06 Oct We Lose 30% of Our Collagen in the First 5 Years of Menopause. Here Is What to Do. with Dr. Alessandra Zonari
Have you ever looked in the mirror and thought, when did my skin start doing this?
Not just a new line or two. The whole feel of it. Thinner. Drier. Less bounce. Like it just stopped responding.
I’ve been there. In my 40s, I still felt like I was 30. Then my 50s hit and it felt like it happened overnight. I kept reaching for richer and richer creams, and nothing seemed to absorb or last the way it used to. If you’ve been told it’s “just aging,” or a friend has hinted that caring about your skin is shallow, I want you to hear this clearly: what you’re feeling is real, it’s biological, and it’s tied directly to menopause.
Here’s the number that stopped me in my tracks. In the first five years of menopause, women can lose about 30% of their collagen. We also lose hyaluronic acid and elastin, the very things that keep skin plump, firm, and hydrated.
That’s why I brought back Dr. Alessandra Zonari, a skin longevity scientist trained in tissue engineering and stem cell biology. She’s been studying human skin samples in the lab since she began her PhD in 2010, and the last time she joined me, we talked about senescent cells (those “zombie cells” that drive aging). This time we went much deeper into menopause skin specifically: what’s happening under the surface, why your old products stopped working, and what you can actually do about it.
Whether you’re team “no procedures ever” or you love your Botox appointments, this conversation isn’t about judging your choices. It’s about understanding your skin so every choice you make actually works.
Why Menopause Skin Feels Different Almost Overnight
Dr. Zonari hears the same story from women again and again. There’s a wake-up moment where skin suddenly feels drier, stops bouncing back, and stops reacting the way it used to. Many women assume they didn’t take good enough care of themselves.
That’s not what’s happening. Your skin is a structure with a barrier designed to hold in water. When menopause arrives, several structural changes happen at once, and your skin starts behaving differently. The process is accelerated by hormonal shifts, not caused by a personal failure.
The good news is that biology is malleable. Once you understand what’s changing, there are real ways to slow those changes and even rebuild some of what’s been lost.
Why So Many Women Are Blindsided
Dr. Zonari holds a biology degree and still doesn’t recall ever learning, in her 20s or 30s, that women go through such a major hormonal shift at midlife. She only became educated on it once she started researching it herself.
That gap in education is a big reason so many of us feel caught off guard. Menopause affects sleep, bone density, and skin, and when no one prepares us, we tend to accept decline instead of supporting our bodies through the change. Dr. Zonari sees it the opposite way: midlife can be one of the best seasons of our lives when we understand what our bodies need.
How Estrogen Protects Your Skin
We usually talk about estrogen in terms of fertility, but your skin cells have estrogen receptors too. When estrogen is plentiful, it binds to those receptors and helps skin produce collagen, elastin, and hyaluronic acid.
Dr. Zonari describes estrogen as a protective molecule for your skin. Your skin is your largest organ, and its main job is keeping a strong barrier so nothing harmful gets in. Estrogen helps it do that job.
When estrogen drops, two things happen:
- Production slows. Your skin makes less collagen, elastin, and hyaluronic acid.
- The barrier weakens. It starts leaking more water and becomes more vulnerable to irritants, which is why many women notice new redness, itchiness, and inflammation in midlife.
Hormone replacement therapy can help mitigate some of this, but Dr. Zonari points out that it isn’t the whole picture. With less of this protective hormone in your body, your skin needs more support from other places.
The Collagen Loss Numbers Nobody Warned Us About
After our 20s, we lose roughly 1% of our collagen per year. It’s gradual enough that we don’t notice it.
Then menopause hits, and in the first five years, that loss can accelerate to around 30%. As Dr. Zonari explains it, each of those years can represent about six years of collagen loss. After that initial drop, the decline continues at roughly 2% per year.
That’s why it feels sudden. It is sudden.
Other changes Dr. Zonari shared:
- Hyaluronic acid, the molecule that binds water in the skin, can decline by around 77% by age 75
- By around age 70, roughly half of the collagen and elastin scaffolding is gone
- Elastin fibers keep declining, which is part of why skin gets so thin later in life
- Older skin heals more slowly, so a small bruise that once took a few days can take far longer to recover
Dr. Zonari remembered her grandmother’s skin being so thin that a firm touch could bruise it. That’s what happens when the skin’s support structure isn’t supported.
The encouraging part? You can’t get your 20-year-old skin back, but you can slow that steep decline and even rebuild some collagen.
