time.
Night B: Estriol Cream
This is the piece most midlife women are missing entirely, and it's the one that made the biggest difference for me personally.
Remember how I said estrogen is what signals your fibroblasts to produce collagen? Estriol is the weakest and most topically targeted form of estrogen, and applying it directly to your skin essentially restores some of that signaling that got lost when your hormone levels dropped. It tells your skin: hey, make collagen again.
I know what you're thinking. Estrogen… on my face?
Yes. And it's not new. Doctors have been doing this for decades. The research that exists isn't as common as the research on tretinoin, but it's genuinely promising. Studies have shown decreases in wrinkle depth, improvements in elasticity and firmness, and better hydration in the face and neck. The formula I use is 0.3% estriol combined with DMAE and hyaluronic acid. Those three ingredients together are specifically targeted at rebuilding the skin's collagen signaling system.
A three-month supply runs about $150, but because I alternate it every other night, that same supply lasts me six months. So we're talking roughly $25 a month for a prescription-strength hormone cream that's actively rebuilding my skin's foundation.
Two things worth knowing before you start: estriol does require a prescription because it's a hormone, not a cosmetic. And if you're a breast cancer survivor or at elevated risk for estrogen-positive breast cancer, this is a conversation to have carefully with your doctor before proceeding.
How I get both prescriptions without fighting my regular doctor for them: MIDI Health. All of their clinicians are trained specifically in menopausal care, so they already know about estriol, they know the research, and they don't need you to come in with a stack of studies to convince them. They're in all 50 states, they accept most insurance, and you can book an Age Well appointment that covers your hormone panels and all the labs your regular doctor keeps telling you aren't necessary. That's actually how I started using MIDI… because I needed someone who wouldn't look at me blankly when I asked about estriol face cream.
What About Red Light Therapy?
While we're talking about rebuilding skin thickness and collagen, I want to mention one device that I use and that the research actually supports: red light therapy.
I've interviewed a lot of dermatologists and plastic surgeons on The Chalene Show, and the ones I trust most are the skeptics — the ones who won't endorse something unless the science is there. When I asked about red light devices specifically, the answer was consistent: they work, but the technology and quality of the device matters enormously.
The one I use is the iRestore Elite. I originally got it for hair regrowth — and I am seeing regrowth — but the skin benefits are real too. Red light at the right wavelength has clinical evidence behind it for increasing dermal thickness and supporting collagen. I use it at least three times a week while I'm doing my makeup, took about three days to build the habit, and now it's just part of the routine.
If you've been thinking about it, use code CHALENE for a discount. And before you buy anything in this category, look up the peer-reviewed research on red light therapy for skin — there's more of it than most people realize.
Step 3: The Barrier Cream Dermatologists Keep Recommending (It Costs $12)
After you apply your active for the night, you seal everything in with a barrier cream. Every single night, no exceptions.
I need to tell you how I found out about this one, because it's a whole thing.
After my facelift, I made the mistake of going back to tretinoin way too soon. My skin completely freaked out. I developed contact dermatitis — my face was red, hot, swollen, painful. I was calling every doctor I knew on a weekend in full panic mode convinced I had destroyed my facelift.
Every single one of them said the same thing.
That's it. Not some proprietary post-surgery miracle product. Not something that costs $200. Vanicream. Twelve dollars at the drugstore. The dermatologists, the plastic surgeon, the NP, the hormone clinician… all of them. Same answer.
It's fragrance-free, formulated to repair the skin barrier rather than just sit on top of it, and gentle enough that even a post-surgery face in full revolt will tolerate it. Once your barrier is intact and healthy, your actives work better, your skin holds moisture, and you stop reacting to everything in your environment.
Slather it on every night after your active. Don't skip this step. It's the most boring and most important part of the whole routine.
Why Your 10-Step Routine May Actually Be Making Things Worse
I know it feels counterintuitive. More products feels like more effort, more care, more results.
But here's what actually happens when you stack too many actives and too many products on midlife skin: you keep it in a constant state of low-grade irritation. And skin that's busy trying to calm down and heal itself cannot simultaneously rebuild. You're blocking the very process you're trying to trigger.
More is not better here. Consistent is better. Targeted is better. Three steps that address the actual foundation is better than twelve steps that address the symptom.
The women I know with the most beautiful skin in their 70s and 80s? When you ask them what they use, the answer is almost always three products. Three simple, consistent products. Every time.
What This Routine Actually Costs (Because the Math Will Surprise You)
- Gentle cleanser: varies, roughly $20-30 a month
- Tretinoin: less than $25 a month
- Estriol cream: approximately $25 a month the way I use it
- Vanicream: $12, lasts months
You're looking at roughly $80-90 a month for a prescription-strength, clinically supported, foundation-rebuilding routine. I spent more than that on one serum I used for six months that did nothing.
And for collagen support from the inside, I add Organifi collagen to my morning coffee daily. Flavorless, dissolves completely, and use code CHALENE for 20% off. Topical plus ingestible collagen support together is where I've seen the biggest cumulative difference.
The Bottom Line
Your skin didn't fail you. The advice did.
Once estrogen declines, your skin needs a different strategy. Not more products. The right products, targeting the right problems, at the foundation level.
The menopause skincare routine that actually rebuilds your skin:
- A gentle, barrier-protecting cleanser
- Two prescription actives alternated nightly: tretinoin and estriol cream
- Vanicream barrier cream every single night
Start with your cleanser and Vanicream if you're not ready to tackle the prescriptions yet. Get comfortable with the routine. Then book a consult at MIDI Health and ask about tretinoin and estriol. The clinicians there know exactly what you're talking about and they're ready to help.
Your skin can get better. Not back to 30 — better than that. Better in a way that makes sense for the body you actually have right now.
Love you, mean it. Chalene
P.S. Some links in this post are affiliate links with brands I personally use and trust. You may get a discount and I may earn a commission. When in doubt, code CHALENE works at checkout.
