Menopause marks a significant physiological transition in a woman’s life, characterized by the cessation of ovarian function and a sharp decline in estrogen levels. This hormonal shift has profound effects on the skin, contributing to visible and functional changes that impact both appearance and quality of life. Estrogen plays a crucial role in maintaining skin integrity by regulating collagen synthesis, elasticity, hydration, pigmentation, and barrier function. Its decline leads to a range of dermatological concerns, including xerosis, thinning, increased wrinkling, impaired wound healing, and heightened sensitivity. Additionally, hormonal imbalance during menopause contributes to conditions such as acne, hirsutism, and female pattern hair loss, and the genitourinary syndrome of menopause (GSM). Understanding these changes is essential for comprehensive care. Management strategies include general lifestyle modifications, targeted dermatological treatments and in some cases, hormone replacement therapy (HRT). This chapter explores the multifaceted impact of menopause on the skin and offers evidence-based guidance for clinicians to address these challenges through individualized and holistic care.