Why Is My Skin Crawling?! An Integrative Approach to Itchy Skin in Perimenopause

Skin

Have you ever felt like your skin is crawling, prickling, or just unbearably itchy — for no apparent reason?

If you’re in your 40s or 50s, and this symptom seems to come and go with no clear cause, you’re not imagining things. Itchy skin is a real and under-discussed symptom of perimenopause, and it deserves more than just a tube of steroid cream.

In this blog, we’ll explore the why behind the itch, and what you can do — both conventionally and holistically — to calm your skin, balance your hormones, and keep your cool. 

What’s Causing the Itch?

As oestrogen begins to fluctuate during perimenopause, it affects not just your mood or periods — but also your skin barrier, hydration, and histamine levels.

  • Oestrogen supports skin hydration and collagen. When it drops, your skin becomes drier, thinner, and more reactive.
  • Oestrogen also stimulates histamine. So when oestrogen spikes or drops without enough progesterone to calm the system, histamine can build up in the body. Cue: flushing, itching, rashes, hives, or even rosacea flares.

So What Can You Do When Your Skin Feels Like It’s Crawling?

1. Soothe It Topically

Choose fragrance-free, barrier-repairing products that cool, hydrate, and protect your skin.

My go-to calming favourites:

  • QV Balm or Cetraben Cream – occlusive, soothing emollients
  • La Roche-Posay Lipikar AP+M Balm – microbiome-supportive for itchy skin
  • Clinisoothe+ or Tower 28 SOS Spray – hypochlorous acid spray to reduce inflammation & itch
  • Aloe vera gel or cold chamomile compress for natural soothing

If the itch is severe or spreading, a short course of 1% hydrocortisone cream can help— but avoid prolonged use on the face.

2. Strengthen Your Skin to Reduce Future Flares

Skin in perimenopause needs support from the inside out:

Lifestyle & Nutrition Support:

  • Omega-3s (e.g. Bare Biology, Wiley’s Finest): Help reduce inflammation and maintain skin barrier
  • Collagen peptides + bone broth: Support skin structure and hydration
  • Hydration: More than ever— internally and externally
  • Sleep + Stress Support: Cortisol spikes make your skin more reactive. Consider magnesium glycinate, adaptogens like ashwagandha, or restorative practices like yin yoga, breathwork or meditation. 

Functional Testing to Get to the Root

When itchy skin becomes chronic or unpredictable, testing can help uncover hidden triggers:

  • DUTCH Complete or DUTCH Plus – to assess oestrogen, progesterone, and cortisol balance
  • GI-MAP Stool Test – to look at histamine-overproducing bacteria or leaky gut
  • Food Sensitivity Testing – to reduce inflammatory load
  • Histamine + DAO levels (plasma) – for those with rashes, flushing, or swelling
  • Micronutrient Panel – assess zinc, B6, and vitamin C status (key for histamine clearance)

3. Reduce Histamine & Balance Hormones to Prevent Flare-Ups

If you’re histamine-sensitive, here’s how to dial it down:

Nutrition & Supplements:

  • Low-histamine trial – temporarily avoid fermented, aged, or leftover foods
  • Quercetin + Bromelain (e.g. Designs for Health): Natural antihistamine and mast cell stabilizer
  • Vitamin C & B6: Supports histamine breakdown
  • Zinc + Omega-3: Calms inflammation and supports hormone metabolism
  • DAO Enzyme (e.g. Seeking Health): Take before meals if histamine symptoms persist

To Support Hormone Balance:

  • DIM (with supervision): Helps with estrogen detox
  • Myo-inositol or Vitex (chasteberry): May support progesterone naturally
  • Bodyidentical hormone therapy (if appropriate): Discuss with your integrative practitioner or GP

When to Seek Prescription Support

If itch is severe or associated with rash, hives, or swelling:

  • Oral antihistamines (e.g. Piriton, Loratadine)
  • Short-Course oral steroids (like prednisolone) – best used with caution and support

Final Thoughts

Your skin is a messenger — not a nuisance. If it’s itchy, it’s talking to you.

Perimenopause is a window of rewiring and rebalancing, not just of hormones, but of how your body handles inflammation, histamine, and stress.

The good news? With the right tools, testing, and support, your skin can be resilient again.

Want to Go Deeper?