Background: Female skin aging is not a linear process. Beyond chronological aging, the menopausal transition represents a distinct biological rupture. While postmenopausal skin changes are well documented, the perimenopausal period - the first phase of hormonal instability - remains poorly characterized in vivo. This study investigates the biometric skin alterations across the menopausal timeline, with particular emphasis on perimenopause vs early menopause.

Methods: A total of 121 healthy Caucasian women aged 30–65 years were stratified into four groups: premenopause (n=30, 30–40 years), perimenopause (n=30, 45–55 years), early menopause (≤5 years since menopause; n=30, 45–55 years), and late menopause (>5 years since menopause; n=31, 60–65 years). Non-invasive facial assessments included sebum production, transepidermal water loss (TEWL), stratum corneum hydration, mechanical skin properties, and standardized facial imaging. Statistical analyses were performed using parametric or non-parametric tests (p ≤ 0.05).