The Density Shift: What Scientists See Under the Microscope
When Dr. Zonari examines skin samples in the lab, one of the main things she measures is collagen density. Younger skin is packed with collagen. Older skin has noticeably less, and that density visibly drops at midlife. She calls this the density shift.
Her analogy is a sponge. A new, dense sponge holds a lot of water. A loose, worn-out sponge with big holes can’t hold much at all. Collagen provides the scaffold that keeps skin firm and helps it retain moisture, so when density drops, skin loses both structure and hydration.
Why Botox and Procedures Can’t Rebuild Thinning Skin
This one surprises people. Many cosmetic procedures help skin look younger without helping it function younger.
Botox is a good example. It relaxes the muscle, so a wrinkle softens. But it doesn’t tell your skin cells to produce more collagen, and it doesn’t strengthen or thicken your barrier. Dr. Zonari’s view is that if you love procedures, that’s your choice, but pair them with real support for your skin cells so the skin itself gets stronger.
I’ll share my personal experience here. I went through a season of using Botox on my forehead, and for my face, I didn’t like the result. It made me look older to myself, almost collapsed. I’d rather have the lines. That’s my choice, and yours might be different. The point is that thinning skin needs to be rebuilt from within no matter what else you do.
Why Richer Creams Stop Working on Menopausal Dry Skin
This was the big lightbulb moment for me.
When skin gets dry, most of us reach for something heavier. It feels great at first. Then by the next day, your skin is dry again, so you apply more.
Dr. Zonari explains why. Your skin is a smart organ with a feedback loop. When you constantly coat it with a heavy, occlusive layer (think petroleum-type products or excess oil used for long periods), your skin cells can read that as a signal that they don’t need to make their own moisturizing factors. Over time, the skin gets lazier and weaker instead of stronger.
Instead of smothering the skin, the goal is to give it the right building blocks, such as fatty acids, ceramides, and cholesterol, so it can keep building its own strong barrier.
Brick and Mortar: How Your Skin Holds Water
Dr. Zonari uses a simple picture. Think of your skin barrier as a brick wall. Your skin cells are the bricks, and the mortar between them is made of natural moisturizing factors your skin produces itself.
If you just fill the gaps with a heavy cream, you’re patching the wall without letting the cells make their own mortar. Once the cream wears off, the wall is still weak.
Your Skin Makes Its Own Moisturizer: Natural Moisturizing Factor
I had never heard of natural moisturizing factor until Dr. Zonari explained it, and I’m guessing many of you haven’t either.
Your skin cells produce small molecules, including amino acids, fatty acids, cholesterol, and ceramides, that keep the barrier hydrated and protected. When those factors are supported, hydration lasts. When they’re suppressed, you get that frustrating cycle where you moisturize and feel dry again a few hours later.
Long-lasting skin hydration comes from helping your skin produce its own moisture, not from covering it up.
Senescent Cells: The Zombie Cells Accelerating Skin Aging
Senescent cells are cells that have accumulated damage but don’t get cleared out. Instead of repairing or being eliminated, they linger and keep releasing inflammation. That’s why they’re nicknamed zombie cells.
In skin, much of that damage comes from UV exposure, which Dr. Zonari calls one of the top accelerators of skin aging. Some damage also builds up simply with time.
Here’s where menopause makes it worse. Once estrogen’s protection drops, the inflammation from these accumulated zombie cells has more room to spread. That inflammation breaks down collagen and weakens the skin barrier.
I think of it like cleaning a house while the trash keeps piling up. You can vacuum and spray all you want, but if the garbage isn’t removed, the house never feels clean. Your skin works the same way.
Dr. Zonari also explained that many senescent cells sit deep in the dermis, where fibroblasts (your collagen-making cells) turn into zombie fibroblasts. Lasers may stimulate the healthy cells, but in her view they don’t fully clear out those senescent ones, which means a root cause of skin breakdown can remain.
In her lab, Dr. Zonari found something striking: when healthy skin from a 30-year-old was built in the lab and loaded with senescent cells, it ended up resembling 80-year-old skin. That’s how powerful these cells are as drivers of aging.
Skin Biological Age vs Chronological Age
Your chronological age is your birthday. Your biological age reflects how your body, including your skin, is actually functioning.
Two people born the same year can have very different skin depending on sun exposure, smoking, stress, and other lifestyle factors. Dr. Zonari’s team measures skin biological age by reading the DNA of skin samples, and that research guided how they identified their own peptide. Her takeaway is hopeful: the gap between a 50-year-old whose skin is acting 60 can be narrowed with the right approach.
Sun Exposure in Midlife: Finding the Balance
I can’t believe sun has become controversial, but here we are.
I love the sun. We need it for vitamin D, mood, and circadian rhythm, and I get outside every day. I’m also living proof of what too much does. I spent years laying out with baby oil, and I have sunspots that no laser has been able to fully remove.
Dr. Zonari, who grew up in Brazil and loves the sun too, agrees that it’s about timing. Early morning and evening light offer benefits without the same burn risk. Midday sun with a high UV index, without protection, gives you mostly the damaging side. A sunburn is inflammation, and inflammation creates more of those zombie cells.
Her routine is similar to mine. She runs in the early morning with a hat and no sunscreen, wears SPF on her face during the day, and on outdoor weekends uses clothing, shade, and sunscreen while avoiding peak sun. I wear a wide-brim hat and a tinted mineral SPF on my face daily.
Peptides for Skin: How to Cut Through the Hype
Every brand seems to be claiming peptides right now. So what are they?
Peptides are small chains of amino acids, the building blocks of proteins. They act as signals, telling your body to do specific things like produce collagen or calm inflammation. Insulin and GLP-1 are peptides too.
But not every peptide can penetrate skin, and not every formula delivers them well. Dr. Zonari’s advice is to take ownership and do a little research before you buy:
- Does the brand name the specific peptide?
- Do they explain how it works?
- Do they share lab or clinical data?
If all you see is buzzwords and miracle promises, keep scrolling.
She also explained GHK-Cu (copper peptide), which delivers copper, a cofactor in collagen production. She considers it a good peptide that works, though she’s noticed in her lab that quality can vary by supplier. Her team’s peptide, OS-01, was developed for a different purpose: reducing the burden of senescent cells. According to Dr. Zonari, her team screened close to a thousand peptides over years of research before identifying it.
A Skincare Product Built for Menopausal Skin
OneSkin’s newest release is a rich face cream formulated specifically for menopausal skin and the density shift. Dr. Zonari describes it as dual delivery: fast relief for dryness plus ingredients meant to support collagen production, natural moisturizing factors, and reduce senescence.
She shared a behind-the-scenes story I loved. The first version went into a clinical study, and when the results weren’t there, they stopped the study midway and went back to the lab for months. According to the company’s lab findings on living human skin samples, the final formula increased collagen by 29%, hyaluronic acid by 77%, and filaggrin (a key barrier protein) by nearly 300%. In their reported clinical study, which included a basic rich-cream comparison group, participants saw improved hydration and smoother fine lines after six weeks.
I’ll be honest: when it arrived, I thought, oh, another cream. Then I put it on at night and it was still there the next morning. I texted their team right away. And on my body, switching to their body cream (once I finally got consistent) completely changed the crepey texture of my skin. It doesn’t erase brown spots, but the texture difference is real.
Dr. Zonari says the rich cream can be layered with retinoids, applied before or after depending on your routine, and recommends using it morning and night. If you only do one, don’t skip nighttime, because that’s when your cells do the most repair.
What Your Menopause Skincare Routine Actually Needs
Based on our conversation, here’s what to look for:
- Collagen, elastin, and hyaluronic acid support to address what estrogen loss is slowing down
- Barrier support with ingredients like ceramides, fatty acids, and cholesterol rather than heavy occlusives alone
- Cellular aging support that addresses senescent cells, not just the surface
- Smart sun habits that let you enjoy sunlight without accumulating damage
- Consistency with a few proven products instead of chasing every trend
On devices like red light therapy, Dr. Zonari sees real science behind it when used correctly and consistently with a quality source. But if you can only choose one thing, she’d choose topical care, because light can stimulate cells but doesn’t give them the building blocks they need.
Consistency Over Complexity
If there’s one message I want you to take from this episode, it’s that skin biology doesn’t change overnight. If something promises overnight change, be skeptical.
Just like strength training or changing how you eat, healthy skin is built through consistency. Dr. Zonari had extremely irritated, red skin about a decade ago, and she credits years of a simple, consistent routine for how her skin looks today.
Your skin isn’t vanity. It’s your largest organ, it protects everything inside you, and when it’s strong, you feel more confident showing up in your life.
Listen to the full episode with Dr. Alessandra Zonari to hear the whole conversation, and explore everything I use from OneSkin at oneskin.co/NatalieJill
The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.
